By Gloria Diaz
About 20,000 Arizona children who need medical attention for mental-health problems may benefit from the recent settlement of a lawsuit filed in 1991 by a mother who was unable to obtain medical services for her son, Jason Koch, under Arizona's managed-care system.
The J.K. v. Eden lawsuit, which aims at a complete reform of the managed health-care system, was settled two months ago. Now, controversy is arising over whether the 11 main provisions detailed in the settlement will actually help mental health clinics.
After being refused mental-health care under Arizona's system, Jason Koch ran away from home and attempted suicide, eventually ending up in a mental hospital.
La Frontera Center Inc., the largest nonprofit community-owned behavioral health center in Arizona, has more than 400 employees who serviced close to 8,000 clients in the last year. Of these, 3,100 were children who could have been affected by the settlement.
La Frontera Center Inc., 502 W. 29th St., is a treatment and management facility for mental health, substance abuse and psychiatric rehabilitative services.
La Frontera's executive director, Daniel Ranieri, said a settlement like that of J.K. v. Eden would not really help La Frontera because the real problem is a serious lack of funding that keeps turnover rates for highly trained and competent individuals high. Ranieri said that as a result, the clients were not being served well.
Cindy Chatfield, a team leader for La Frontera's Child and Family Center, said she wishes there was more money available to improve ratios of children to counselors.
"I would like to see improvements in providing staff to work with the children," Chatfield said. "Funding is a very important piece of that puzzle."
Chatfield is doubtful that the center will improve or change as a result of the settlement.
Many people believe the settlement will bring about important changes in treating children with mental health problems. Anne Ronan, staff attorney for the Arizona Center for Disability Law, is one of those people.
"We (the state of Arizona) never had a vision or idea of what we wanted to do to help the mentally ill," Ronan said. "Now we do."
Ronan said she thinks the managed-care overhaul will not cost the state any more money, because the system itself is already in place - only the focus is changing.
But not everyone will benefit from the settlement.
Ronan said she thinks it is unfortunate that children who are not Medicaid-eligible will not benefit from the new principles of counseling.
"The law only provides for Medicaid patients, and a lot of private insurance doesn't cover mental health care for children, or if they do, it's often not enough," Ronan said.
According to Lee Carty of the Bazelon Center for Mental Health Law, the greatest predictor for Medicaid eligibility is low-income status. Carty said the settlement is not meant to drastically overhaul the mental health system for every mentally ill person, but rather to improve the situation for those who are underprivileged.
"Medicaid children were not getting adequate mental health treatment," Carty said. "The idea (of the settlement) is to get services for these children."
Unlike Ranieri, Ronan thinks public will see "a noticeable change within two years."
It is estimated that two-thirds of all young people in this country with mental health problems are not getting the help they need. Serious emotional disturbances affect 9 to 13 percent of children between 9 and 17 years old, according to Substance Abuse Mental Health Services Administration (SAMHSA.)
The reform of the managed-care system under the settlement will be founded on 11 key principles. The first goal is a collaboration between the child, their counselors and their family.
The second principle aims to deter delinquency and promote
success in school.
Another important principle will bring together all the agencies
helping children.
"The good thing about Jason K. is that all the different agencies will work together," Ranieri said.