Category Archives: St. Petersburg Times

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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In wake of child’s suicide, Legislature moves to limit foster care’s reliance on psychiatric drugs

St. Petersburg Times
By Cristina Silva, Times Staff Writer

TALLAHASSEE — A year after a 7-year-old boy heavily medicated on powerful psychiatric drugs hanged himself in his Margate foster home, lawmakers are pushing to reform state medical requirements for foster children.

The Senate’s Children, Families, and Elder Affairs Committee unanimously approved a measure Thursday designed to curb the prescription of mental-health drugs to children in state care.

The proposed law would require the state Department of Children and Families to assign volunteer guardians to oversee each child’s mental health care. It prohibits foster children from being the subject of clinical drug trials and raises the age at which children are allowed to take these drugs from 6 to 11 in many cases.

The measure (SB2718 and HB1567) would also give children some say in the drugs they take.

“We are not just going to medicate them until they turn 18 and then dump them into adulthood,” said sponsor Sen. Ronda Storms, R-Brandon, chairwoman of the Children, Families, and Elder Affairs Committee.

The state’s growing use of adult medication on emotionally and mentally troubled children has sparked debate for years.

Multiple state studies show child-welfare doctors and case managers routinely failed to follow legally required treatment plans or properly document when and why drugs were given to foster children, creating a network of youth sedated by “chemical straitjackets,” Storms said.

The death of Gabriel Myers in April further revealed the shortcomings of 2005 legislation that required more information sharing, parental involvement and second-party review of doctors’ prescriptions for the youngest children.

Because foster children are often cared for by multiple service contractors, communication lapses and fragmented mental health care are still rampant, a recent state report on Myers’ death determined.
“Our response to him was to medicate him, and medicate him, and medicate him,” Storms said.

Under the bill, proposed medical treatment plans must be explained to a child and the child must consent to the treatment in many cases before taking the drugs.

“What this means is less medication and more behavior analysis so that they are not just sedated little zombies,” said Jan Montgomery, president of the Florida Association for Behavior Analysis, which would train legal guardians to observe and treat behavioral problems.

Still, Montgomery said she did not expect a sudden culture shift, given failed past efforts to track foster children’s medical records.

“It’s going to be a slow slide toward what we are hoping is the right way,” Montgomery said.

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Role of drug questioned in boy’s suicide

St. Petersburg Times

FORT LAUDERDALE — It is unclear whether powerful psychotropic medications played a role in the death of a 7-year-old foster child, and the boy may have hanged himself for attention, according to a medical examiner’s report released Thursday.

Gabriel Myers locked himself in a bathroom and hanged himself with a shower cord in April, but the report classifies his death as undetermined. The report says it’s possible Gabriel did not intend to kill himself and did not fully understand the finality of his actions.

“His psychiatric history suggests that this fatality may represent a tragically flawed attempt of self-injury for secondary gain,” wrote Dr. Stephen Cina, Broward County’s deputy chief medical examiner.

Gabriel was on several powerful psychotropic medications, including Symbyax, before his death. That drug carries a U.S. Food and Drug Administration label warning for children’s safety and increased risk of suicidal thinking. It is not approved for use with young children, but doctors often prescribe them.

The boy’s death prompted debate at the state’s child welfare agency about stricter rules for prescribing powerful antidepressants and other drugs to foster children. The drugs affect the central nervous system and can change behavior or perception. They are prescribed for depression, anxiety, schizophrenia and other psychiatric conditions.

Critics say the drugs are overused for unruly children. A report by the Department of Children and Families released earlier this year indicates the 2,699 children taking psychotropic drugs account for 13 percent of all Florida children in out-of-home foster care. That compares with only an estimated 4 percent to 5 percent of children in the general population.

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Panel says foster care workers ignored drug policies for kids

St. Petersburg Times
By Kris Hundley

Foster care workers at all levels routinely ignored policies designed to protect children in their care from being given psychotropic drugs without proper consent or monitoring. That was the conclusion of a panel looking into the suicide of Gabriel Myers, a 7-year-old foster child who killed himself in April while taking two psychotropic medications.

