DHCS Rule Aims To Curb Antipsychotic Drugs for Children in Medi-Cal

A new California Department of Health Care Services rule will require physicians to obtain additional authorization when seeking to prescribe antipsychotic medication to children enrolled in Medi-Cal, the San Jose Mercury News reports. Medi-Cal is California's Medicaid program (de Sá, San Jose Mercury News, 9/19).

Background

The new rule comes after a Mercury News investigation found children in the California foster care system are prescribed psychiatric drugs at a rate that is three times higher than children nationwide.

Specifically, the investigation found that nearly 25% of California children currently in foster care have been prescribed psychiatric drugs, including:

• Antipsychotics;
• Antidepressants;
• Mood stabilizers; and
• Stimulants.

In 1999, state lawmakers passed legislation requiring juvenile courts to approve psychiatric drug prescriptions for foster youth and review the decisions every 180 days.

However, the investigation found that the law has "done nothing" to lower such prescribing rates (California Healthline, 8/26).

Details of Rule

Under the rule, California pharmacists beginning on Oct. 1 will need to show the "medical necessity" for antipsychotic drugs prescribed to children ages 17 and younger who are covered by Medi-Cal.

The rule expands upon a 2006 requirement that such verification be completed for children ages five and younger.

Physicians who advocated for a reduction in the overmedication of foster children said the rule is a good start, but noted that its potential effects are unclear.

Further Investigations Launched

Following the Mercury News investigation, the Medical Board of California launched further reviews of physicians.

In addition, Los Angeles and Santa Clara counties -- where the majority of the state's foster children are located -- have launched probes into prescribing practices and oversight (San Jose Mercury News, 9/19).