Monthly Archives: April 2010

Effort to protect children from overmedication fails

Miami Herald
The product of state child welfare administrators’ half-year of soul-searching, a bill to protect foster kids from powerful mental health drugs is killed by doctors.
BY CAROL MARBIN MILLER AND MARC CAPUTO
April 30, 2010

TALLAHASSEE — When a heavily medicated foster child died of an apparent suicide, the response seemed obvious: Better oversight of the way doctors prescribe psychiatric drugs to children in state care.

But in the waning days of Florida’s 60-day lawmaking session, what looked like common-sense regulation to some has no chance of passing, a victim of conflicting ideologies and the power of doctors and psychiatrists in the Capitol who don’t want government telling them what to do.

The bill, sponsored in the Senate by Sen. Ronda Storms, a Valrico Republican, would have required doctors to seek the “assent” of older foster kids before they could be medicated, and upheld provisions of current law that require doctors to gain consent from a parent or judge in most cases before a foster child could be drugged.

“I’m extremely disappointed,” said Jim Sewell, a former lawman who headed up a six-month investigation for the Department of Children & Families into the April 16, 2009, death of 7-year-old Gabriel Myers. “For all of us, this was a real involvement of the heart, and to see it not get codified into law was a big disappointment.”

Sewell, a former Florida Department of Law Enforcement deputy commissioner who is now special assistant to DCF Secretary George Sheldon, presided over a series of public hearings on Gabriel’s death, and published a surprisingly frank report last November. Gabriel had been prescribed several mental-health drugs in the months before his death, including anti-depressants linked to an increased risk of suicide among children. Sewell’s report contained a host of recommendations for changes in state law — many of which were in the bill.

Among other things, the bill would have banned children in state care from being enrolled in clinical drug trials — a provision that gained momentum last month when Gabriel’s psychiatrist, Dr. Sohail Punjwani, received a stern warning from federal regulators over his conduct in a drug trial for an undisclosed psychiatric drug.

The measure flew through the Senate with unanimous votes in every committee. But in the House, Rep. Paige Kreegel, a physician, refused to even hear the bill in his Health Care Services Policy Committee.

“I don’t feel right now that we are in definite need of any additional regulation in the state,” said Kreegel, a Punta Gorda Republican. “There’s all kinds of regulation.”

Kreegel said he didn’t know the particular facts behind the case of Gabriel Myers — who authorities say hanged himself with a shower cord in the bathroom of his Margate foster home. But he said Storms’ legislation would effectively have stopped psychiatrists from prescribing medicine to needy children.

Kreegel called some of Storms’ statements about out-of-control doctors “baloney.” Storms was outraged that Kreegel was able to kill the bill — which was one of DCF’s highest legislative priorities.

“How can anyone be against protecting children?” Storms said.

Storms spent a feverish week trying to get around Kreegel’s procedural maneuver. She amended her bill onto a must-pass piece of legislation governing DCF. Then she persuaded Senate leaders to make the issue part of budget negotiations.

Among other moves, Storms passed around a Miami Herald story showing a Miami doctor had ignored scores of letters — and three office visits — from state health regulators who warned his mental health drug prescribing practices were potentially dangerous. One of the doctor’s patients, a disabled 12-year-old, died of complications from over-medication.

But the House balked at every turn.

Sen. Nan Rich from Weston, who will become the ranking Democrat next year, said the Houses’s failure to take up the bill will allow future child welfare administrators to “once again fall back into the path of least resistence” by using mental health drugs as a chemical restraint on unruly foster kids.

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Amendment to bill targeting foster kids’ medication draws fire


Miami Herald

Critics are questioning an amendment to a bill designed to protect foster children from being inappropriately medicated with mental-health drugs.
BY CAROL MARBIN MILLER

One of the largest providers of inpatient psychiatric care for Florida foster kids successfully pushed for an amendment to a bill that will make it easier for group homes and treatment centers to begin medicating foster children without the consent of a parent or judge.

Psychiatric Solutions, which operates 13 residential treatment programs in Florida, including three in Broward County, proposed an amendment to state Sen. Ronda Storms’ bill that will allow the company, and others like it, to administer mental-health drugs to young foster children for three days without the consent of a parent or judge. The legislation was prompted by the 2009 death of a 7-year-old Margate foster child, Gabriel Myers.