The 26-page report, released Thursday, highlighted a lack of communication, inadequate supervision and inaccurate information in the Department of Children and Families’ handling of Myers’ case. About 15 percent of foster children in out of home care are on at least one psychotropic medication.

DCF’s secretary, George Sheldon, said he looks forward to hearing the work group’s recommendations. Among the options: a second-party review of all foster children on psychotropic drugs regardless of the diagnosis.

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Officials working on better way to track foster kids’ medical, court histories


St. Petersburg Times

By Ileana Morales

TAMPA — The group formed after the 7-year-old boy’s suicide in April.
The idea was to examine his death and prevent similar ones, but the group has found itself struggling to solve the problem of simplifying paperwork for the medical histories of Florida’s foster children.

The Department of Children and Families’ Gabriel Myers Workgroup met for the fifth time on Friday. Members want fewer but better forms tracking foster children to lessen the burden on case managers already swamped with cases of paperwork in their cars.

But the question of how to do that remains unanswered.

Gabriel Myers, 7, hanged himself with an extendable shower hose in his South Florida foster home. He was taking a combination of psychotropic drugs without state-required approval from his parent or a judge.

After Gabriel’s death, DCF secretary George Sheldon said he intended to require consent for each prescription of psychiatric drugs. Then he started the task force.

Still, problems abound. Case workers didn’t provide prior medical information to prescribing physicians in 65 percent of cases and failed to inform parents of prescriptions in 85 percent of cases, according to a recent DCF report.

Employees need support from a better system, said Bill Janes, DCF assistant secretary for substance abuse and mental health.

Maybe a checklist for case managers, said Dr. Rajiv Tandon, a University of Florida psychiatry professor.

Sheldon encouraged the panel to create a whole new system if necessary and leave the worry of budgetary constraints to him.

Our Kids, a group focusing on child welfare in Miami-Dade and Monroe counties, presented on Friday its progress with an electronic database of documents for 3,500 foster children. It highlights each child’s current prescriptions and missing paperwork in the electronic case files. Medical histories and scanned court orders or other related documents are available through the program.

“We didn’t do this with millions and millions of dollars,” said Pat Smith, the agency’s chief information officer. “It’s a very simple program.”

Wurm hopes DCF gets on board to find the quickest route to the group’s statewide goal. One way may be through new legislation.

The next public meeting is Aug. 5 at the DCF Suncoast Regional Office, 9393 N Florida Ave., in Tampa.

Ileana Morales can be reached at imorales@sptimes.com or (813) 226-3403.

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DCF’s child-drugging problems

St. Petersburg Times

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Child-welfare doctors and case managers routinely failed to complete legally required treatment plans, share information or properly document the prescribing of powerful psychiatric drugs for children, according to a new state study of 6- and 7-year-olds medicated in state care.

One of the 268 children was Gabriel Myers. The troubled 7-year-old, medicated with an adult anti-depressant known to cause suicides in children, hanged himself in April in his Margate foster home.

But the state study, which documents how many times caseworkers and doctors followed child-welfare rules and laws, shows that it would be a mistake to blame Gabriel’s death solely on the drug, Symbyax, said Florida’s drug czar, William Janes.

”It wasn’t just the medications,” said Janes, who sits on a committee investigating ways to prevent cases like Gabriel’s. “It was the system and his world. His environment just collapsed on him. And there was no one there to really put their arms around him.”

More here

— Marc Caputo

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DCF says its rules on children’s drugs are often ignored

St. Petersburg Times
In Print: Tuesday, July 7, 2009

TALLAHASSEE — Child-welfare doctors and case managers routinely failed to complete legally required treatment plans, share information or properly document the prescribing of powerful psychiatric drugs for children, according to a new state study of 6- and 7-year-olds medicated in state care.

One of the 268 such children was Gabriel Myers. The troubled 7-year-old, medicated with an adult antidepressant known to cause suicides in children, hanged himself in April in his Margate foster home.

