Calif. Bills Targeting Foster Kids’ Medication Could Be National Model

A package of bills aimed at reducing  the amount of psychiatric medication prescribed to children in California's foster care system could become a model for national legislation, KQED's "State of Health" reports (Korry, "State of Health," KQED, 9/2).

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, 8/20).

Details of Bill Package

Four bills being considered by the state Legislature seek to change the way psychotropic drugs are administered to foster youth:

• SB 238, by state Sens. Holly Mitchell (D-Los Angeles) and Jim Beall (D-San Jose), 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 interactions;
• SB 253, by state Sen. Bill Monning (D-Carmel), would change 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, 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, would establish treatment protocols and state oversight of psychotropic drugs in group-home settings (Gorn, California Healthline, 8/27).

The state Senate approved the bills, and they now are being considered by the Assembly.

Bills Could Shape National Efforts

According to "State of Health," some observers say the reforms could be used as a template for national legislation.

Anna Johnson, a social analyst at the National Center for Youth Law in Oakland, said, "The [California] legislation describes in detail the oversight function -- what everyone's role is, from the juvenile court judge and the social workers, to the care providers, the lawyers, the doctors." She noted that the legislative package also "names specifically the prescribing practices we want to see reduced: the use of multiple drugs on children, dosages that exceed maximums and the use of antipsychotics where not medically necessary because of physical health risk factors."

Johnson praised the California efforts for not being a "drugs-only approach."

Ken Berrick -- president and CEO of the Seneca Family of Agencies, which offers mental health services and other care for California children -- said, "It is well beyond time for us to be having this discussion and intervening."

Berrick added, "If we really want to solve this problem, we have to make the alternative interventions available at the same level at which medication is available. It's really a question of access. When that happens, people will make the right decision" ("State of Health," KQED, 9/2).