Thursday November 21st, 2019 2:43PM

Watchdog slams safeguards for foster kids on psych drugs

By The Associated Press
Related Articles
  Contact Editor

WASHINGTON (AP) — Thousands of foster children may be getting powerful psychiatric drugs prescribed to them without basic safeguards, says a federal watchdog agency that found a failure to care for youngsters whose lives have already been disrupted.

A report released Monday by the Health and Human Services inspector general's office found that about 1 in 3 foster kids from a sample of states were prescribed psychiatric drugs without treatment plans or follow-up, standard steps in sound medical care.

Kids getting mood-altering drugs they don't need is only part of the problem. Investigators also said children who need medication to help them function at school or get along in social settings may be going untreated.

The drugs include medications for attention deficit disorder, anxiety, PTSD, depression, bipolar disorder and schizophrenia. Foster kids are much more likely to get psychiatric drugs than children overall.

"We are worried about the gap in compliance because it has an immediate, real-world impact on children's lives," said Ann Maxwell, an assistant inspector general.

Among the situations investigators encountered was the case of a 6-year-old boy diagnosed with ADHD, learning and speech disorders, outbursts of temper and defiance, and hair-pulling disorder. He had been put on four psychiatric drugs.

But a medication review questioned the need for some of the medications. Of the four, two were discontinued and one was reduced in dosage, investigators said. Two different medications were then prescribed.

Investigators found no evidence that a treatment plan for the boy had been developed in the first place, before starting him on medication.

In another case, an 11-year-old boy had been put on two medications after being diagnosed with ADHD, anxiety and behavior problems. But over a three-month period his foster mother had problems getting prescription refills. By the fourth month, the boy's life was out of control. His decline included stealing, lying, bullying and an in-school suspension.

Investigators found there was no requirement in that state for case workers to follow up with foster parents about medications. The lack of effective follow-up contributed to the boy's downward spiral.

"These children are at greater risk of not getting the medications they need, but equally important, they are at risk of getting powerful medications that they do not need," Maxwell said.

The inspector general is recommending that the HHS Administration for Children and Families develop a strategy to help states meet their existing requirements for prescribing psychiatric drugs to foster children, and to generally raise standards for case-by-case oversight.

In a formal response to the report the children's agency said it may need additional legal authority. The agency also said it is committed to making sure foster children get psychiatric medications only when medically appropriate. Officials noted that the inspector general's findings covered just five states.

Foster children come into the mental health system with added complications. Their most basic connections in life have been stressed or severed. They may have suffered neglect or abandonment. They may have witnessed or been a victim of abusive behavior or violence.

A 2010 study from the Tufts Clinical and Translational Science Institute found that estimated rates of psychiatric drug use among youth in foster care are much higher (13 percent to 52 percent) than among youth overall (4 percent).

Compounding the challenge for foster children is the fact that responsibility for their well-being is often divided among foster parents, birth parents, relatives and case workers. That can increase chances for miscommunication and conflict, not to mention everyday problems going unaddressed until they escalate.

Caring for foster kids is a shared responsibility of state, local and federal agencies. The federal government provides grants to state programs and also covers health care for foster children through Medicaid, which spends hundreds of millions of dollars annually on psychiatric drugs. Nationally, it's been estimated that about 120,000 children in foster care take at least one such medication.

The inspector general scrutinized a sample of 125 cases from each of five states with the highest overall percentages of foster children treated with psychiatric drugs. Those states were Iowa, Maine, New Hampshire, North Dakota and Virginia. The cases covered the period from October 2014 through March 2015. Investigators looked at each state's compliance with its own particular requirements for treatment planning and follow-up.

Maxwell said the finding that 34 percent of children did not have either treatment plans or follow-up monitoring translates to about 4,500 children in the five states examined. She said the national number would certainly be higher but the design of the inspector general's review did not allow for a simple extrapolation. Even among the five states cited there were wide differences.



