The County joined San Francisco in challenging California’s practice of terminating children’s Medi-Cal eligibility when they enter the juvenile justice system, denying inpatient psychiatric and hospital care for children during detention, and failing to reinstate Medi-Cal eligibility in a timely manner upon release. Youth in detention have disproportionately high mental health needs, and the State’s policy exacerbated the challenges of providing adequate care and reducing recidivism. The lawsuit prompted the proposal and passage of SB 1147, signed by Gov. Schwarzenegger in 2008, which required the State to suspend – rather than terminate – children’s enrollment in Medi-Cal while they are in custody. In 2010, we secured a writ of mandate from the San Francisco Superior Court ordering Medi-Cal to pay for inpatient psychiatric treatment coverage for youth in custody up to age 21.