CONSENT NEEDED

Under current law, and under the bill that Storms, a Valrico Republican, proposed, children younger than age 11 in the care of the Department of Children & Families cannot be given psychiatric drugs without the consent of a parent, or a state judge in cases where the child’s parents have lost their parental rights.

In her bill, Storms proposes that caregivers for foster children must present a “compelling government interest” that medication is in the “child’s best interest.” The bill requires DCF to get an independent review in order to medicate children younger than 11.

In an e-mail to DCF’s legislative affairs director, Jim R. Henry, the director of Manatee Palms Youth Services, which is owned by Psychiatric Solutions, suggests that the state has, by definition, a compelling interest in allowing children to be medicated at treatment centers, since the kids already are presumed to be mentally ill.

Jeff Turiczek, who runs Manatee Palms, wrote in a March 26 e-mail that the amendment “basically [makes] the case that by the admissions requirements into those facilities the compelling governmental interest has been met.” In other words, a child entering a treatment center or therapeutic group home already has been diagnosed with a mental illness, and therefore may need to be medicated. Turiczek did not return calls seeking comment.

Storms said Friday she did not amend her bill to benefit the company. “It is true lobbyists come to see me,” Storms said. “No one said, hey will you do this from PsychSolutions, or whatever. I’m not trying to do it for any singe entity’s benefit. I am saying I want to fend off as much of the opposition as I can, so it gets through.”

Storms’ bill requires that doctors receive informed consent from a parent or guardian before administering mental-health drugs.

But the bill, as amended by Storms on Tuesday, makes exceptions: Doctors may begin the use of psychiatric drugs, without consent or a court order, if a child is in a mental hospital, a crisis stabilization unit, a residential treatment center or therapeutic group home. In such settings, DCF must seek a court order to administer the drugs within three days of beginning the medication.

Critics of the amendment note that children in such institutional settings are the most at risk of being inappropriately medicated.

In May 2009, during DCF’s investigation into the use of psychotropic drugs, the agency reported that 26 percent of children in group homes or other institutional settings were being given mental-health drugs, compared to 21 percent of children in foster homes and 4 percent of children living with relatives.

Jim Sewell, a special assistant to DCF Secretary George Sheldon who chaired a task force last year that looked into the use of mental-health drugs among foster kids, said supporters of the amendment had not spoken to him about it. “It was kind of a surprise,” he said.

“The language can be better, a lot of us believe. But rule-making authority will enable us to put things in place that ensure the protection of kids,” Sewell said.

Another member of the Gabriel Myers Work Group has expressed misgivings about the amendment. Gabriel died a year ago Friday after hanging himself in a foster home shower. He had been prescribed several mental-health drugs in the months before his death, including anti-depressants linked to an increased risk of suicide among children.

“The fact that a child needs residential treatment is not per se sufficient to say they need medication,” said Robin Rosenberg of Florida’s Children First. “I think there is too much potential for abuse.”

PROTECTING KIDS

Storms, who has been extremely vocal about her concern that doctors are relying far too heavily on drugs to manage troubled foster kids without first attempting other methods, said doctors still will have to seek consent from a judge. Storms said the bill will better protect children than current law.

She said she added the amendment to drum up more support for the bill, as she had received a number of calls from concerned treatment centers that they would not be able to medicate if a child were pulling out their hair, cutting themselves, or banging their head on a table without end.

Miami Herald staff writer Robert Samuels contributed to this report.

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Vigil will be held in memory of boy


St. Petersburg Times

CLEARWATER
Times staff

One of four statewide candlelight vigils in memory of 7-year-old Gabriel Myers, a foster child in state care who reportedly hanged himself while on three powerful psychotropic medicines, will be held from 7 to 8:30 p.m. Friday on the bike walk of the Memorial Bridge in downtown Clearwater. Hosted locally by Dr. Elizabeth Young, Pamela Seefield and the Citizens Commission on Human Rights of Florida, the vigil will also address issues related to the right to informed consent. State Rep. Kevin Ambler, R-Tampa, will speak. For more information, call (727) 442-8820.

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