Inspector general's report:

  • Associated Categories: Associated Press (AP), AP National News, AP Online National News, Top General short headlines, AP Online Headlines - Washington, AP Health, AP Health - Children's Health
© Copyright 2019
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Watchdog slams safeguards for foster kids on psych drugs
Federal watchdog agency slams safeguards for foster kids prescribed powerful psychiatric drugs
10:31AM ( 6 minutes ago )
The Latest: Kavanaugh again denies woman's assault claim
Supreme Court nominee Brett Kavanaugh is again denying a woman's allegation he sexually assaulted her at a party three decades ago
10:31AM ( 6 minutes ago )
The Emmy winner is ... maybe viewers, diversity, 'SNL' brand
As Emmy Award nominees nervously wait to hear their name called, or not, there's more on the line at tonight's ceremony than personal glory
10:26AM ( 11 minutes ago )
Associated Press (AP)
Hope fades in Philippines for dozens buried in landslides
A Philippine mayor says it's highly unlikely any of the 40 to 50 people who are feared buried in a mudslide set off by Typhoon Mangkhut can be found alive
9:15AM ( 1 hour ago )
Kavanaugh's accuser willing to talk to Congress, lawyer says
The woman accusing Judge Brett Kavanaugh of sexually assaulting her is willing to tell her story in public to a Senate panel considering his nomination to the Supreme Court, her lawyer says
9:07AM ( 1 hour ago )
Mattis condemns Russian influence-peddling in Macedonia
Defense Secretary Jim Mattis is condemning Russian efforts to use its money and influence to build opposition to an upcoming vote in Macedonia that could pave the way for the country to join NATO, a move Moscow opposes
8:59AM ( 1 hour ago )
AP National News
Carrie Underwood reveals she had 3 miscarriages in 2 years
Carrie Underwood says she turned to God after experiencing three miscarriages in the past two years
7:22AM ( 3 hours ago )
Mattis condemns Russia for influence-peddling in Macedonia
Defense Secretary Jim Mattis is condemning Russian efforts to use its money and influence to build opposition to an upcoming vote in Macedonia that could pave the way for the country to join NATO _ a move Moscow opposes
6:34AM ( 4 hours ago )
Accuser's story of attack roils plan for Kavanaugh vote
Kavanaugh's confirmation takes an uncertain turn as GOP senators express concern over woman's private-turned-public allegation
6:22AM ( 4 hours ago )
AP Online National News
Niece: Family won't take in Elizabeth Smart's kidnapper
Once an accomplished organ player in Salt Lake City, Wanda Barzee has become a disturbing figure even for members of her own family for her role in the 2002 kidnapping of then-teenager Elizabeth Smart
5:32PM ( 1 day ago )
Former Colorado nuke site opens to public as wildlife refuge
Cyclists and hikers are exploring a newly opened wildlife refuge at the site of a former nuclear weapons plant in Colorado
3:53PM ( 1 day ago )
New US survey shows some progress against opioid crisis
A U.S. government survey shows some progress in the fight against the ongoing opioid addiction crisis
6:39PM ( 2 days ago )
AP Health
Calling teen vaping 'epidemic,' officials weigh flavor ban
The U.S. Food and Drug Administration says teenage use of e-cigarettes has reached "epidemic" levels in the U.S. and called on manufacturers Wednesday to address the problem or have their products pulled off the market
1:18PM ( 4 days ago )
Immigrant families struggling with trauma of separation
Immigrant kids suffer bouts of crying, withdrawal as parents look to US government to pay for trauma from 'zero-tolerance' policy
3:40PM ( 1 week ago )
Palestinian teen killed by Israeli fire at Gaza border rally
Gaza's Health Ministry says a teenager was killed and dozens of other Palestinians injured by Israeli gunfire at a border protest
3:24PM ( 1 week ago )
AP Health - Children's Health
US stocks edge lower amid more trade tariff worries
U.S. stocks are edging lower in early trading amid speculation that the Trump administration is preparing to impose tariffs on another $200 billion-worth of Chinese goods
10:18AM ( 20 minutes ago )
The Latest: Warships ready to help with Florence response
Two U.S. Navy warships carrying helicopters and rescue equipment are in position off the East Coast to help with the response to Hurricane Florence
10:13AM ( 25 minutes ago )
Easier gambling has sports worried about fighting the fix
Some pro and college sports are worried about games being fixed as legal sports gambling spreads in the United States
10:00AM ( 38 minutes ago )
The Latest: Floods raise concerns about dams holding up
The devastating flooding in North Carolina from Florence has raised concerns about whether some dams will be able to hold up under the strain
9:34AM ( 1 hour ago )
Florence flooding spreads as storm heads northeast
The remnants of Hurricane Florence are spreading more flooding across as the storm heads northeast
9:20AM ( 1 hour ago )