Hearing Targets Foster Kids’ Medication

State lawmakers convened an oversight hearing on Tuesday in the Capitol to address the possible over-prescription of psychotropic medications, such as antipsychotics and antidepressants, to foster children in California.

Foster children in California are prescribed psychotropic drugs at a rate about three-and-a-half times higher than the national average, according to joint committee Co-Chair state Sen. Mike McGuire (D-Healdsburg).

“It has been 10 years since the Legislature first took up the issue of psychotropic medications in foster care,” McGuire said in Tuesday’s hearing. “And yet this problem is bigger than ever.”

McGuire said  FDA hasn’t actually approved use of psychotropic drugs for children, so the high rate of psychotropic prescription for foster youth is particularly troubling, he said.

“And once on a medication, kids are not able to taper off,” McGuire said, “contrary to best medical practices.”

Joint oversight committee Co-Chair state Sen. Ed Hernandez (D-West Covina) said he had a lot more questions than answers.

“Why is this population being prescribed medication at such a high rate?” Hernandez wanted to know. “Do they have many more mental health problems? Is that the appropriate standard of care?”

A package of four bills addressing the issue is making its way through the Legislature this session. The Senate has passed all four bills, and they now all are in the Assembly Committee on Appropriations.

They are:

  • 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 interactions;
  • SB 253, by state Sen. Bill Monning (D-Carmel), which 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, 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.

The package of four bills is estimated to cost the state between $8 million and $22 million per year.

McGuire said he was heartened to see state guidelines issued in May 2015 for monitoring psychotropic medications. But that’s far from an answer by itself, he added.

“There’s a problem,” McGuire said, “and I hate to say this. But we don’t monitor. We do not monitor use of psychotropic medications. These guidelines will become dusty government reports that don’t change the actual practice. It’s great to have these guidelines, but we’re not moving the needle on over-prescription. And that’s not enough.”

McGuire said he needs to see change after all the time spent talking about change.

“We are here to be collaborative,” McGuire said, “but we can’t wait another 10 years.” 

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Capitol Desk Mental Health