child-welfare administrators are largely ignoring a host of rules put
in place to protect children from potentially dangerous -- and
sometimes unnecessary -- drugs, according to a detailed state review of
the records for more than 100 young foster children who are being given
powerful psychiatric medications.
Caseworkers under contract with the
state Department of Children & Families are failing to comply with
almost every benchmark governing the use of psychotropic medication
among foster children, according to the DCF report, obtained Tuesday by
The Miami Herald.
''The deeper I get into this thing, the more my
blood pressure rises,'' DCF Secretary George Sheldon said. ``This
really is unacceptable.''
The study, which included 112 children
younger than age 6, is the most recent measure of the state's progress
in curbing mental-health drug use among foster children since the April
death of a 7-year-old boy who had been given several psychiatric
medications during a nine-month stay in foster care.
revelations come only four years after state lawmakers passed
legislation to curb the use of mental-health drugs among children in
state care. The law requires, among other things, informed consent from
a parent or judge, second-party review of doctors' prescriptions for
the youngest children, and annual reports to the state Senate.
the most troubling findings, child advocates say, is the state's almost
complete failure to seek a second opinion from a psychiatrist under
contract with DCF before administering mental-health drugs to the
youngest children in state care -- younger than age 6.
it was bad. We just didn't know it was this bad,'' said Andrea Moore,
the former head of Florida's Children First, who has led efforts to
reduce the state's reliance on mental-health drugs for almost a decade.
``It is more than frustrating, because children have been left at
Sheldon, who ordered the ongoing reviews, said he, too,
is not surprised by some of the findings, though he was a bit struck at
``the number of places the system has broken down.''
physicians don't want to be second-guessed. Some case-management
agencies were aware of our policies, but haven't been communicating
them to caseworkers. And you've got the department that hasn't been
doing appropriate oversight,'' Sheldon said. According to the study,
conducted over three days last week:
did not complete a treatment plan for 83 children, or 74 percent of the
112 whose files were studied. The treatment plans are designed to
ensure that troubled children receive psychological care, in addition
to drugs, and do not become overly reliant on powerful medications.
more than 95 percent of the cases studied, the foster child's doctor
did not review his or her plans with a consulting psychiatrist under
contract with DCF to ensure the children in state custody are well
• In 72 percent of
the files studied, caseworkers had entered inaccurate data in the
state's computerized child-welfare database, called Florida Safe
Families Network. Erroneous information included mistakes about the
names of medications and dosages prescribed.
• Caseworkers had failed to obtain informed consent for the medications for 45 percent of the children studied.
issue of consent has gained significance in the wake of the April death
of Gabriel Myers, a 7-year-old foster child who hanged himself in the
bathroom of his Margate foster home. A report in The Miami Herald that
Gabriel had been on several mental-health drugs -- including
anti-depressants linked to an increased risk of suicide among children
-- prompted DCF's investigation on the use of such drugs.
percent of the kids, parents already had been stripped of their right
to raise the children, potentially freeing the children for a possible
adoption, the report said.
The lion's share of the 112 youngsters
whose cases were reviewed last week were age 5, said DCF Family Safety
Director Alan Abramowitz, and most of the children had a diagnosis of
attention deficit/hyperactivity disorder.
None of the foster kids
in Miami-Dade in the study younger than age 6 were taking mental-health
drugs, and only three from Monroe County were on such drugs. Ten
Broward County foster children younger than 6 were included in the
''What concerns me is that the Legislature may have taken
action, a lot of attention was paid to it, we wrote a lot of policies
-- and then just assumed those policies would be followed,'' Sheldon
said. ``Frankly, there's got to be an enforcement arm that goes along
with that, and an oversight arm.''