There has been inadequate oversight regarding the administration of psychotropic medication to Florida foster children. A recent examination conducted by the Department of Health & Human Services has brought to light a concerning deficiency in supervision and record-keeping within Florida's child welfare system regarding the administration of potent psychotropic medications to foster children. This lapse in oversight has raised apprehensions regarding the safety and welfare of the state's vulnerable foster children.

The investigation entailed a random assessment of 115 records of children who were prescribed psychotropic or opioid medications. The findings unveiled a disconcerting absence of adequate documentation and adherence to state regulations governing medication usage. This lax approach to oversight exposes foster children to the possibility of mismanagement of medications and potential harm.

One distressing case highlighted in the assessment revolved around a 5-year-old boy in foster care who had been receiving the anti-seizure medication Keppra for over a year, even though he lacked a documented epilepsy diagnosis. This medication left him in an almost "catatonic" state, with no evidence of authorization from either his biological mother or a judge, as mandated by state law. Fortunately, the foster mother's vigilance prompted the gradual discontinuation of the medication, leading to the cessation of seizures.

Improper Psychotropic Medication Administration

The boy's biological mother corroborated this account and asserted that she was neither consulted nor would have consented to such treatment. Instances of improper medication administration raise substantial concerns regarding the well-being and safety of foster children in Florida.

Interestingly, federal audits in other states like Indiana, Michigan, and Ohio have also exposed insufficient oversight of psychotropic medication use among foster children, hinting at a possible nationwide issue. In Maryland, a class-action lawsuit, spearheaded by the American Civil Liberties Union and other non-profit organizations, alleges that up to 34% of the state's foster children are prescribed psychotropic drugs without a proper psychiatric diagnosis.

Child advocates contend that these instances underscore a systemic failure to diligently supervise medication use among foster children, a group already more likely to be prescribed medications compared to their peers.

10% Of Florida Foster Care Children Receive Psychotropic Medication

Currently, in Florida, over 2,200 foster children, roughly constituting 10% of the state's foster care population, receive medications usually prescribed for mental health conditions like schizophrenia, depression, bipolar disorder, and ADHD. Shockingly, this includes 73 children aged 5 and under. Among foster children aged 13 and older, almost one in three is prescribed such medications, more than twice the rate among their counterparts in the general population.

Troublingly, auditors discovered that nearly half of the reviewed cases had no records of prescribed psychotropic medications within the state's primary case management system. Additionally, logs containing details about medication frequency and dosage were absent from 66% of case files, and authorization records were missing in over one-third of cases. The situation was graver for opioid medications, where records were practically non-existent.

The high turnover of case managers in the foster care system exacerbates this problem since accurate documentation is indispensable for seamless care. Foster children, especially teenagers, often transition between various foster families and group homes, potentially exposing them to the risk of overdoses or hazardous drug interactions, a matter emphasized by the Food and Drug Administration in 2016.

Correcting The Issue

In response to the audit's findings, the Florida Department of Children and Families is contemplating more efficient methods of uploading records into the state's child welfare system and is looking into utilizing supplementary data sources to cross-verify information in case files.

Effective supervision of medication use in foster care is vital to guarantee the well-being and safety of these vulnerable children. Without it, the quality of care and the health and safety of children may be compromised. Furthermore, the lack of access to crucial Medicaid data and the inadequacy of training for child protective investigators and case managers only compound the issue.

It is crucial for Florida and other states to promptly address these systemic concerns to protect the health and well-being of foster children and prevent further tragic incidents. Adequate management of medications, meticulous record-keeping, and rigorous oversight are indispensable to ensure that these children receive the appropriate care they require, safeguarding their rights and safety.

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