Mar 2, 2010
Bill Tightens Rules For Foster Kids' Prescriptions
KELLI KENNEDY, Associated Press Writer
FORT LAUDERDALE, Fla. (AP) ― Powerful mental health drugs dispensed to Florida foster care children would be more closely monitored under a bill introduced in the Florida legislature that comes after the death of a 7-year-old boy who was taking several psychiatric medications.
Sen. Ronda Storms, who filed the bill (SB 2718), said the drugs have replaced talk therapy and are over-prescribed to subdue unruly children. The measure requires an independent review before psychiatric drugs can be administered to children 10 or younger.
The bill, filed late last week, also expands the role of court-appointed guardians in overseeing children on mental health drugs and requires caseworkers to explain the possible side effects of such drugs to children in an age appropriate manner.
Mez Pierre, who entered the foster system at age 5, said he was given various medications, including one that caused diabetes, and said it's crucial that children be involved in their own treatment.
"Its fair to know what it is you're putting in your body," said Pierre, 22.
The proposal is largely based on the findings of a task force formed after Gabriel Myers, who was on several psychotropic drugs, locked himself in a bathroom and hanged himself with a shower cord last April.
Gabriel was on Seroquel and other psychiatric drugs linked by federal regulators to potentially dangerous side effects, including suicide, but the risks may not have been adequately communicated to his foster parents. They are not approved for use with young children. But doctors often prescribe them 'off-label,' for purposes for which the drugs have not been approved.
"All you do is mask the behavioral problems by treating him psychotropically. All you're doing is putting him in a chemical straight jacket so that he can't act out so you can get him to 18 and dump him into adulthood and that's not acceptable," said Storms, R-Valrico.
A similar bill was filed in the House on Tuesday.
Gabriel's death prompted a statewide investigation that found 13 percent, or 2,699, of all foster children are on such drugs, according to a Department of Children and Families study. That compares with only an estimated 4 percent to 5 percent of children in the general population.
"I think it's an extremely important step forward," DCF Secretary George Sheldon said Tuesday. "The key is going to be the ability of the department to implement and hold people's feet to the fire. You can have the best statutes but if we don't do our job it's not going to make a difference."
Child advocates say prescribing doctors often lack pertinent information on the child, including medical history and behavioral background. The bill requires caregivers and doctors to report any adverse side effects, which DCF must document.
"There was no record when a child had a bad reaction of any kind to the medication. There was no way to keep that information," said child advocate and Broward County attorney Andrea Moore.
The bill also requires children to have a mental health treatment plan that includes counseling for children prescribed such drugs. Sheldon said he's heard from too many foster children who were kept on mental health drugs until they turned 18. Treatment plans must include a time frame for discontinuing medications, he said.
Basic analysis of all medications for children in state care — such as what medication they were taking, why and when it was prescribed, and whether it worked — was supposed to be collected beginning in 2005, but that never happened.
A DCF review shows caseworkers failed to complete treatment plans, didn't consult psychiatrists and failed to obtain consent for the drugs in many cases. The bill addresses each of those issues.
The bill says foster children often receive "fragmented medical and mental health care" and requires a court-appointed guardian to oversee mental health treatment plans for all foster children prescribed such medications. The Gabriel Myers' work group recommended a lawyer instead for each child.
"We very often are the ones in the courtroom standing up expressing concern or disagreement when it comes to pyschotropic medications," said Marcia Hilty, spokeswoman for the Florida statewide guardian ad litem office.
The increased role of the court-appointed guardian could require more funding for additional training as medications are constantly changing, she said.
Pierre said his court-appointed guardian was a wonderful mentor, but Pierre thinks it's "ludicrous" for them to play such a large role in medical treatment plans. He said an attorney is better equipped to navigate those matters.
"Why would we ask people who are just volunteers to go through the court system and be a liason on the way medications are distributed to children?"