But the state study, which documents how many times caseworkers and doctors followed child-welfare rules and laws, shows that it would be a mistake to blame Gabriel’s death solely on the drug, Symbyax, said Florida’s drug czar, William Janes.

“It wasn’t just the medications,” said Janes, who sits on a committee investigating ways to prevent cases like Gabriel’s. “It was the system, and his world. His environment just collapsed on him. And there was no one there to really put their arms around him.”

The Department of Children and Families study, presented Monday to the committee, indicates that a number of rules and laws on medication for children in state care weren’t followed for all 6- and 7-year-olds:

• In 86 percent of cases, the prescribing physician didn’t complete what’s known as a “psychotherapeutic medication treatment plan,” which helps caseworkers, legal guardians, judges and other physicians determine a child’s mental well-being.

• In 75 percent of the cases, the caseworkers did not provide physicians with pertinent medical information about the child.

• In 76 percent of the cases, the caseworker didn’t provide parents with information about the psychotropic drugs their kids were being prescribed. Nor did the caseworker help arrange transportation or phone conversations between the doctor and the child’s guardian.

• In 58 percent of the cases, the case manager didn’t attempt to speak with or meet the parent or guardian before seeking a court order to medicate the child.

The committee plans to issue a report by Aug. 20. It is only touching on Gabriel’s case, which is the subject of a Margate police investigation. Some doctors and caseworkers — all of whom work for privatized agencies under contract with the state — might face sanctions, pending the report.

Marc Caputo can be reached at mcaputo@MiamiHerald.com

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Foster care failures


St. Petersburg Times

Foster care failures | June 7, editorial

We must all make children a priority

As always, you lay out the problems confronting our child protection system fairly accurately and with surgical precision. I marvel at your knowledge of complicated matters such as psychotropic medications given to children. And I wonder why you seem to wait for errors to impart your wisdom and educate the citizenry.

Certainly I share your concerns for the children. I believe that most of us do. We also share your concerns about the overmedication of our seniors and our infirm. You mention the new protocols that may protect children from the errors of overmedication in the future, and write, “Such changes will only work if (Department of Children and Families Secretary George) Sheldon succeeds in changing a culture that ignored such safeguards.”

Here’s my point. The culture extends so far beyond DCF, which is but a reflection of the wider culture. Here’s how it sometimes feels to those of us working in the trenches of child protection: Citizens, make a choice. Which would you rather have in your community — a new sports stadium or an exemplary child protection system? If this choice was placed on the ballot, which proposition do you believe would win the vote and get the funding?

We, as citizens, parents, institutions and moral individuals need to change our minds and our hearts to make children a priority. We need to speak out and contribute before the next death or disaster. The victims are not foster care failures. They are our failures.

Douglas Bonar, Pinellas Park

Foster care failures | June 7, editorial

What are we doing to the children?

Your editorial was two-thirds on the mark in citing as foster care failures the “extraordinary prescription rate” for children under care of the Department of Children and Families and the way “a 2005 law aimed at tackling that problem” has been ignored.

The missing third is the most important: What in the world are we doing to these children that creates such a need for antipsychotic medication?

In my court I’ve seen psychiatric medication recommended for children as young as 4 and 5, because they are “out of control,” and for teenagers who are running away and breaking the rules. Those “out of control” preschoolers have been bounced from foster home to foster home. No wonder they are angry and defiant. Many of the teenagers have been given back to the state by relatives who liked them at 6, but not at 16. Kids need stability!

Irene Sullivan, Pinellas-Pasco Circuit Court judge, Pinellas Park

Foster care failures | June 7, editorial

Guardians needed

We can do at least two things to lessen “Foster care failures”:

1. Go to http://www.guardianadlitem.org and volunteer to become a Guardian ad Litem. The guardians are the only persons legally appointed to represent and advocate in the best interests of the child in the entire system, but most children do not have one. We have a desperate need for more trained guardians.

2. Don’t stand by and let Florida cut more of the budget that supports vital programs for children. Talk to your legislators and tell them that you care about children and will be watching how they vote.

