Legislators to review state foster system’s misuse of psychotropic drugs

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State Sen. Mike McGuire will head an oversight hearing Monday to publicly discuss the findings of a state audit criticizing county foster care systems, including Sonoma County’s, for not adequately monitoring the use of psychotropic drugs among local foster youth.

The report, released in August and conducted by the state Auditor’s Office, raised the possibility that Sonoma County may be inappropriately medicating children or over-prescribing the mind-altering medications. The hearing, scheduled for 1 p.m Monday in Room 3191 of the state Capitol, will be a joint session of the Senate Human Services Committee and the Senate Budget and Fiscal Review Subcommittee.

McGuire said the audit has revealed a “systemwide failure to protect foster youth from serial over-prescribers” of psychotropic drugs, including powerful, mind-altering anti-psychotic drugs.

He said the report found that foster youth are getting too many psychotropics, their dosages are too high and they are being prescribed psychotropic medications without the court authorization required by state law.

“Unfortunately, our worst fears have played out via this scathing audit,” said McGuire, adding that 56 percent of the state’s foster youth in group homes are being prescribed anti-psychotic medications, a figure that is “off the charts” compared to other states.

McGuire said he hopes the hearing will bring attention to a bill currently awaiting Gov. Jerry Brown’s signature, which would authorize the California Medical Board to collect confidential information about psychotropic medications prescribed to foster youth.

The bill, SB 1174, would allow the medical board to investigate possible cases in which a physician is over-prescribing or inappropriately prescribing psychotropic drugs.

On Friday, county officials with Family, Youth and Children’s Services said they take the audit “very seriously.” Paul Dunaway, section manager of the department, said his department has already begun resolving some of the issues in the report but that more needs to be done.

“In this circumstance, areas have been identified to address the practice of how Sonoma County foster youth are prescribed psychotropic medication and how they are monitored,” said Dunaway.

Sonoma County was among four counties selected for review in the state’s audit, but the findings were indicative of statewide trends, the report said. The others were Los Angeles, Madera and Riverside.

Among the many findings, the audit found Sonoma County often failed to show that it properly tracked cases in which foster kids were prescribed multiple psychotropic drugs from the same class, which the state discourages; failed to show it was reviewing cases where drug dosages exceeded state guidelines; and did not show that youth were receiving adequate follow-up visits after being prescribed new psychotropic medications.

Many children in the foster care system suffer from emotional and behavioral issues and often have greater need for mental health care than children in the general population.

But foster youth advocates have raised concerns about the higher-than-usual prescription rates for foster kids. State guidelines recommend that foster children should take no more than one psychotropic drug from each medication class, which include antipsychotics, antidepressants, mood stabilizers, stimulants and anti-anxiety drugs.

The report found that 12 percent of the state’s more than 79,000 foster youth were prescribed psychotropic medications during the 2014-2015 fiscal year. Almost 23 percent of Sonoma County’s 661 foster kids were prescribed psychotropics during that time period. That share is slightly less than 23.6 percent in two years prior.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.

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