Friday, December 02, 2011

What If Every State Had Foster Care Medical Review Panel?

What if every state had a Foster Care Medical Review Panel, serving in a role similar to a Medical Ombudsman, that foster care youth, alumni, foster parents, CASA/GAL, etc. could contact with  concerns about over-medication?   

Forgotten Children A Special Report on the Texas Foster Care System Comptroller Carole Keeton Strayhorn (April 2004)


  • DPRS exercised little meaningful oversight over the treatment of foster children with psychotropic medications.
  • No formal investigation related to psychotropic medications had ever been conducted.
  • YFT did not attempt to assess the appropriateness of medications.
  • Many foster children were being prescribed psychotropic medications by physicians who were not trained in child psychiatry.
  • Even though federal law requires a foster child’s medical records to be reviewed, updated and given to foster care providers, foster care providers of 46% children in a study conducted by the OIG never received medical histories of the children in care, including children with serious medical conditions.   Without access to a child’s medical records, it was difficult for foster parents to effectively care for foster children.

Challenges Noted:
The Advisory Committee recognized that “[c]oncerns exist regarding the inappropriate use of psychotropic medication and inadequate monitoring of prescribed medications.  

There was also a lack of data available regarding physician prescribing practices and child outcomes.  Children in foster care may be subject to widely varied standards of care.  There is currently no way to monitor the quality of care and no system for resolving concerns associated with the use of psychotropic medication for children. 

Also there is no method for “second” opinions to be easily obtained by DFPS staff when they have concerns or questions.”

In response, their plan was to:
  • Develop review panels of medical professionals including (trauma-informed) child psychiatrists to provide recommendations regarding care for foster children where there is a question on whether their care is clinically appropriate.
  • Establish clinical guidelines and protocols for psychotropic medications and a review process for identifying children’s medical records that fall outside the guidelines and reviewing them for inquiry or possible corrective action.
  • Develop a medical and educational passport for each child that follows the child through placement changes and is readily available to healthcare providers and schools electronically.

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