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Márquez and Herrera win case to restore Medi-Cal benefits to at-risk youths

Lawsuit by Santa Clara County and San Francisco forces State to cover inpatient psychiatric care for youths in custody, end cost-shifting to local governments

SAN FRANCISCO (May 6, 2010)—A San Francisco Superior Court has ordered the State of California and its Department of Health Care Services to provide Medi-Cal coverage for youths in need of inpatient psychiatric treatment while they are in the custody of a public institution and immediately following their release. The judgment entered late Tuesday comes in response to a lawsuit filed in Oct. 2007 by the City and County of San Francisco and the County of Santa Clara, which alleged that California’s Medi-Cal system was violating federal and state laws by cutting off coverage for all youths who entered juvenile detention facilities, and by refusing to cover certain essential hospital services for which federal funding was available. As a result, at-risk youths with serious medical and psychiatric needs often received no health coverage after their release, forcing counties like San Francisco and Santa Clara to bear the full burden of paying for their care.

“I’m gratified by the Court’s ruling to make the state live up to its obligations to provide adequate coverage for juveniles in custody, and to stop pushing this burden onto local governments,” said San Francisco City Attorney Dennis Herrera. “Youths in custody often suffer from mental illness and severe substance abuse issues. At a time in which our national leaders have begun to address spiraling medical costs and inadequate coverage by enacting comprehensive health care reform, it’s critical for the state to own up to its responsibilities, and provide at-risk youths with the coverage to which they’re entitled under the law.”

“Both the legislative victory and this court decision help ensure that at-risk youths get the consistent psychiatric care they need—before, during and after being taken into custody,” said Miguel Márquez, Acting County Counsel for the County of Santa Clara. “Consistent care is critical if we’re serious about reintegrating detained youths into the community as productive, healthy members of society and preventing entry into the juvenile detention system from becoming a revolving door.”

The lawsuit by San Francisco and Santa Clara also prompted the proposal and passage of SB 1147, which Gov. Arnold Schwarzenegger signed into law in 2008. That legislation requires the State to suspend—rather than terminate—youths’ enrollment in Medi-Cal while they are in custody. The court ruling provides additional protection to youths who need intensive psychiatric treatment. Such at-risk youths are dramatically overrepresented in juvenile detention facilities.

Funded by both the federal and state government, and administered by Department of Health Care Services, Medi-Cal is California’s Medicaid program which provides healthcare coverage to low-income minors and their families.

The case is City and County of San Francisco, County of Santa Clara v. State of California, California Department of Health Care Services, Sandra Shewry et al., San Francisco Superior Court Case No. 468-241, filed Oct. 16, 2007. For more information and related documents, visit the San Francisco City Attorney’s Web site at http://www.sfcityattorney.org/


Media Contact: Gwendolyn Mitchell/Laurel Anderson, Office of Public Affairs, (408) 299-5119; City of San Francisco: Matt Dorsey (415) 554-4662
Posted: May 6, 2010