Missouri Settlement Changes Psychiatric Drug Use in Foster Kids

A class action federal lawsuit [Case No. 2:17-cv-04102-NKL] against the Missouri Department of Social Services alleging the overdrugging of foster children with harmful and addictive psychotropic drugs was given preliminary approval for settlement by U.S. District Court Judge Nanette Laughrey (Western District of Missouri) on Monday, July 15, 2019.

The case was first filed in June 2017 by national non-profit organizations Children’s Rights and the National Center for Youth Law (NCYL), the Saint Louis University School of Law Legal Clinics, and pro-bono counsel Morgan, Lewis & Bockius LLP.

The lawsuit claimed that children in Missouri foster care are at increased risk of being improperly or unnecessarily administered psychotropic drugs, leaving the children vulnerable to various serious adverse effects, including hallucinations, self-harm and suicidal thoughts.

Roughly 13,000 children are in Missouri’s foster care system. More than 30% of them are prescribed these harmful drugs, and 20% are taking two or more drugs at the same time. Medicaid pays for a majority of the healthcare services that children in foster care receive, including psychotropic drugs.

Most psychotropic drugs have not been FDA approved to treat children, who are at great risk of serious harm from these drugs because the drugs play Russian Roulette with neurotransmitters in the brain.

The settlement calls for multiple reforms, although without any of the defendants admitting any liability concerning any of the claims or allegations in the complaint. Objections, support, or comments by Class members or their legal representatives (or other interested parties) can be provided by October 23, 2019 per the “Notice of Proposed Class Action Settlement in M.B., et al. v. Tidball, et al.

The Missouri Department of Social Services, on behalf of the Missouri Children’s Division of the Department of Social Services, has contracted with the University of Missouri-Columbia to constitute a Center for Excellence within its Department of Psychiatry to undertake various responsibilities regarding this settlement, for roughly $3.8 million through July 31, 2021, although this contract is not specifically part of the settlement. While we applaud the Missouri government for taking action to address the abuse of foster children in their care, we must note that having psychiatrists oversee psychiatric abuse is like putting the fox in charge of the henhouse.

Specific commitments of the settlement include (these provisions are only briefly summarized here; refer to the actual settlement for full details):
1. Children’s Division (CD) shall maintain a full-time employee responsible for overseeing the implementation of policies and procedures concerning the use of psychotropic drugs for children in CD foster care.
2. Provisions for CD Case Management Staff Training.
3. Provisions for Resource Provider Training.
4. Provisions for training in the child welfare community serving children in Missouri.
5. CD shall maintain sufficient Case Management Staff to perform functions of the agreement.
6. Every child shall have a mental health assessment prior to being prescribed a psychotropic drug.
7. Every child prescribed a psychotropic drug shall have medical examinations.
8. Every child prescribed a psychotropic drug for ongoing use shall have monitoring appointments.
9. Every child prescribed a psychotropic drug shall receive concurrent nonpharmacological treatment.
10. Defendants are committed to developing and operating one or more statewide systems for maintaining medical records and/or medical information of each child in the custody of CD.
11. Defendants are committed to developing and operating one or more systems whereby pertinent medical records and/or medical information of the child will be made available to appropriate members of the child’s treatment team.
12. CD will implement and maintain a system for conducting secondary reviews of prescriptions of psychotropic drugs prescribed to children in the legal custody of CD.
13. CD shall maintain a policy governing informed consent and informed assent for psychotropic drugs, including a process for parental disagreement. The difference between consent and assent is basically that consent comes from the case manager and assent comes from the child.
14. Provisions for emergency administration of psychotropic drugs.
15.Defendants will appoint and maintain a psychotropic drug Advisory Committee to provide professional and technical consultation and policy advice.
16. Provisions for excessive dosage guidelines.

There are other provisions for data validation, enforcement, reporting, and exit criteria from the agreement. Refer to the actual agreement for these details.

Go here for more information about psychiatric abuse in the foster care system.

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