Take Action – Missouri Legislature – Foster Care

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.

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