Archive for January, 2017

Take Action – Missouri Legislature – Foster Care

Tuesday, January 31st, 2017

Periodically we let you know the progress of various proposed legislation making its way through the Missouri General Assembly and suggest ways for you to contribute your viewpoint to your state Representative and state Senator.

You can find your Representative and Senator, and their contact information, by entering your 9-digit zip code here.

This time, we’d like to discuss Senate Bill SB160, which Creates the Foster Care Bill of Rights, sponsored by Senator David Sater (R, District 29).

“This act establishes and enumerates the Foster Care Bill of Rights. The Children’s Division shall provide every school-aged foster child and his or her foster parent with an age-appropriate orientation and explanation of the bill of rights, as well as make them readily available and easily accessible online. Additionally, every Children’s Division office, residential care facility, child placing agency, or other agency involved in the care and placement of foster children shall post the bill of rights in the office, facility, or agency.”

This foster care bill of rights is primarily concerned with familial stability, which we think is a good thing. We would like to suggest an amendment aimed at reducing the amount of harmful psychotropic drugs regularly given to foster children in Missouri’s care.

Missouri Foster Care serves individuals age 0 to 21; not all states provide care to age 21. In FY2014 Missouri extended Medicaid benefits up to age 26 for individuals who have aged out of foster care. Medicaid pays for the psychotropic drugs given to foster children.

The high rates of psychotropic medication use in the Medicaid population, risks associated with these drugs, and research documenting inappropriate prescribing, have raised concerns, especially for children involved in the child welfare system.

Studies suggest that appropriate prescribing practices, that is, adhering to FDA-approved use and accepted clinical guidelines, may not always be followed for certain Medicaid populations such as the high-risk populations of children in foster care. In actual fact, multiple studies and reports have found that children in foster care are vulnerable to inappropriate or excessive medication use. Children in foster care are often prescribed more than one psychotropic medication at the same time. A review in Missouri once found some children in foster care prescribed five or more psychotropic drugs.

Psychotropic Drug Classes given to children in Missouri foster care (contact CCHR STL at CCHRSTL@CCHRSTL.ORG  for the complete report, or download it from cchrstl.org/foster.shtml):

ADHD
Antianxiety
AntidepressantAntipsychotic_Combo
Antidepressants_MAOIs
Antidepressants_SSRIsAndSimilar
Antidepressants_Tricyclics
Antipsychotics_FirstGeneration
Antipsychotics_SecondGeneration
Barbiturates
Bipolar Disorder
InsomniaNarcolepsySleepDisorders

Total foster care drug costs in Missouri have averaged roughly $16 Million per year, with a total for the five years 2010-2014 over $81 Million. All of these psychotropic drugs given to Missouri foster care children between the ages of 0 and 26 are harmful and can have serious side effects including violence and suicide.

The top costs are for ADHD drugs and Antipsychotics for all ages. ADHD drug costs appear to be increasing year over year. Babies less than a year old are more commonly given Barbiturates, one presumes as a remedy for insomnia. Barbiturates are highly dangerous because of the small difference between a
normal dose and an overdose.

For all these reasons, CCHR would like to see an amendment for SB160 to this effect:

Foster Children have the right:
(a) To be free of the administration of medication or chemical substances unless authorized by a physician,
(b) To be informed of the risks and benefits of psychotropic medication in an age appropriate manner,
(c) To tell their doctor that they disagree with any recommendation to prescribe psychotropic medication,
(d) To go to the judge with an advocate of their choice and state that they object to any recommendation to prescribe psychotropic medication,
(e) To refuse the administration of psychotropic or other medication unless immediately necessary for the preservation of life or the prevention of serious bodily harm,
(f) To refuse the off-label prescription of psychotropic drugs and at-risk polypharmacy,
(g) To have prescribing doctors disclose any financial ties they have to pharmaceutical companies in writing in an age appropriate manner.

Contact your Missouri state Representative and Senator, and let them know what you think about this. Such an amendment to the proposed legislation would certainly strengthen the rights of foster children and reduce the administration of psychiatric drugs, since they are all inherently damaging to young children and should not be held as standards of care.

For more information click here.

The First Line of Therapy

Monday, January 23rd, 2017

Dr. Hansa Bhargava, a practicing pediatrician and medical editor with Medscape, is starting to recognize that drugs should not be the first line of therapy for children with symptoms of difficult behavior.

