Children Lost in the System

March 12, 2010

An investigation by the California Department of Education has found several Monterey County agencies are violating state and federal laws in their handling of students with mental health problems.

The investigation was prompted by a complaint filed by Ilene Allinger Candreva on behalf of her son, Liviu, and another Monterey Peninsula boy whose family asked to remain anonymous.

In a 125-page report, the Department of Education detailed the cases of 24 students with a wide range of mental health needs and found consistent violations that range from not having a written agreement between agencies for the delivery of mental health services to failure to adhere to timelines and to provide written assessment reports.

The agencies named in the report are the Monterey County Office of Education and its Special Education Local Plan Area, along with Monterey County Behavioral Health, the Monterey Peninsula Unified School District, the Salinas City Elementary School District and the Carmel Unified School District.

The extent of the problem is something that Maggie Roberts, an attorney with Disability Rights California, said she had not seen in her dealings with other counties.

"It’s particularly egregious," she said. "We’ve seen other problems about the referral system in other counties, but never such widespread problems. They did result in kids not gett ing critically needed services in a timely fashion, not having the right people involved in making decisions. Some who had serious mental needs never got services at all."

Among the problems spelled out in the report:

· The districts don’t have documents that spell out each other’s responsibility;

· Special-needs children are not receiving an adequate educational program by a designated team;

· The districts and Behavioral Health did not include all the required mental health services provided in the student’s individual plan.

What this translates into is long delays to receive services for kids with very serious needs, some who may even be suicidal, said Roberts.

"Some of them had life threatening (problems). One kid ended up in a homeless shelter, their needs ignored by the school and mental health (providers)," Roberts said.

Wayne Clark, chief of the Behavioral Health Division of the Monterey County Health Department, said the errors resulted from a new agreement between his agency and the Special Education Local Plan Area for Monterey County Office of Education, which oversees plans for students with special education needs.

"We created a new (memorandum of understanding) three years ago to improve the process and streamline the referral," he said. "Instead of enhancing and streamlining, what we did essentially is that we created problems where children were not being referred in the appropriate way."

While several districts were named in the investigation, Carol Lankford, director of the county Special Educa tion Local Plan Area, said the blame can’t be pinned on one agency or another but rather on a flawed process.

"Over the years, the process that has been used for identifying and serving students who may require those services has been based on misinterpretation," Lankford said. "It’s not possible to blame a particular district or Behavioral Health. It’s been a misinterpretation of all parties involved, and we are all working together to make sure everyone has the correct information."

The cases include children who suffered from neglect, severe depression, aggression, even suicidal tendencies.

The investigation was launched by a complaint filed Sept. 22 on behalf of two children on the Monterey Peninsula. After an initial inquiry suggested a systemic lack of coordination between districts and Behavioral Health, the state reviewed additional student records.

The two children were denied services by Behavioral Health because they suffer from autism, the Department of Education inquiry showed. Children with autism or other developmental disabilities which are treatable but not curable are referred to the San Andreas Regional Center so they can learn the skills they will need to live independently.

But the two lead complainants argued that their children had other problems and could have benefitted from other services.

Instead of routinely referring children with autism to the occupational center, the agencies involved should evaluate what the children’s needs are and have at least some services offered to them, Roberts said.

"The state law is clear about what kids need to get if they have mental health issues or behavioral prob lems," Roberts said. "They’re eligible for services, but (Behavioral Health) put those exclusions in there."

Clark, from Behavioral Health, said the department’s main difficulty lies with diagnosing young people who suffer from behavioral and brain disorders.

"It’s a gray area and it becomes problematic," he said. "We’ve met with school districts and have put in place procedures to reflect the letter of the law more."

At Behavioral Health, specialists treat children who act out or have acquired behaviors that can be un-learned, said Services Manager Bob Brunson. Neurological disorders (autism, mental retardation) irreversibly influence the way the brain works.

Another source of confusion arose because Behavioral Health was treating children who normally would be seen at their own school or their district counselors. Having clients with different timelines and funding sources made the process confusing, Brunson said.

"A lot of times kids will get related services but still need (mental health services), and the handoff was confusing," he said.

A spokeswoman for the Department of Education would not discuss the report’s findings, saying the report is incomplete until the parties involved have had a chance to respond.

"There were issues of noncompliance for a number of schools," said spokeswoman Tina Jung. "There were some findings and we sent them back to school districts to address."

The Department of Behavioral Health and the schools have different timelines to implement changes. Among the corrective action s required by the state are:

· An updated agreement between Behavioral Health and Monterey County Board of Education to meet state and federal requirements;

· Documentation to demonstrate all mental health services provided during the 2008-09 fiscal year, as well as identification of payments and funding sources

· Training for service providers that details coordination between school districts and Behavioral Health and spells out other federal and state requirements.

The districts also must change assessment procedures and notify schools about the changes. All districts within Monterey County will have to review the files of all their students with mental health needs by June 30 to make sure they have the appropriate individualized plan and complete information, and that the districts are adhering to mandated guidelines.

"The only thing I want to emphasize is that the districts do take compliance seriously," Lankford said. "There was never intent by anyone to deny children services."

Candreva believes there are many more families who were denied services and that this report will help them get the help they need.

"What happened to our family is important, but the fact that it happened to 23 students, that’s really what’s important," she said. "There are other families that now will be able to access (the services they need). They need to know they can get them, and if mental health says ‘we don’t do that,’ they still have the right to get them."