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Miami Herald
Study: Florida's psych drug rules for foster kids ignored
A new state study found that child-welfare doctors and case workers aren't following the rules when it comes to the drugging of 6- and 7-
year-olds in state care.
By Marc Caputo

TALLAHASSEE -- Child-welfare doctors and case managers routinely failed to complete legally required treatment plans, share
information or properly document the prescribing of powerful psychiatric drugs for children, according to a new state study of 6- and 7-
year-olds medicated in state care.

    One of the 268 children was Gabriel Myers. The troubled 7-year-old, medicated
    with an adult anti-depressant known to cause suicides in children, hanged himself
    in April in his Margate foster home.

    But the state study, which documents how many times caseworkers and doctors
    followed child-welfare rules and laws, shows that it would be a mistake to blame
    Gabriel's death solely on the drug, Symbyax, said Florida's drug czar, William

''It wasn't just the medications,'' said Janes, who sits on a committee investigating ways to prevent cases like Gabriel's. ``It was the
system and his world. His environment just collapsed on him. And there was no one there to really put their arms around him.''

The Department of Children and Families study, presented Monday to the committee, indicates that a number of rules and laws on
medication for children in state care weren't followed for all 6- and 7-year-olds:

• In 86 percent of cases, the prescribing physician didn't complete what's known as a Psychotherapeutic Medication Treatment Plan,
which helps case workers, legal guardians, judges and other physicians determine a child's mental well being.

• In 75 percent of the cases, the case workers did not provide physicians with pertinent medical information about the child.

• In 76 percent of the cases, the case worker didn't provide parents with information about the psychotropic drugs their kids were being
prescribed. Nor did the case worker help arrange transportation or phone conversations between the doctor and the child's guardian.

• In 58 percent of the cases, the case manager didn't attempt to speak with or meet the parent or guardian prior to seeking a court
order to medicate the child.

• In 89 percent of the cases where parental consent wasn't obtained to medicate children, case managers failed to inform state lawyers
that they were seeking a court order to administer the medication.

The DCF study also found numerous record-keeping and data discrepancies in the state's child-tracking system, Florida Safe Families
Network. The study follows a similar review last month concerning the drugging of children in state care under the age of 6. DCF is now
studying other age groups.

Dr. R. Scott Benson, former head of the American Psychiatric Association, pointed out the difficulties physicians have in meeting all the
state record-keeping requirements.

Benson, who doesn't treat children in state care, said he found it ''horribly troubling'' that physicians weren't given all the pertinent
medical information about the children prior to making a prescription. But, he said, he wasn't surprised because of the complicated
nature of child-welfare cases and clients.

The committee probing the child-welfare system plans to issue a report by Aug. 20.

It is only touching on Gabriel's case, which is the subject of a Margate police investigation. Some doctors and case workers -- all of
whom work for privatized agencies under contract with the state -- might face sanctions, depending on what the report finds.

The DCF study, as well as Gabriel's case, show the troubles with 2005 legislation designed to curb the prescribing of mental-health
drugs to kids in state care.

Among its requirements, the law mandates more information sharing, parental involvement and second-party review of doctors'
prescriptions for the youngest children.

One committee member, Dr. Rajiv Tandon, pushed for a simple electronic record system that physicians and case workers can share.

He said the system also needs to be ''tweaked'' to clarify who's in charge and who needs to do what.

''There's only so much we can do. There's no substitute for common sense,'' Tandon said. ``There's no substitute for people doing the
right thing. Sadly, in this case, the right thing wasn't done by some people.''

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To see more about Big pharma, the FDA's neglect &/orcriminal involvement, See my page "Links to FDA, FTC, and EPA
For resources to take action on various situations in the world today see my page Thomas Jefferson
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Miami Hearld
Study: Florida's psych drug rules for foster kids ignored
Page created 7/7/09
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