Calif. Senate Approves Bills Targeting Rx Use in Foster Care System

On Wednesday, the California Senate passed a legislative package aimed at reducing the amount of psychiatric medication prescribed to children in the state's foster care system, the Contra Costa Times reports (de Sá, Contra Costa Times, 6/3).

Background

Last year, a San Jose Mercury News investigation found that children in the California foster care system are prescribed psychiatric drugs at a rate three times higher than the national average.

Specifically, the investigation found that nearly 25% of California children 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, 4/13).

Details of Legislative Package

The legislative package, introduced in response to the investigation, includes four bills:

• SB 238, by state Sens. Holly Mitchell (D-Los Angeles) and Jim Beall (D-San Jose), which would require the state to provide more data on the number of children in foster care who are prescribed psychotropic drugs, along with other medications that might cause harmful drug interactions;
• SB 253, by state Sen. Bill Monning (D-Carmel), which would change the juvenile courts' process for authorizing psychotropic drugs by prohibiting such drugs from being authorized without prior medical examination and ongoing monitoring of the child;
• SB 319, by Beall, which would establish a system for public health nurses to monitor and oversee anyone in foster care who is prescribed psychotropic medications; and
• SB 484, by Beall, which would establish treatment protocols and state oversight of psychotropic drugs in group-home settings (California Healthline, 5/18).

Next Steps

Following the package's unanimous approval, Beall said, "The Senate has sent a clear message: The system must never permit powerful psychotropic drugs to replace other effective and necessary treatments."

The bills now head to the Assembly.

According to the Times, if approved, the legislative package would become the country's broadest set of reforms to stem psychiatric drug use in the foster care system.

However, while the bills have faced no formal opposition, they have received some criticism, such as from psychiatrists who have said they could hinder access to medication in necessary situations.

In addition, the legislative package's price tag could threaten its passage if it makes it to Gov. Jerry Brown (D), the Times reports (Contra Costa Times, 6/3).

Various cost estimates project that the package of bills could cost the state between $8 million and more than $22 million per year (California Healthline, 5/18).

Implications

Some advocates say the legislation could influence similar efforts across the country.

Shadi Houshyar, vice president of First Focus, said, "We can all look to California because I really don't know of any other state that has taken such a comprehensive approach," adding, "This is a really promising process, and we'd like to see other states tackling it in this way (Contra Costa Times, 6/3).