Declaring that mental-health drugs have
uses other than the treatment of psychiatric problems, Florida child
welfare administrators have sometimes ignored a 2005 law that requires
the agency to obtain the consent of a parent or judge before giving
mind-altering medications to foster children.
The head of the state
Department of Children & Families acknowledged Friday that an
agency administrator has allowed caseworkers to bypass the requirement
when a foster child's doctor insists such drugs are not being used for
psychiatric purposes.
''He did take that position,'' DCF
Secretary George Sheldon said of Frank Platt, a DCF policy analyst who
oversees medication of foster children. ``He won't take that position
tomorrow.''
''That is not our policy, and I intend to make that
clear,'' Sheldon added, saying he does not know exactly how many
children were medicated without a parent or judge's consent as a result
of the directive. He has asked a work group to pull the files of every
child in state care to ensure state law is being followed, he said.
Sheldon's
comments Friday, in an interview with The Miami Herald, come amid a
far-reaching department inquiry into the use of sometimes powerful
psychotropic drugs among the 35,000 children in DCF's care. The
investigation was prompted by the death last month of Gabriel Myers, a
7-year-old Broward boy who hanged himself in a foster home.
Though
Gabriel had been prescribed several psychotropic drugs in his last
months, DCF administrators acknowledge he started taking the drugs
before a judge was asked for consent, and DCF's computerized record
system did not accurately reflect the medications he was prescribed.
DEEPER ISSUE
Some
Florida lawmakers, who ended their annual session Friday, are
suggesting Gabriel's death may be a symptom of deeper problems. The
2005 law was passed after lawmakers became concerned that kids in
foster care were being needlessly medicated to control difficult
behavior.
''This case raises serious concerns which demand
attention and answers,'' Sen. Ronda Storms, a Brandon Republican who
chairs the Children, Families and Elder Affairs Committee, wrote in an
April 27 letter to Sheldon.
Among the questions, she said: ``To
what degree, if any, has the [department] ignored or circumvented . . .
the 2005 law which curbed the use of psychotropic drugs in the
treatment of our children in department care?''
A former lawmaker
who authored the 2005 legislation, Walter G. ''Skip'' Campbell, a
Democrat who also chaired the children's committee, accused the
department Friday of ''cooking the numbers'' in an effort to make it
appear DCF had curbed the use of mental health drugs to manage the
behavior of unruly children.
In a report last September to the
Florida Senate, DCF said less than 7 percent, or 2,307 foster kids,
were on such drugs, and in almost all cases the agency had received
proper consent. But the report to lawmakers relied on DCF's internal
database, called Florida Safe Families Network, or FSFN, which
administrators long have acknowledged is unreliable.
In a
September 2006 memo, DCF's then-director of family safety, Patricia
Badland, said DCF's computer system recorded that only 4 percent of
children in the state's care were being given psychotropic drugs -- but
a separate system kept by Medicaid said nearly 12 percent of such
children were on psychotropic medications.
''This discrepancy
would . . . indicate there is under-reporting of children being
prescribed psychotherapeutic medications,'' Badland wrote. ``It is
critical that the . . . database be accurate and up-to-date to assure
that we are able to monitor all children taking these medications.''
Eight
months later, DCF reported to the Senate that, among all age groups,
11.3 percent of children in DCF's care from September through November
2006 had been prescribed mind-altering drugs.
DCF RESPONSE
Sheldon bristled at the suggestion his department intended to mislead lawmakers.
''I
don't think there was an overt effort to misrepresent or cook the
numbers,'' he said. ''But I do think there was an over-reliance on our
database. I think we should have put more time and energy'' into
preparing the Senate report.
Beginning in 2001, The Miami Herald
reported that child welfare administrators were relying on powerful
mind-altering drugs to manage the behavior of unruly foster kids, who
sometimes developed dangerous side-effects. Advocates accused the
department as using such drugs as ''chemical restraints,'' eventually
leading to the 2005 law.
Dr. Ewald Horwath, interim chairman of
the University of Miami Medical School's psychiatry and behavioral
sciences department, said that although some mental health drugs can
have different uses, they are still psychiatric drugs.
''What use
can one have for an anti-psychotic drug, other than a psychiatric
one?'' said Horwatch, who has no connection to either the agency or its
critics.
He said the requirement for informed consent is
important so that parents or other caregivers can make well-reasoned
decisions on children's behalf.
''It seems to me you would want
parental consent before prescribing,'' he said. ``You would want
someone exercising judgment in place of the child, who cannot make
decisions on whether benefits outweigh risks.''
Referring to the
consent issue, Sen. Rudy Garcia, a Hialeah Republican who is a member
of the Senate Children, Families and Elder Affairs Committee, said
Friday: ``These are the types of things that we've been worried about
that fall through the cracks. These are the things that I believe keep
the secretary [of DCF] awake at night.''
Miami Herald staff writer Breanne Gilpatrick contributed to this report.