California SB 1174 and SB 1291

“Doctors could lose their medical licenses if they overprescribe psychiatric medications to California’s foster youth under a new Senate bill that for the first time targets the source of the often-questionable drugs being used to sedate troubled kids in the country’s largest child welfare system.

Another bill, introduced Friday, would sanction government agencies that fail to offer nondrug therapy alternatives to help foster youth recover from their traumatic childhoods.

The new legislation expands on a series of laws passed last year to restrict the excessive use of psychotropic drugs — the subject of the San Jose Mercury News’ ongoing investigative series “Drugging Our Kids.”

CARE FOR KIDS

The laws that take effect this year focus on the courts, social workers, caregivers, public health nurses and group homes that care for foster kids. But the new bills, sponsored by the Oakland-based National Center for Youth Law, would broaden the tracking of prescriptions and step up scrutiny of those who write them. The legislation is expected to face strong opposition from physicians who want free rein to prescribe as they see fit.

But state Sen. Mike McGuire, who authored the prescriber bill, said the state needs a better way to stop the overmedicating at the doctor’s office.

“Currently, California has no way of identifying out-of-the-ordinary prescribers of these mind-altering medications,” said McGuire, D-Healdsburg. “There’s no system for evaluating the medical soundness of high prescribing, and no way to measure the impacts.”

Under Senate Bill 1174, physicians who “frequently prescribe outside recognized safety parameters for children” would be investigated by the state Attorney General’s office and could face challenges to their medical licenses in extreme cases when they failed to change their ways. Doctors associated with questionable patterns such as medicating very young children, or prescribing dangerous drug combinations, would be identified through regular reports shared between the Department of Health Care Services and the California Medical Board.

BOARD REVIEW

As a result of the series by Mercury News, the Medical Board is reviewing doctors who prescribed three or more psychotropics to Medi-Cal-enrolled children for more than 90 days, but the new bill would go beyond a one-time review, requiring ongoing monitoring and investigations.

The Mercury News found that almost one in four California foster teens has been prescribed psychiatric drugs, the vast majority antipsychotic medications that are designed and approved only for severe and rare mental illnesses. The drugs can cause lifelong health impacts, such as obesity, diabetes and irreversible tremors. But many of the drugs are heavily sedating — a plus for caregivers and group home staff dealing with the difficult behaviors of deeply traumatized kids.

On Friday, a spokesman for the influential California Medical Association, with 41,000 members, said the group’s board had not yet met to consider the new bills. But physicians and some critics of the previous bills expressed concerns that there will be few alternatives in place if the state places more restrictions on medications used to keep distraught and aggressive foster kids from harming themselves and others.

Sen. Jim Beall, D-San Jose, introduced Senate Bill 1291 to address that. The bill would require county mental health plans to gather data and submit annual plans detailing how they serve foster youth for everything from crisis care to ongoing counseling. Under the bill, the state could step in if counties fall short.

“As we passed legislation last year to stop the over-prescription of psychotropic drugs to control foster youth with behavioral problems, there were lingering questions about the responsiveness and efficient delivery of mental health services,” Beall said in an email statement. He added that this bill — Beall’s third to address the overuse of psych meds — would provide those answers in a public format by requiring they be posted online.

PAIN ENDURED

Shanequa Arrington, a former foster youth working as an advocate with the National Center for Youth Law, said she hopes today’s foster kids will be spared what she endured: dozens of medications that caused her excessive weight gain, diabetes and a drowsiness so persistent that she slept through school.

When she misbehaved in foster care, Arrington said, it was learned behavior from group homes, or an attempt to express her confusion and sadness after experiences like seeing her sister be abused.

“Counseling would have worked wonders, or art therapy or music therapy,” said Arrington, 23. Instead, “I started taking medication when I was 7. I got medicine instead of something teaching me how to cope.””

Two more bills aim to protect California foster youth from dangerous psychiatric drugs [Santa Cruz Sentinel 2/19/16 by Karen de Sa]

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