California Approves Laws To Cut Use Of Antipsychotics In Foster Care

Efforts to protect children in foster care from being inappropriately medicated with powerful antipsychotic drugs got a big boost forward on Tuesday, when California Gov. Jerry Brown signed three bills into law designed to reform prescribing.

Overprescribing of psychiatric meds for foster youth is a persistent problem nationwide, with children given the drugs at double or triple the rate of those not in foster care.

In 2011, the federal Government Accounting Office found nearly 1 in 4 children in foster care was taking psychotropic medications, which include antipsychotics, antidepressants, mood stabilizers and stimulants.

Hundreds of children were found to be taking five or more psychotropic medications at a time, and thousands were prescribed doses that exceeded FDA-approved guidelines. According to the report, monitoring programs fell short of guidelines established by the American Academy of Child and Adolescent Psychiatry. Many of the medications have side effects that include lethargy, weight gain, diabetes and tremors.

The California legislation, which covers 63,000 children and teens in foster care, will allow public health nurses access to medical records to monitor the foster children who are prescribed psychotropic drugs; identify the group homes that rely most on these medications and potentially require them to take corrective action; and provide child welfare workers with better training and oversight tools to spot dangerous prescribing practices.

"I hope the approval of this legislation tells our foster care youth that we love them, that their lives matter to all of us and that we care deeply about their future," said state Sen. Jim Beall, a San Jose Democrat, author of two of the bills.

The Oakland-based National Center for Youth Law, which was among the legislation's sponsors, called it the most comprehensive effort in the U.S. to date to curb the misuse of psychotropics in foster care. However, a bill that would have required a prior medical examination and ongoing monitoring before a juvenile court could authorize psychotropic drugs was pulled from the legislative package following intensive lobbying by associations representing physicians and group homes.

The bill's author said he would reintroduce the measure in January.

Elaine Korry writes about health care and social policy from the San Francisco Bay Area. She recently wrote about antipsychotic medications and foster care for NPR and Youth Today.