Florida has no list of foster kids on psychiatric drugs

Florida has no list of foster kids on psychiatric drugs

An official of Florida's family safety program has revealed that the state still doesn't know how many foster kids are on psychiatric medications.

September 23, 2006

Carol Marbin Miller

Miami Herald

No list of kids on mood drugs More than a year after legislators passed a law to curb the wholesale use of mood-altering drugs among Florida foster children, state child welfare officials acknowledge they do not even have an accurate list of the children in state care who are being given such medications.

The head of Florida's family safety program, in a letter to administrators statewide, acknowledged this week that caseworkers have been failing to keep track of foster kids who are taking anti-depressants, anti-psychotics and other drugs designed to combat mental illness. Advocates have claimed for years that such drugs -- most of which have never been tested on children -- routinely are used as "chemical restraints" to control the behavior of unruly children.

"It is critical that the [computer] database be accurate and up to date to assure that we are able to monitor all children taking these medications," wrote Patricia Badland, who heads up the Department of Children & Families' family safety program.

In her letter, Badland expressed particular concern for the lack of information on children younger than 6, many of whom have been given psychiatric drugs -- sometimes cocktails of drugs -- in the past.

"This is an important feature of our system to safeguard the youngest children we serve," she wrote. State Sen. Walter G.

"Skip" Campbell, a Tamarac Democrat who introduced the legislation for four years before it passed, said he was "very disappointed" that DCF apparently has not done better at protecting children who are prescribed psychiatric drugs.

"This is a failure," Campbell said. "They assured me that this problem would be solved, and it certainly has not come to fruition.

They have got to do a better job of following the law we passed, and if they don't, they should be taken to task."

'RECORDS DO EXIST'

Al Zimmerman, a DCF spokesman, said the failure of workers to include information on psychiatric drugs in the computer system doesn't mean the information isn't being kept.

"The records do exist for every child," Zimmerman said.

"It's not that the records are not there."

There are about 50,000 children in state care.

Over the past year, DCF hired 25 psychiatrists and children's mental health experts to develop guidelines for prescribing psychiatric drugs for children in the agency's care, said Frank Platt, who heads behavioral healthcare for the family safety office.

"They can identify practices that may be questionable," he said.

"If they see any practices that seem out of the ordinary, they will let us know."

Since the 2005 law, Platt said, DCF is "doing better" at overseeing children who need psychiatric drugs and will be adding additional safeguards in the future. In her memo, Badland noted that DCF's child welfare computer database, called HomeSafenet, contained the names of only 2,082 children -- or about 4 percent of the children in state care -- who are being given psychiatric drugs.

But the state's Medicaid program for the needy reported close to 12 percent of children in care were on mood-altering drugs, she added.

"It is clear," Badland wrote, "that several areas of the state are not reporting, or are under-reporting" the names of children on the drugs.

Last year, in testimony before the state Senate Children & Families' Committee, which Campbell chaired, DCF officials reported that one in four foster children were taking at least one mood-altering drug.

Among the drugs: Ritalin and Adderall for attention deficit hyperactivity disorder; antipsychotics such as Risperdal, Clozaril and Geodon; lithium for bipolar disorder; and Prozac, Zoloft and Paxil for depression.

DCF's inability to safeguard or keep track of foster kids using psychiatric drugs has been a nagging problem for several years.

A 2005 report by the state Senate said that "despite initiatives by the department to identify children in its care who are on psychotropic medications and to determine the appropriateness of this treatment, limited information exits."

Children who are technically in DCF care but are not in foster homes, like those living either with their parents or relatives but under supervision of caseworkers, were far less likely to be medicated.

Only 7.4 percent of kids with their birth parents and 6.2 percent of kids with grandparents or other relatives were on psychotropic drugs, records showed.

From budget year 2001 through 2005, state spending on psychiatric drugs for kids in care nearly tripled, from $237 million to $680 million, the lawmakers were told. Controversy has raged over the use of psychiatric drugs among children in state care since 2001, when Coral Springs attorney Andrea Moore wrote a local DCF official to complain that the powerful psychiatric drugs were being abused as "chemical restraints" on troubled foster kids.

TROUBLING EFFECTS

Moore warned that several foster kids she represented in court had displayed troubling side effects from the prolonged use of a particular anti-psychotic drug -- including sluggishness, drooling, an inability to concentrate, and the development of lactating breasts, even in boys.

For four years, Campbell and others in the Legislature fought to pass a bill to reduce the use of psychiatric drugs among dependent children and to better protect the children who do use the medications.

Lawmakers gave final approval to a bill in 2005 that, among other things, restricted the state's ability to medicate foster children without the consent of their parents or a juvenile judge.

The law also required foster care caseworkers to provide to psychiatrists "all known pertinent medical information" before drugs are prescribed.