San Jose Mercury News: California Senate passes sweeping reforms to curb psych medications in foster care
SACRAMENTO -- In a major step toward curtailing the excessive use of psychiatric drugs on foster children, the California Senate on Thursday approved a package of bills that is already being eyed as a model in Washington, D.C., and across the country.
The four proposed laws -- if approved by the state Assembly and signed by the governor -- would become the nation's most sweeping set of legislative reforms to curb the foster care system's reliance on psychotropic medications, the subject of this newspaper's yearlong investigation "Drugging Our Kids."
"I know that it will inspire other states, I have no doubt about it," U.S. Rep. Karen Bass, D-Los Angeles, said in response to the bill package. "We are going to continue to make sure that we can do the same on a federal level."
The newspaper's investigation found the powerful medications, which can cause debilitating side effects, are often prescribed to control troubled children's behavior. But the bills, approved unanimously in the Senate Thursday, would improve how the state's juvenile courts approve prescriptions; create new training programs; expand the ranks of public health nurses; and require ongoing reporting of how often foster children are being medicated.
Social workers would be alerted when kids receive multiple medications or high dosages and when psychiatric drugs are prescribed to very young children. And residential group homes, where prescribing is typically the highest, would be more closely monitored and subject to corrective action.
The proposed legislation authored by state Sens. Jim Beall, D-San Jose; Holly Mitchell, D-Los Angeles; and Bill Monning, D-Carmel, has so far received no formal opposition. But the bills carry a multi-million-dollar price tag that could threaten passage if they reach the governor's desk, and child psychiatrists have expressed concerns that access to necessary medications could be hindered by too many new rules.
The newspaper's investigation found almost one in four California teens in foster care have been given psychotropic drugs over the past decade, the vast majority receiving antipsychotics, which can cause dramatic weight gain, diabetes, and irreversible tremors.
But now, the state's reform efforts are being watched by children's advocates across the country.
"We can all look to California because I really don't know of any other state that has taken such a comprehensive approach," said Shadi Houshyar, vice president of the national children's advocacy group First Focus. The bipartisan organization has spent eight years pushing states and the federal government to reduce psych med use in foster care, and to increase funding for more effective and proven treatments for trauma. "This is a really promising process, and we'd like to see other states tackling it in this way."
Other states are addressing the problem through more limited legislation and policy changes. For example, a bill signed into law in April by Washington Gov. Jay Inslee requires a second medical opinion by a psychiatrist for all antipsychotics prescribed to foster children. In 2009, Oregon strengthened an existing statute, requiring regular data reports and a second medical opinion for kids prescribed more than one drug or any antipsychotic.
The Oregon law empowered caseworkers to question the appropriateness of medications, but did not go far enough in strengthening the rights of foster youth to refuse the drugs, said Steve McCrea, who supervises court-appointed child advocates in Multnomah County.
McCrea said California's legislation, by contrast, would allow medicated foster youth greater opportunity to have their experiences heard by judges, caregivers and attorneys.
Former foster youth are encouraged that the reforms will give some of California's most vulnerable kids a stronger voice in their own care.
"I know how it feels to have someone tell you something is wrong with you, to have someone sit down and tell you the only way you can be normal is to take these medications," said DeAngelo Cortijo, 22, a former foster child and an intern with the National Center for Youth Law. "These bills will bring us a wider and more holistic perspective, so we don't just say, 'Let's just control them by giving them meds.'"
Rep. Bass, who held public hearings on the issue a decade ago when she served in the state Assembly, said she was astounded to learn then that kids on psychotropics were often unable to stay awake, and that they could be punished in group homes for refusing to take their pills. With new laws, she said, kids suffering the effects of abuse, neglect and abandonment will receive more helpful therapies.
Bass and 15 of her Congressional colleagues recently signed a letter supporting President Barack Obama's $250 million budget proposal to fund state programs that reduce psych med use among foster youth by creating programs that more effectively treat trauma.
Bass said she will bring the reforms California is proposing to her 160-member Congressional Caucus on Foster Youth, to the Ways and Means Committee, and ultimately will consider possible federal legislation.
"My hope is that we treat youth in the foster care system the same way we would want our own children treated," Bass said. "If our own children were facing challenges, we would address those challenges, we wouldn't drug them. Why are we drugging children who don't have families?"