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Fla. officials struggle to reform foster system

Mlive.com (Michigan)
By KELLI KENNEDY
The Associated Press

(AP) — FORT LAUDERDALE, Fla. – 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 eight, Foster said her actions were easy to explain: she was sad she couldn’t 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,” the 25-year-old Foster 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 case workers 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 simply 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’s appointment fell short. Forty percent of the 112 foster children’s files studied, were not accompanied to their appointment. Many were dropped off by medical transport, making it that much harder for an adult to communicate crucial details about the child’s 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.

“The whole system broke down in the community,” Janes said. “Everybody involved in this case was disconnected from that level that we would expect at some degree.”

Mez Pierre, who entered the foster system at age 5, said he was given plenty of medication but very little emotional support.

“I felt like I was an animal in a farm being tested on,” the 22-year-old told DCF officials Thursday. “Irresponsibility is just not worth a life. We need to do whatever we can to make sure another Gabriel does not happen again.”

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Report focuses on Fla. foster kids’ prescriptions

MLive.com – (Michigan)
BILL KACZOR
The Associated Press

(AP) — TALLAHASSEE, Fla. – Proper authorization wasn’t obtained for 16 percent of the Florida foster children who have taken antidepressants and other prescribed psychotropic drugs, according to a study ordered after one of those youngsters apparently committed suicide.

Florida Department of Children and Families Secretary George Sheldon announced the findings at a news conference Thursday.

A photo of 7-year-old Gabriel Myers was projected onto a screen behind Sheldon, who said there was no excuse for failing to comply with a law that requires parental consent or a court order for such prescriptions.

The drugs affect the central nervous system and can change behavior or perception. They are prescribed for depression, anxiety, schizophrenia and other psychiatric conditions. Some are used to alleviate pain.

Gabriel was found hanging from a shower cord in the bathroom of his foster parents’ Margate home April 16.

“Anyone who’s heard of Gabriel’s story, I know, is in disbelief and parents everywhere are wondering themselves how could this have happened,” Sheldon said. “Normally a 7-year-old boy is learning to read and tie his shoes, not contemplating death.”

Sheldon has appointed a task force headed by Jim Sewell, a former Florida Department of Law Enforcement assistant commissioner, to determine if the drugs he was taking or alleged sexual abuse were factors in his death. Records show he had allegedly been molested by an older boy in Ohio, where he had lived until last June.

The panel also is looking into whether psychotropic drugs are being prescribed for the wrong reasons. Critics say they are misused as a chemical restraint for unruly children.

Sheldon said he expects to receive the panel’s finding within two months.

Officials early on realized the department’s database failed to show Gabriel had been taking the drugs and they had been prescribed without proper authorization, Sheldon said.

Sheldon then ordered a check of all foster children’s records. The resulting report shows parental consent or court orders had not been obtained for 433, or 16 percent of 2,669 foster children receiving such drugs.

“That is unacceptable,” Sheldon said.

The report also indicates the 2,699 children taking psychotropic drugs comprise 13 percent of all Florida children in out-of-home foster care. That compares to only an estimated 4 to 5 percent of children in the general population.

It’s a discrepancy that raises a “red flag,” Sheldon said, but he added that he’ll wait for the task force’s findings before making any judgments.

“We need to constantly keep the face of Gabriel Myers continually in our minds and in our hearts and get this right,” Sheldon said.

Sheldon said he didn’t believe an erroneous memo issued by his department contributed to failures to obtain parental consent or court orders. It said those requirements could be bypassed if psychotropic drugs are prescribed for non-psychiatric purposes. Sheldon said few people knew about the memo and he rescinded it when he found out about it.

The department, private contractors working for the agency and legal service lawyers will try to obtain parental consent or court orders for all children who have been prescribed such drugs by June 5. Sheldon said he also is asking dependency judges to expedite those cases.

Parents must be advised about specific drugs including warnings of potential hazards before giving informed consent, Sheldon said.

Standard medical consent forms, such as one Gabriel’s mother signed, do not meet that requirement. Sheldon said Candace Myers also may have been high on prescription drugs when she signed the form as authorities took the boy away from her in a restaurant parking lot. Xanax and other prescription drugs were found in her car.

During the last few weeks of his life, Gabriel’s mother lost her visitation rights and he lived in three different foster homes, was told he was going back to Ohio, lost his toys, changed therapists and switched psychotropic drugs, Sheldon said. He said those changes would have been traumatic for anyone regardless of age.

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