While ADHD itself is a fake illness, the observed symptoms are real, and the root causes must be diagnosed, recognized, and treated for whatever they are.

Children are being diagnosed with symptoms of so-called ADHD at younger and younger ages. Instilling good behavior and lifestyle habits as they grow will help them improve as they move into adolescence and adulthood.

The Centers for Disease Control and Prevention (CDC) reported that almost 1 in 2 preschoolers with a “diagnosis” of ADHD get no behavioral therapy, but instead get drugs as the first form of “treatment.”

There is growing evidence that the first approach in addressing these symptoms should be nonpharmacological.

For example, the National Sleep Foundation reported that as many as 80% of teens do not get enough sleep. Sleep-deprived kids often lack focus and may have symptoms of hyperactivity, which can mistakenly be attributed to this fake disease. Dehydration may have effects on one’s ability to control one’s behavior. And exercise is well established as important for overall physical fitness, growth, and mood, but it turns out that it may be particularly helpful in kids with behavioral symptoms.

A “diagnosis” of ADHD is based solely on opinion, and should never be taken as a fact before non-psychiatric, clinical evidence determines what is actually medically the case.

What is ADHD then? In 1987, “Attention Deficit Hyperactivity Disorder” (ADHD) was literally voted into existence by a show of hands of American Psychiatric Association members and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Within a year, 500,000 children in America alone were diagnosed with this. It is an excuse to sell drugs and make money.

ADHD actually represents the spontaneous behaviors of normal children. When these behaviors become age-inappropriate, excessive or disruptive, the potential causes are limitless, including: boredom, poor teaching, inconsistent discipline at home, reading difficulty, tiredness, street drugs, nutritional deficiency, toxic overload, and many kinds of underlying physical illness.

There is no valid ADHD test for children. There is no valid ADHD test for adults. ADHD in adults is just as bogus as ADHD in children.

The ADHD diagnosis does not identify a genuine biological or psychological disorder. The diagnosis is simply a list of behaviors that may appear disruptive or inappropriate.

Click here for more information.

Drugging Children in Missouri Foster Care

Wednesday, January 18th, 2017

The high rates of psychotropic medication use in the Medicaid population, risks associated with these drugs, and research documenting inappropriate prescribing, have raised concerns, especially for children involved in the child welfare system.

Studies suggest that appropriate prescribing practices, that is, adhering to FDA-approved use and accepted clinical guidelines, may not always be followed for certain Medicaid populations such as the high-risk populations of children in foster care. In actual fact, multiple studies and reports have found that children in foster care are vulnerable to inappropriate or excessive drug use. Children in foster care are often prescribed more than one psychotropic drug at the same time. A review in Missouri once found some children in foster care prescribed five or more psychotropic drugs.

Missouri Foster Care serves individuals age 0 to 21; not all states provide care to age 21. In FY2014 Missouri extended Medicaid benefits up to age 26 for individuals who have aged out of foster care.

In Fiscal Year 2015, Department of Social Services MO Healthnet (Medicaid) spent $1,254,900,000 for pharmacy services for 883,672 people, approximately 60% of whom were children. There were an average of 13,033 children monthly in Foster Care (19,429 individuals for the year.) The total 2015 state population of children under 18 was 1,399,075.

(Data is primarily from the Missouri Department of Social Services and Child Division reports available on the state website dss.mo.gov, as well as various Medicaid-related publications, and sites such as the Medicaid Statistical Information System.)

Average number of MO Children in Foster Care per month by Fiscal Year:

FY Avg # of Children per Month Total Individuals per Year
2003 12,246
2004 11,634
2005 11,402
2006 10,904
2007 10,571
2008 9,760
2009 9,532
2010 9,785
2011 10,536 16,493
2012 11,059 17,160
2013 11,257 18,289
2014 12,104 18,290
2015 13,033 19,429

You can see that over the last four years, Missouri has been experiencing an increase in the Foster Care population, which in 2015 was the highest in the previous 12 years; indicating at the very least unmanageable caseloads.

The average age of a child in Missouri Foster Care is 10 years old, and spends an average of 24 months in foster care.

In 2014, for example, there were 7,259 Children entering or reentering state custody. There were 24,388 children, in or out of foster care, who were receiving public mental health services (meaning they were likely on one or more psychotropic drugs.)

