Struggle to fix foster system

Sarasota Herald Tribune
TRACKING PROBLEMS: Changes prompted by suicide of 7-year-old
By KELLI KENNEDY The Associated Press

FORT LAUDERDALE – Kimberly Foster was on psychotropic medications every day during the decade she spent in foster care.

Locked in a mental facility with green walls, barred windows and four-point restraints from the age of 8, Foster said her actions were easy to explain: She was sad she could not be with her mother.

“They looked at me as a troublemaker instead of a child who is coming out of a troubled environment. If you cry, you’re depressed. If you act out in school, you’re a behavior problem. We’re so quick to put these diagnoses on children,” Foster, 25, said Thursday in a meeting with officials from the Department of Children and Families. “Youth in foster care are overmedicated, overdiagnosed.”

As state officials wade through the systemwide failures that led to the suicide of 7-year-old foster child Gabriel Myers in April, two issues come up repeatedly: the alarming use of psychotropic medications and the inability of doctors, foster parents and caseworkers to track problems with such powerful medications.

About 2,699 children in out-of-home foster care, or about 13 percent, are taking psychotropic drugs. That compares with about 4 percent to 5 percent of children in the general population, according to a recent DCF study.

Problems range from incorrectly entering basic information like a child’s gender and age into a database to overloaded and inexperienced case workers who are expected to understand warning labels on psychotropic medications.

Even logistics of accompanying a foster child to a doctor fell short. Forty percent of the 112 foster children whose files were studied were not accompanied to their appointment. Many were dropped off by medical transport, making it harder for an adult to communicate crucial details about treatment.

Some officials proposed further training for foster parents and case workers, while others worried a four-hour training session on psychotropic drugs and what to look for would change little. Especially in a system with a nearly 50 percent turnover rate among case workers.

“Global training is important but I don’t think it’s going to get us to the level of specificity that we need,” said William Janes, a member of the work group examining the boy’s death. He stressed the importance of case managers.

“It’s not about psychotropic medications solely,” he said. “It’s about the care that this boy did not get.”

Basic analysis of medications for children in state care — such as what medication they were taking, why and when it was prescribed, and whether it worked — is not being completed in many cases. That information was supposed to be collected beginning in 2005.

“But it did not see the light of day,” said Dr. Rajiv Tandon, a work group member who is a psychiatrist at the University of Florida. “This particular form was an integral part of that plan and it never happened.”

In Gabriel’s case, his foster parents and teachers reported disturbing behavior, including sexual advances toward classmates. At one point, the child admitted to trying to strangle himself.

Yet his doctor continued on the same treatment plan.

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