Twenty years ago, public interest lawyers filed a landmark class-action lawsuit against California and Los Angeles County, claiming a lack of mental health care led to foster children being warehoused in group homes and psychiatric hospitals.
In 2014, the state’s shortcomings were resolved to the court’s satisfaction.
But in Los Angeles County — the nation’s largest local child welfare system — the case is still pending, with some parties questioning whether children’s needs are being properly met. A tentative agreement is in place to close out the case, which is set to be formalized by a federal judge next month.
But a panel of child welfare experts involved with the suit is now reporting that if the case is formally settled and court oversight is terminated, it would put “the well-being of children in the County’s care at risk.”
The experts want the settlement nullified, and a new agreement reached to ensure that the mental health needs of Los Angeles County’s foster children will be met. The greatest concern is whether the county will adequately provide intensive home-based services to stabilize foster children who would otherwise have to change placements because of their mental health issues.
The public interest lawyers who sued L.A. County did not respond to a request for comment about the panel’s objections.
A spokesperson representing the Los Angeles County Department of Children and Family Services and the Department of Mental Health, defendants in the case, said the agencies welcomed the changes that were prompted by the long-running Katie A. v. Bontá class-action lawsuit. But they have maintained that the county agencies no longer need supervision, after spending more than $2 billion to improve mental health care for foster youth.
“Even after judicial supervision has ended, and this case is resolved, we remain committed to the improvements,” the spokesperson stated in an email. The services “will continue to benefit children and families for years to come.”
‘No relief to the class’
In the California child welfare field, the case widely known as “Katie A.” has become synonymous with the fight to provide better mental health care for foster children, who have typically suffered repeated traumas.
The original Katie A. lawsuit was filed in 2002 on behalf of five L.A. County foster children, including the 14-year-old girl identified only as Katie A. She had entered foster care at age 4 when her mother was living on the streets and her father was incarcerated. Katie A. spent a decade in foster care, and by the time she became a teenager the county had moved her 37 times — including 19 stints at psychiatric hospitals and numerous stays at the notorious MacLaren Children’s Center. Throughout it all, she received no therapeutic services while living in foster homes.
Lawyers from numerous advocacy organizations — including the Western Center on Law & Poverty, Disability Rights California, the Bazelon Center for Mental Health and the National Center for Youth Law — sued California and L.A. County officials for not providing mental health services to children in the foster care system and those at risk of removal from their families. In their 30-page complaint, the groups said that the lack of appropriate services had made it more likely that foster youth would end up “warehoused” in institutions and group homes instead of in family homes and their communities.
The ruling in the case placed the county’s child welfare and mental health systems under court oversight for 17 years. There have been notable improvements during that time. The lawsuit resulted in the expansion of mental health assessments and access to individualized, at-home therapy for foster youth — preventing significant numbers of children in government custody from ending up institutionalized.
In 2011 — after years of litigation and negotiation — state leaders reached a settlement on the statewide issues in the case, exiting federal oversight three years later. California agreed to cover several “wraparound” services through the Medi-Cal program, although Katie A. compliance was largely uneven in counties up and down the state, mental health advocates said.
The most recent twists in the decades-long case were announced in September 2020, when Los Angeles County officials reached an agreement with the youth advocates to end the Katie A. v. Bontá case.
By all accounts, L.A. County’s progress during the Katie A. consent decree has been noteworthy. The lawsuit forced the county’s child welfare and mental health systems to better collaborate, and it represents a model for other child welfare agencies, according to a 2015 study in the Children and Youth Services Review.
A Department of Children and Family Services spokesperson stated that local officials have implemented “myriad enhancements” and have trained thousands of staff members “in order to improve the quality of mental health services for children and families.” There has also been success placing more foster children in long-term, stable care.
“Currently, the county outperforms the national benchmark, the state average and each of the five largest counties in California in placement stability,” the statement read. “With placement stability being a focal point of the lawsuit and the settlement, this is an especially important metric that shows the county’s enhancements to care are working.”
But the court-appointed advisory panel remains concerned about the future, according to an Oct. 17 court filing. Members have asked a U.S. District Court judge to reject the terms of the most recent settlement at a Dec. 5 hearing, citing an “unacceptable” number of foster children who continue to have placement disruptions as a result of removal requests by foster parents or for their behavioral issues.
Child welfare experts Marty Beyer, Paul Vincent and Edward Walker state they fear foster youth could face more frequent moves and avoidable stays in psychiatric hospitals and group care placements if the court oversight ends, as it would under the terms of the tentative settlement set to be finalized next month.
“The Settlement Agreement, if approved, offers no relief to the class,” a lawyer for the panel members stated, “and, therefore, does absolutely nothing to meet the mental health needs of class members.”