Pennsylvania Latest State To Try To Curb Psychotropic Prescribing To Foster Children

Rob Wipond
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Like in many other states, foster children in Pennsylvania are being given psychotropic drugs by physicians at rates that are “disturbing” and “unacceptable,” according to a press release and new report from the state’s Department of Human Services (DHS). The state government also announced its plans to try to rein in the practice.

DHS Secretary Ted Dallas said in the press release that, “The research confirms our concerns and shows an unacceptable use of these medications for children in foster care. The steps we are announcing today are designed to address this disturbing analysis. Starting with the Department, all of us have a responsibility to make sure children in foster care receive the care they need.”

The commissioned investigation from PolicyLab in Philadelphia reported that, “For youth ages 6-18 years old in 2012, the use of psychotropic medications was nearly three times higher among youth in foster care than youth in Medicaid overall (prescribed at 43% versus 16%).”

The researchers also found that the use of antipsychotics was four times higher among youth in foster care (22%) than youth in Medicaid overall (5%) in Pennsylvania, and that half of the antipsychotic users in Medicaid had a diagnosis of ADHD but no appropriate clinical indication for being prescribed the antipsychotics. In addition, four times as many youth in foster care were being given multiple drugs (12% versus 3%).

The investigators further found that the youth in foster care in Pennsylvania “were more likely to have not received any visits within the year with a provider for their behavioral health concerns while on psychotropic medications.”

Some of the report’s recommendations that DHS decided to take action on included offering telephone consultations to physicians and encouraging the use of trauma-screening tools. DHS said it would also more closely monitor prescribing.

The report, however, also recommended that Managed Care Organizations that oversee children and youth in foster care should be required to obtain prior authorization from independent experts before prescribing antipsychotics to a child, as most other organizations in Medicaid in Pennsylvania currently do. And it recommended that DHS “expand investments in and reimbursements of non-pharmacological behavioral health interventions(.)” The DHS press release did not address these recommendations.

Pennsylvania Takes Action to Address Psychotropic Medication Use among Medicaid-Eligible Foster Children (DHS press release on PRNewswire, June 16, 2015)

Psychotropic Medication Use by Pennsylvania Children in Foster Care and Enrolled in Medicaid (PolicyLab, June 2015)

4 COMMENTS

    • Some are totally against it, others are the worst perpetrators who have personal physicians they go to who will prescribe what the foster parent wants. It’s totally pot luck.

      Interestingly, when kids are placed with family members, their psych drug rates are only slightly higher than the general population. So there is some protective effect of being placed with someone who already knows you. But foster kids are totally vulnerable and rarely have anyone looking out for them. They are possibly the most disempowered population in modern society.

      —- Steve