News Press (Fort Myers)
By Janine Zeitlin
The head of Florida’s child welfare agency vowed to carry out and put dollars behind recommendations in a recent report that shows officials have often ignored years-old guidelines on medicating children in state care.
Last week, the Department of Children and Families released a final report from a panel that investigated the death of a 7-year-old Broward County foster child, who hanged himself, and the system’s use of psychotropic medications.
“Before you can solve a problem, you’ve got to own to it and identify it,” said DCF Secretary George Sheldon. “I think they’ve done a very good job of doing that.”
The report concludes it’s essential all officials treat foster children like their own.
Sheldon said officials will first try to carve out resources internally to act on suggestions such as bringing on a medical director to oversee the use of mind-altering drugs.
He’s also considering requiring an additional review before any child is given such drugs. The report highlights the need for training, court advocates for all foster children and attorneys for those taking such medication.
“There might be some financial resources that are needed,” Sheldon said.
He said he’ll have a budget recommendation by October but has yet to determine how much more the agency might need.
“I want to present a responsible request to the Legislature, and we will look at these recommendations and price them out.”
In Southwest Florida, almost 13 percent of children in state care — 129 — are taking drugs such as antidepressants and mood stabilizers. Medications range from Adderall to Zoloft.
Statewide, it’s about 15 percent.
Education for judges and a bench reference on the medication were some recommendations made by Judge James Seals that were included in the report.
He presides over Lee County’s court for abused, neglected and abandoned children.
Also the president of the Florida Council of Juvenile and Family Court Judges, Seals testified before the panel.
“Much of our concerns flow from the fact that we know less than we ought to know,” Seals told the group earlier this month.
The law requires parental consent or a court order before doling out such medications. Seals said heading to a judge must be the last resort. He worried parents weren’t fully included or informed.
“I have doubts that parents really understand what they’re doing, and I fear that parents may even be pressured into signing consent forms.”
Seals later said he doesn’t know that for certain but is concerned the urgency in some cases might cause corner-cutting.
The informed-consent form used locally did not include American Medical Association guidelines such as looking at the risks and benefits of alternatives to treatment and of doing nothing, Seals said.
Sherman McDade, a Fort Myers father whose 6-year-old is in foster care, believes his son was on psychotropic drugs for attention deficit hyperactivity disorder without his consent.
He said he later argued in dependency court for him not to take the drugs.
McDade believed his son’s behavior related to the trauma of moving between multiple foster homes.
“The children get frustrated because they want to come home,” he said.
Trauma may be one factor leading to the over-medicating of foster children some advocates believe is happening.
Currently, a child is given a behavioral assessment within 30 days of coming into care, Sheldon said, noting that is when the child is most traumatized.
“I don’t think we should be making a long-term diagnosis at that point.”
Sheldon said the report shows the need for ongoing follow-up, which is not typically done, according to report findings.
It notes physicians often lack medical history and basics about the child when prescribing.
Among their next steps, administrators say, is working to develop a simple, straightforward policy.
On Aug. 10, a legislative committee sent a letter to DCF indicating an existing rule may not conform to the law on gaining consent for all psychotropic medication.
Children’s advocate and Coral Springs attorney Andrea Moore fought for existing legislation to protect foster children taking psychotropic medication.
“It’s very hard for people who work on this to see it come back again and after all this hard work, it’s ignored anyway,” Moore said.
She’s hopeful, noting Sheldon is showing a respect for the law.
He pledged to gain compliance on systemic failures that were identified.
“Regrettably, I’m afraid people said, ‘We dodged a bullet’ and it never got out into the field,” Sheldon said of past reviews on the issue. “That cannot be the case this time.”
For his part, Seals said he’ll be further questioning the consent that comes before him.
“I think the judiciary will be watching these motions for psychotropic medications more carefully.”