Governor Brown signs Senator McGuire's bill on psychotropic medication for foster youth; release claims strongest protection in U.S.

Over the past two years, Senator Mike McGuire has chaired four oversight hearings, requested and received a scathing state audit, held countless meetings with foster youth, advocates and families, and today has passed legislation that will become the strongest law in America focused on protecting foster youth from medical professionals who are overprescribing psychotropic medication.

California’s foster care system has become addicted to psych meds – prescribing rates have increased 1400% over the past 15 years – and the problem has impacted thousands of California’s foster youth for more than a decade.

Today, Governor Jerry Brown signed Senator McGuire’s legislation to ensure the state has the ability to monitor the administration of these mind numbing drugs among our state’s foster youth. SB 1174 establishes a formal, on-going process for the California Medical Board to responsively review and confidentially investigate psychotropic medication prescription patterns outside the standard of care. And in the worst cases, revoke the medical license of a proven serial over-prescriber.

“This legislation stems from a culture that has developed in our State’s foster care system where excessive prescriptions of psychotropic medication have become the norm and have impacted the lives of thousands of California’s most vulnerable youth, foster kids,” Senator McGuire said. “California is now the only state in the nation where a medical professional can lose their license to practice medicine if they are proven to be a serial over-prescriber of these powerful drugs. This bill ensures the state takes a no tolerance approach to over-prescribing and that the Medical Board and Attorney General get the data they need to protect California’s 66,000 foster youth.”

In 2014-2015, over 8,000 complaints were advanced to California’s Medical Board about over-prescribing of medications, but not one complaint came from the California foster care system.

While the Federal Child and Family Services Improvement and Innovation Act of 2011 requires each state to oversee and monitor the use of psychotropic medications, California currently has no requirements to identify those who are over-prescribing medication to foster youth. The state has no system for evaluating the medical soundness of high rates of prescribing and no way to measure the efficacy of these practices. In fact, the California Medical Board, doesn’t even have the authority to review psych med prescribing patters for foster youth.

McGuire’s bill will change this by establishing a formal, on-going process for the California Medical Board to responsively review and confidentially investigate psychotropic medication prescription patterns among California’s foster youth. If an over-prescription pattern is discovered, the Medical Board can advance that case to the California Attorney General and pending their confidential investigation, the medical professional’s license can be revoked.

It is simple, without data, the medical board cannot perform their mandated oversight duty. SB 1174 will enable California to implement what is already standard oversight practice in Washington, Illinois and Ohio. These state initiatives have shown a 25 percent decrease in dangerous prescribing practices and have improved the overall prescription frequency for medically acceptable reasons. 

Nearly 1 in 4 California foster teens are prescribed psychotropic drugs; of those, nearly 60 percent were prescribed an anti-psychotic – this is the most powerful drug class that is susceptible to damaging side effects. Thirty-six percent are prescribed multiple medications. Teens in foster care are three and a half times more likely to be prescribed psych medication than their peers who are not in foster care.

“This is unacceptable given that it is the state’s responsibility, as the guardian of these children, to monitor the administration of these drugs and to ensure the health and well-being of foster children. Our state’s foster youth deserve better, including access to proactive and sustained mental health services. When medication does become necessary, we need to create a better system that includes assessment and accountability measures,” Senator McGuire said. 

Another accountability measure that McGuire and the Senate Human Services Committee advanced last year was an audit of prescribing patterns of psychotropic prescriptions among foster youth. The scathing audit, “California’s Foster Care System: The State and Counties Have Failed to Adequately Oversee the Prescription of Psychotropic Mediations to Children in Foster Care,” was released several weeks ago and a formal hearing to present the audit was held Monday.

The audit and hearing were initially scheduled to be released and held in June, however at the last moment the Department of Health Care Services notified the Auditor that it had failed to provide 617 million medical service records that were relevant to the Auditor’s review. After a two month delay, the audit was finalized and recommended better state oversight of county prescribing patterns to foster youth. One key finding is the need to improve the current system of tracking prescription use which, in many cases, involves a foster parent taking a doctor’s note to the social worker for input into the statewide database.

The auditor found that in many cases, counties weren’t receiving the mandated permissions prior to prescribing these mind-numbing drugs, counties and the state have not been uploading and tracking prescription data and that children were prescribed multiple psychotropic medications, medications in higher dosages and medications without recommended follow up doctor’s visits at significant rates. The report also identifies a lack of concurrent psychosocial services provided to children who are taking psychotropic medication. Data in the auditor’s report also shows that more than one-third of all paid psychotropic medications were for anti-psychotic drugs, which pose significant risks for side effects for children. State Auditor Elaine Howle detailed her findings during a hearing at the State Capitol Monday