For 2008, Medicaid Pharmacy Benefit statistics for Missouri from the Centers for Medicare & Medicaid Services show 122,274 children 5 years of age or younger; 121,095 ages 6 to 14; and 54,645 ages 15 to 20. This includes children in foster care. The top drug group for all these prescriptions in terms of cost was antipsychotics.

Missouri consistently ranks nationally in the bottom one-third of overall health status as compared to other states. Nationally, about 14 percent of Medicaid beneficiaries used a psychotropic medication during calendar year 2011. In 2011, Medicaid spent about $8 billion in fee for service for psychotropic medications—30 percent of the program’s total fee-for-service drug spending.

Some General Observations from the Data
1. Top costs are for ADHD drugs and Antipsychotics for all ages.
2. ADHD drug costs appear to be increasing year over year.
3. Babies less than a year old are more commonly given Barbiturates, one presumes as a remedy for insomnia. Barbiturates are highly dangerous because of the small difference between a normal dose and an overdose.
4. Total foster care drug costs have averaged roughly $16 Million per year, with a total for the five years 2010-2014 over $81 Million.

Drug Classes given to children in Missouri foster care (ask us for a copy of the full report):
ADHD
Antianxiety
AntidepressantAntipsychotic_Combo
Antidepressants_MAOIs
Antidepressants_SSRIsAndSimilar
Antidepressants_Tricyclics
Antipsychotics_FirstGeneration
Antipsychotics_SecondGeneration
Barbiturates
Bipolar Disorder
InsomniaNarcolepsySleepDisorders

 

Recommendations / Model Legislation
§ As an example, there are currently close to 63,000 children and youth in California’s Child Welfare System. Refer to this model legislation from California:
California Assembly Bill AB-1067
http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB1067
Approved by the Governor 09/30/16.
Requires the Department of Social Services (DSS) to convene a working group to develop standardized information about the rights of all minors and nonminors in foster care, and expands requirements regarding the distribution of information regarding these rights.

§ As another example, see this draft copy of suggested California legislation to expand the rights of children in foster care regarding the use of psychotropic drugs:
http://www.cchrstl.org/documents/Draft%20CA%20Foster%20Care%20Bill.pdf
A bill to amend the existing Foster Child Bill of Rights (WIC 16001.9) to strengthen the rights of foster children to participate in any decision to require mental health treatment and psychotropic medication. The state of California finds that Foster Children are subjected to excessive diagnosis and treatment by psychotropic medications, and hereby amends the Foster Child Bill of Rights to include the following additional protections for children under the care of Child Protective Services.
Section 16001.9 (a) 5 of the Welfare and Institutions Code is amended to read:
(5) (a) To be free of the administration of medication or chemical substances unless authorized by physician,
(b) To be informed of the risks and benefits of psychotropic medication in an age appropriate manner,
(c) To tell their doctor that they disagree with any recommendation to prescribe psychotropic medication,
(d) To go to the judge with an advocate of their choice and state that they object to any recommendation to prescribe psychotropic medication,
(e) To refuse the administration of psychotropic or other medication unless immediately necessary for the preservation of life or the prevention of serious bodily harm,
(f) To refuse the off-label prescription of psychotropic drugs and at-risk polypharmacy,
(g) To have prescribing doctors disclose any financial ties they have to pharmaceutical companies in writing in an age appropriate manner.

§ Go here to download more information about drugging foster care children:
http://www.cchrstl.org/documents/facts_about_foster_care_children.pdf

Remembering Carrie and Debbie

Friday, January 6th, 2017

We are sincerely grieved at Carrie Fisher’s death December 27th from heart failure. When we read that Carrie Fisher suffered a heart attack December 23rd on a plane flight from London to Los Angeles, we were shocked.

Fisher as Princess Leia was just 19 years old when she began shooting “Star Wars.” By the time she was 21 she was doing LSD in an attempt to self-medicate. In 2011 she confessed to Oprah that she had electroshock therapy every six weeks, since the antidepressants were not entirely effective in dealing with her mental issues, suffering memory loss as a result. She was hospitalized in 2013 for so-called bipolar disorder, and she was still taking psychotropic drugs and getting ECT.

One can only assume such treatment continued into present time, so it is now hardly shocking that she has suffered a heart attack as well. The amazing part is her resilience. All those drugs and electric shocks through the years, in a normal person, may well have been fatal far sooner.

