Bill would monitor medication prescriptions for foster kids

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February 6th, 2012

Omaha, NE – The number of foster care children in Nebraska who are on psychotropic medication is far greater than children who aren’t in the system. Some lawmakers are calling for more oversight over how those medications are administered – and to examine whether they’re really necessary.

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As we reported on the state of child welfare in Nebraska last month, we came across a recurring concern among parents with children in the system:

Latoria Cook and her husband Charles Gilmore were featured in the KVNO News series, Child Welfare: Navigating a Fractured System. Click the image to read more. (Photo by Robyn Wisch)

“He is now seven years old, about to be eight in February, on at least six medications,” said Latoria Cook, a young mother with four children in foster care. She told her story at a meeting of several parents with kids in the system. The group got together at the offices of Nebraska Families Collaborative to share their stories for our series last month on the state’s fractured child welfare system.

Cook’s oldest son has been diagnosed with Autism. And she says while in foster care, he was placed on medication that had damaging side effects. “What they’ve done to my son is that they put him on this Risperdal again when they took him,” she told the group. “Now my son has … epilepsy at seven years old… and sometimes he will start drooling at the mouth and he can’t talk.”

Joan Theye and her three daughters were also featured in the series. Click the image to read more. (Photo by Robyn Wisch)

Another mother in the group, Joan Theye, has three daughters in foster care. They’ve been diagnosed with Attention Deficit Disorder, and she said she feels she has no choice but to make sure they’re medicated.
“I’d rather take vitamins and minerals, and do the whole natural thing than to take prescriptions, I just believe in that,” Theye said. “Well, they push prescriptions; they push things that I don’t really want my kids on. And they just don’t really give you a choice.”

“This is a very, very scary time for families,” explained Candy Kennedy-Goergen in a later interview with KVNO News. Kennedy-Goergen heads the Nebraska Federation of Families for Children’s Mental Health.

“It’s very, very intimidating to have your child removed from home and want to do the right thing,” she said. “But even when you feel like it’s not the goal to make you successful, it’s hard to be able to verbalize that because you’re concerned you may not get your children back.”

Sen. Gwen Howard has introduced a bill that would create more oversight of the prescriptions of psychotropic medication among foster children. (Photo courtesy Nebraska Legislature)

Kennedy-Goergen said parents often don’t realize they still have a say in how their child is treated – even if they are in the care of another family. But she said there is often little communication between the biological family and the foster family. And that, she said, can lead to misfires in a child’s care.
And in fact, those anecdotes have some backing. According to a report by the Foster Care Review Board last year, the number of foster care children receiving one or more psychotropic medications is far above average – 22.5 percent.

“My question is and has always been is this the best way for us to work with these children that come into the foster care system?” State Senator Gwen Howard has introduced a bill in the Unicameral that would create a task force to oversee the use of medications among foster care children. She said she’s concerned children are being over-prescribed medication for behaviors that might be normal.

“You know, any of us that would lose everything and come into the foster care system with sometimes just the clothes on our backs are going to have a lot of emotions, and a lot of feelings about that,” Howard said. “And to put a child on medication that alters their feelings and behaviors, when they’re going through a time of crisis, I think is only adding to the problem, adding to what should be dealt with.”

Howard is also concerned with gaps in the medical records of foster kids. According to the same foster care review board report, a 24-42 percent of the children in the system did not have adequate or complete medical records.

“And when you add into that, the child moving from placement to placement, if that in fact happens, the child may be seeing more than one doctor or may have a new doctor for a very short period of time,” Howard said. “But I think even more than those factors is the turnover in case management.”

“When there’s a new case manager in charge of a case on a frequent basis, they’re not monitoring that case record to make sure that documentation is in there and to know what that child may or may not be taking.”
The Department of Health and Human Services has not taken a position on Howard’s bill, and could not comment specifically on any of the families we talked to in our reporting. But a spokesperson provided a response, saying the department has established a Healthcare Oversight Team to monitor health issues for kids in the system, and it is looking at ways to reduce the use of psychotropic medications.

Howard said her bill has support at the Capitol. But she says it’s just one piece of the legislature’s examination of child welfare – in all its complex parts.

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