From The Oregonian, November 25, 2007 – not available elsewhere online

Oregon lawmakers said Monday that they’re determined to fix problems with the state’s oversight of psychiatric medications given to children in foster care.

Oregon Senate President Peter Courtney, D-Salem, said the Legislature will hold hearings when lawmakers reconvene in February to examine how well the Department of Human Services supervises the use of mental health medications.

“The state is responsible for the well-being of these children,” Courtney said in a statement. “We need to determine if agency policies are putting the health and potentially the lives of some of our most vulnerable citizens in jeopardy.”

Courtney’s announcement follows a story in The Sunday Oregonian that found more than one in four children in foster care in Oregon take drugs to treat depression, anxiety and other mental health problems.

The newspaper found that 2,400 children in foster care received these drugs in a recent 12-month span — a rate more than four times that of other Oregon kids.

Experts say the drugs can help troubled children in foster care, who often face higher rates of mental problems. The kids have faced grave abuse and neglect or were exposed to drugs and alcohol before they were born.

The newspaper found, however, that the state’s child-welfare system does little to monitor the use of these medications. And state officials ignored warnings from a panel of experts who raised concerns about allowing foster parents to make decisions to medicate children without state consent or adequate medical review.

Dr. Bruce Goldberg, the director of the Department of Human Services, asked for a review of the rules governing the use of psychiatric drugs by children in foster care after The Oregonian raised questions about the practices.

Rep. Wayne Krieger, R-Gold Beach, spent the past two years working with a bipartisan group of legislators on ways to improve the state’s child protection system. He said he welcomes hearings.

“There might be times I disagree with Senator Courtney, but I think he’s right on,” said Krieger, who also spent more than a decade as a foster parent.

Rep. Carolyn Tomei, chairwoman of the House Human Services committee, said she was alarmed by how little medical review the state’s child-welfare system provides as a safeguard for children in foster care placed on psychiatric medications.

“We have just one lone nurse to do the job,” said Tomei, a Milwaukie Democrat. “This is just shocking.”

Tomei said she served as a foster parent and later worked for the state supervising foster homes.

“It’s understandable these children have their own sets of problems, and they might be on medications,” Tomei said. “What’s appalling to me are the sheer number of children on several drugs, and that the state seems to have no oversight.”

Rep. Sara Gelser, D-Corvallis and vice-chairwoman of the committee, thinks the Legislature ought to consider whether children in foster care are getting appropriate screening for conditions, such as autism, that might be better off with some other type of treatment.

Gelser also has questions about how well the state’s system monitors the diagnoses and treatments for children in foster care.

“What is the point of administering the medication to a child? Is it for their well-being? Or is it management of the child within the system?

“If it’s the second,” she said, “we’re failing the children.”

Gov. Ted Kulongoski “takes very seriously the state’s responsibility for the health and welfare of the children in foster care,” his spokeswoman Patty Wentz said Monday. “We support the DHS internal review and the Senate’s review committee and will review the findings carefully.”

Courtney, the Senate president, also said he takes the Legislature’s oversight role seriously.

He is “appalled” by the newspaper’s report that a law passed in 1993 — after a 7-year-old boy in foster care died of an overdose of a drug meant to calm him — is being largely ignored. He said the story shows the need for better legislative supervision of the state’s human services agency.

“We have to find out what the hell we’re dealing with,” he said.

Psychiatric drugs and children in foster care

29.4 percent of children living in foster homes were prescribed at least one psychiatric drug over a 12-month period — a rate 41/2 times that of other Oregon children covered by Medicaid.

The drugs included Ritalin, prescribed for attention deficit disorders, as well as anti-depressants such as Prozac and Zoloft.

Unlike some states, Oregon allows foster parents to ask a doctor to start a child on a new drug without consent of the child’s parent or caseworker.

Foster parents must disclose when they put a child on psychiatric drugs and keep medication logs — but those rules aren’t always followed.

The state lacks a database to help caseworkers track what psychiatric drugs a child may be on.

To read The Oregonian’s stories on the medications used by children in foster care homes, see http://www.oregonlive.com/politics/oregonian/ For information on the Legislature’s February session or to contact your state lawmaker, go to http://www.leg.state.or.us/