Any benefit one claims for ECT, no matter how famous one is, has to speak only for a person’s innate strength, since ECT, as well as psychotropic drugs, is patently damaging.

A cursory review of over 200 psychotropic drugs shows that every one has potential adverse effects of heart attacks or other heart-related problems. During ECT, the heart rate is severely impacted, either speeding up or slowing down dramatically. Most deaths reported during or immediately after ECT are cardiovascular in nature.

And now, the FDA wants to reclassify ElectroConvulsive Therapy machines to exempt them from clinical testing if they are similar to machines currently being marketed, which effectively means they do not have to be demonstrated as safe and effective.

Frankly, the FDA should simply ban outright the use of psychotropic drugs and ECT machines as being dangerous and harmful.

We are doubly saddened by the passing of Debbie Reynolds, Fisher’s mother, just a day after Fisher’s death. Debbie Reynolds was recognized for her decades-long commitment to various charities, including the mental-health organization The Thalians, a group of entertainment professionals who support mental health care issues. Reynolds was among the founders of the Thalians charity group in 1955, and was the Thalians’ third president. A mental health center at the Cedars-Sinai Medical Center was named after the organization. It closed in 2012 and the Thalians now raise funds for veterans with mental health issues in association with the UCLA Medical Center. Honor the memory of both Carrie and Debbie by working with CCHR to continue to bring sanity to the mental health care profession.

Psychiatric Hospital Chain (UHS) Loses $1.5 Billion within 6 Hours

Sunday, January 1st, 2017

Largest U.S. Psychiatric Hospital Chain (UHS) Loses $1.5 Billion within 6 Hours

Following BuzzFeed News Exposé

In the past 18 months, Citizens Commission on Human Rights International (CCHR) has filed over 2,860 official complaints against Universal Health Services (UHS) behavioral facilities with state and federal agencies, the FBI, healthcare fraud control units, and state and federal legislators. CCHR has documented potential fraud and abuse and, therefore, applauds a recent BuzzFeed News exposé – the results of its own year-long investigation into UHS. Within 6 hours of the BuzzFeed News article, stock in UHS, the largest chain of psychiatric facilities in the U.S., that treats 450,000 people annually, plummeted $1.5 billion.

Like CCHR, BuzzFeed News interviewed whistleblowers and staff from UHS psych facilities to obtain its information. It independently documented allegations that UHS staff were pressured to:

  • “Fill beds” by whatever means necessary.
  • “Exaggerate people’s symptoms” or “twist their words” in order to hold them against their will.
  • Lock the door and keep patients until their insurance payments run out.

In response to the BuzzFeed News exposé, three federal legislators have called for a full investigation into UHS, with Senator Charles Grassley, chair of the Senate Judiciary Committee, demanding that the Department of Health and Human Services report what steps are being taken to investigate the patient abuse and fraud claims against UHS psych hospitals. “The pattern of conduct described by the report paints a picture of greed and raises serious questions about patient safety.” Rep. Joe Kennedy III spoke of “abuse, neglect, fraud” at UHS behavioral facilities with “an emphasis of profits over treatment and care.” And Sen. Elizabeth Warren, stated: “The Department of Justice [DOJ] must put an end to these shameful practices for the safety of patients….”

The U.S. Department of Health and Human Services has declined to respond to Senator Grassley’s request due to the legal constraints of ongoing investigations, although it has agreed to brief the Senator’s office.

UHS’s 211 for-profit psychiatric hospitals in the United States earned $7.5 billion in revenues last year. More than a third of the company’s overall revenue comes from taxpayers through Medicare and Medicaid. There are three UHS hospitals in Missouri: Heartland Behavioral Health Services in Nevada; Saint Louis Behavioral Medicine Institute in St. Louis; and Two Rivers Behavioral Health System in Kansas City.

CCHR says its website offers an easy online form for families of patients treated in UHS behavioral hospitals or staff to report in confidence any allegations of abuse. Click here to file a report. CCHR has assisted whistleblowers in getting their allegations reported to the proper authorities for action, but says in the interests of patient welfare, federal investigations should come to a quick resolution.

Help CCHR get this new information broadly known and distributed to state and federal policy makers, law enforcement and health agencies across the country. The for-profit psychiatric hospital system is putting patients at serious risk and with this recent exposé and the legislators’ call, it is vital that we share the evidence that we have about UHS and other privately owned behavioral hospital chains. Visit CCHR STL to donate and see what you can do about this.