Merle F. Allshouse, Guardian ad Litem, St. Petersburg

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A Times Editorial – Foster care failures

St. Petersburg Times

In Print: Sunday, June 7, 2009

Two disturbing facts about the Florida foster care system have emerged following the suicide of a 7-year-old boy on psychiatric drugs. First is the extraordinary prescription rate for children under the supervision of the Department of Children and Families. Second is the alarming revelation that a 2005 law aimed at tackling that problem has been repeatedly and systemically ignored.

So far, DCF Secretary George Sheldon, eight months into the job, is to be commended for the openness and urgency he has brought to the agency’s investigation. But his true challenge will be altering the culture of an agency that failed to implement the safeguards already in place.

Agency critics have long argued that too many foster children are being medicated for the convenience of caregivers. As of Friday, an ongoing review of DCF’s foster care database found that at least 400 more children are taking psychiatric drugs than initially thought. That means at least 3,068 — or 15 percent of the 20,000 foster children — are receiving the drugs, compared to 5 percent of the state’s children.

What’s more, DCF acknowledges at least 14 percent of the children received the drugs without the informed consent of the parent or the court. Sheldon believes the percentage is higher, because he suspects many parents weren’t adequately informed of potential side effects of such drugs or didn’t speak to the physician.

Sadly, the revelations come four years after concerns about pediatric use of antipsychotics and antidepressants — few of which have been tested or approved by the FDA for use by children — prompted legislative action. A 2005 law requires that all foster children’s prescriptions be approved by a parent, or if parental rights have been terminated, by the court. The law also made clear that DCF was to monitor children on such drugs.

In response, DCF included questions about medications and parental consent on its database software. Local providers use the program to create the official state record of each child. But time and again, Sheldon acknowledges, caseworkers have failed to fully complete the forms or lied about obtaining consent.

DCF’s failure to follow the law was laid bare by the tragic death of Gabriel Myers, a 4-foot-tall, 67-pound boy who hanged himself from an extendable shower hose at a South Florida foster home in April shortly after having his medication changed. He was taking Vyvanse, an ADHD drug, and Symbyax, a combination of the antipsychotic Zyprexa and the antidepressant Prozac. Symbyax carries a “black box” warning that it might lead to suicidal behavior among children and adolescents, especially when first prescribed. Neither his parent nor a judge had approved the prescriptions. And his death came after 10 days of tumult: His mother had lost visitation rights. He had been in two foster homes, changed therapists, and been told he would be going back to Ohio, where he had been sexually abused.

Since his death, caseworkers across the state have been ordered to go through their files and remedy shortcomings — from updating the state database to reaching out to parents whose consent was never sought for their child’s medications. DCF has also convened a panel of experts aimed at addressing what else might be done. Among the likely outcomes, Sheldon said, are new protocols before a child is given powerful psychotropic drugs, such as requiring a review by a second doctor.

Such changes will only work if Sheldon succeeds in changing a culture that ignored such safeguards. DCF relies heavily on nonprofit local providers to do its work. Those providers need to fully understand what is at stake, as do their employees. Four years after the Legislature thought it had addressed this problem, a 7-year-old’s suicide is a stark reminder that the system is still terribly flawed. How long will it take to get it right?

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More Florida foster children take psychiatric medications than previously thought

St. Petersburg Times
Kris Hundley, Times Staff Writer
Files show lack of consent for prescriptions

Nearly 400 more foster kids are on psychotropic drugs than was believed a week ago, as the Department of Children and Families continues to review children’s files. An updated database, which will be released today, will show that 3,068, or about 15 percent of children in the DCF’s out-of-home care, have been prescribed the psychiatric medications. Of that group, 14 percent were given the drugs without either the parental or court consent required by law. Even in cases where parental consent is on file, DCF Secretary George Sheldon said there are concerns whether parents were aware of potential side effects or spoke with the physician. The DCF is reviewing all psychotropic prescriptions following the April suicide of 7-year-old Gabriel Myers, a foster child in South Florida who was on two psychotropic medications.

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