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The Miami Herald

State child welfare workers have been forbidden to approve psychiatric drugs for foster children without the consent of parents or a judge, in response to criticism that the drugs are being used as a chemical restraint on unruly children.

The department also has begun an internal investigation into the use of psychiatric drugs, with Broward County foster care administrators taking the lead.

After a meeting between Department of Children & Families Secretary Kathleen Kearney and mental health treatment providers late last week, a lawyer for the department sent an e-mail to treatment providers across the state.

``The clear, unambiguous and adamant statement from the secretary is that, regardless of any arguable authority we might have to consent to psychotropic medications for children . . . the department or its agents are not under any circumstances to give that consent,'' Assistant General Counsel Peggy Sanford wrote in an April 27 e-mail.

Department employees routinely had provided consent for the drugs.

Last week, all private foster care providers in Broward were told to provide information on medication to the department for every child in the department's care.

Last month, The Herald reported advocates' concerns that foster children were being medicated with psychotropic drugs in an effort to control difficult behavior. Some of the drugs have been linked to serious side effects. Advocates say at least one drug, Risperdal, has caused both girls and boys to develop large breasts and begin lactating.

While they applaud the department for addressing the issue, some advocates say DCF's actions fall short of what is necessary.

Last week, the federally funded Advocacy Center for Persons with Disabilities urged the department to place an ``immediate'' moratorium on prescriptions for Risperdal.

Instead, the department appointed two DCF doctors to review foster care files and determine whether such drugs are being used appropriately.

Within a day, Pat Wear, the Advocacy Center's deputy director, sent a response.

``We appreciate the assignment of two staff doctors who will look into the use of antipsychotic drugs on foster children,'' Wear wrote April 25. ``However, the intent of our request was that such a review be independent of the prescribing physicians and also of the Department.

``We believe that an external review is in the best interest of both the children and the Department,'' Wear wrote.

Carolyn Salisbury, associate director of the University of Miami Law School's Children and Youth Law Clinic, agreed that an internal review was not enough.

``They need to have an immediate independent evaluation of every child in foster care being administered these psychotropic drugs, particularly those children in locked treatment centers, as they are the ones most drugged,'' she said.

LaNedra Carroll, a Children & Families spokeswoman, said the evaluation, being conducted by the department's chief medical officer, Eric Handler, and a psychiatrist with the agency's mental health program office, Bob Miles, will be completed fairly. ``It's a number one priority for Dr. Handler and Dr. Miles,'' she said.

``They are not doing this in a vacuum,'' Carroll said. ``They've contacted other professionals, other experts.''

Carroll said the probe is only preliminary. ``If we come to the understanding that there is a problem, we will be calling the experts back,'' she said.

Salisbury said she was not impressed by the department's decision to stop consenting to the use of psychotropic drugs.

``DCF clearly knows they have no authority to consent to the use of psychotropic medication,'' said Salisbury, whose lawsuit on behalf of a foster child committed and treated with drugs against his will was heard last year by the Florida Supreme Court. Parts of the case are still pending.

``For them to say now they are going to stop this practice, even though they [still say they] have arguable authority, is just ludicrous to me. They have no arguable authority,'' Salisbury said.

Carroll, the DCF spokeswoman, said state law does not in fact preclude the department from consenting from use of he drugs, particularly for children of those whose parental rights have been terminated.

Officials at Children & Families are viewing the uproar over the medication of foster kids as a possible public relations nightmare. In her April 27 e-mail, Sanford of the General Counsel's Office wrote: ``This is a potential 60 Minutes and Dateline story.''

Solving the problem to the satisfaction of advocates could prove prickly to the department's relationship with some providers. Some mental health agencies expressed confusion over DCF's decision to quit providing consent.

``The concern we have heard informally is that the decision to require either parental consent or a judicial order could throw treatment agencies into a legal quandary,'' said Pat Curtis, a spokeswoman for the Florida Council for Community Mental Health, which represents the interests of not-for-profit mental health agencies.

In particular, some providers are concerned that the ban could affect the medication of foster kids who have been receiving drugs for months, if not years. To discontinue the drugs' use, Curtis said, could endanger children's mental and emotional stability.

Copyright (c) 2001 The Miami Herald

Record Number: 0105020105

2001 May 1