Florida Times Union
Florida foster kids slower to get medications now
The new rules come after a 7-year-old boy hanged himself in April.
By Brandon Larrabee
TALLAHASSEE – New practices after the death of a 7-year-old foster child who took psychiatric medications have slowed the flow of the drugs to children in state care, local health-care providers say. Whether those changes are for the better is a contentious question.
The renewed attention to so-called psychotropic drugs comes in the wake of the hanging death of Gabriel Myers of Fort Lauderdale, whose apparent suicide in April led to an ongoing examination by the Department of Children & Families. His death sparked promises by lawmakers to strengthen laws aimed at preventing the overuse of the medications by foster children.
It is the latest chapter in an international battle over how and whether the drugs should be used, with medical professionals stressing they are largely safe for older patients but advocacy groups pointing to suicides, particularly among children, as a reason use of the medications should be curtailed. Those fears have prompted the FDA to put a “black box” warning on the drugs.
The task force investigating Myers’ death found hundreds of children were on psychiatric medication without a paper trail showing consent. DCF has in recent months put a renewed emphasis on ensuring that it has the required parental consent or court order for children taking the drugs.
“It has slowed down in some cases the child physically taking the medicine,” said Denise Marzullo, clinical director for Northwest Behavioral Health Services in Jacksonville.
Marzullo said more paperwork has been required recently, perhaps in the last year or so, but that some DCF caseworkers are also ready with the required consent as soon as the child is prescribed the medication, cutting back on delays in those cases. And she said the often tumultuous life of children in state care doesn’t mean that taking time to get the drugs correct, and make sure other drugs might not cause a negative reaction, is a bad thing.
“Who knows what they’re taking from foster home to foster home?” she said.
But Joe Zichi, clinical director at Psi Family Services in Jacksonville, said the problems can actually be interrelated; children who aren’t on the proper medication can actually be shifted from foster parent to foster parent because of adults who don’t know how to care for them.
“Further damage has been done, because he’s been rejected three more times by adults in his life,” Zichi said, using a hypothetical example.
Policies that delayed getting drugs to children picked up steam after Myers’ death, Zichi said, and Psi has dealt with requests from the state for documents like proof a child was tested for sickle-cell anemia or a patient’s dental records before approving prescriptions.
“We’re seeing more and more stuff come down from Tallahassee,” he said. “We don’t need to be going through all these steps when the child needs help yesterday.”
Alan Abramowitz, director of DCF’s Family Safety Program Office, said the agency is working to more clearly spell out what paperwork doctors and the agency need to have a good grasp on a child’s medical history before writing a prescription. Physicians with a question about an unusual state request should contact the agency, he said.
But Abramowitz also said the state is simply following the law and trying to ensure that the drugs are necessary before a prescription is written.
“We want those obstacles,” he said. “Those obstacles are good. Those things are going to make sure a child is not being put on medication as an easy fix. … The purpose of the medicine can’t be just so you don’t act out.”