New Law Curbs Medication of Foster Children

Gov. Gray Davis has given final approval to a bill that requires unprecedented safeguards to protect children in the state’s care from receiving improper and unmonitored doses of psychiatric drugs.

The new law, which Davis approved Tuesday, also requires that social workers maintain up-to-date medical and education records for the state’s 100,000 foster children.

State lawmakers passed the legislation partly in response to a Times investigation in May 1998 that found that thousands of children in California’s group and foster homes are routinely given potent psychiatric drugs, at times simply to keep them docile for their overburdened caretakers. Those responsible for the children’s welfare often didn’t know who put the children on these behavior-altering medications or why, and sometimes were not even aware that the children were drugged.

Under the new law, juvenile court judges alone may approve psychiatric medication requests and children’s medication records must accompany them to each placement. In cases where a child has been removed from a parent’s custody because of abuse or neglect, that parent may no longer consent to the use of such drugs unless a judge makes a special ruling to allow it.

“It was just plain bizarre to have parents who didn’t care or were abusive be in charge of approving psychiatric drugs for their children,” said Sen. Debra Bowen (D-Redondo Beach), author of the bill. “This requirement is going to lead to better medical care for these kids. . . . It’s going to be harder to say, ‘We’re just going to give them a drug to calm them down.’ You’ve got to get a judge to approve that.”

Harold LaFlamme, whose law firm has represented children in Orange County Juvenile Court for more than 20 years, said he worried about voiding parents’ right to consent. But he said more judicial scrutiny “is always a good thing.”

The new law, while closing the most important safety gap, still may leave children vulnerable to improper drugging. Though it now requires judges to sign off on requests to medicate children, many juvenile judges say they don’t know much about the medications or the doctors prescribing them. One judge said he simply must trust that the psychiatrist knows best.

Last year, Los Angeles County’s juvenile court began requiring all such requests to be screened by the county’s mental health unit. But judges elsewhere said they lacked the funding for such a review.

Dr. Ken Steinhoff, UC Irvine’s chief of child psychiatry, said the law puts judges in a difficult spot.

“It would be great if there was some sort of structure, assistance for the judge so he can make sense out of these [medication] issues,” Steinhoff said. “I’m sure we at UCI would be interested in doing that--but not for free.”

Bowen said the judges should take the next step to ensure that the children in their care are protected.

“If there really is a financial problem getting outside panels to review the medication requests, they should ask the Legislature for funding,” she said.

The use of psychiatric medications on some of the state’s most vulnerable children was detailed as part of a series of stories looking at the plight of children taken from abusive parents and placed under the state’s protection.

The Times found children who had been prescribed several types of psychiatric drugs at the same time, often in combinations and dosages that experts said were risky and could cause irreversible harm. Foster children as young as 3 were taking potentially dangerous drugs to control “depression” or “rage.” In a number of cases, children seemed to be misdiagnosed, overmedicated or given the wrong medication.

Bowen said the new legislation will require social workers to maintain updated health and education records for every child. These records, also known as passports, must be provided to new foster parents within 30 days of a child’s initial placement in foster care and within 48 hours after a child is moved to a subsequent foster or group home. The updated records also must accompany every report submitted to the juvenile court.

The Legislature passed a law requiring foster children to have such passports nine years ago. But most counties never followed through because their officials thought the process was too costly and cumbersome, and the law was never enforced. But Bowen said counties may now realize the importance of the passports. None of them opposed the bill, she said, and the law makes them accountable to the courts.

And while there are no sanctions if social workers don’t keep up the passports, under the new law, the workers “have to answer in open court to a judge as to why they didn’t do it,” she said.