Report 2015-131 Recommendation 12 Responses

Report 2015-131: California's Foster Care System: The State and Counties Have Failed to Adequately Oversee the Prescription of Psychotropic Medications to Children in Foster Care (Release Date: August 2016)

Recommendation #12 To: Riverside, County of

To better ensure that foster children only receive psychotropic medications that are appropriate and medically necessary, counties should ensure that all foster children are scheduled to receive a follow-up appointment within 30 days of starting a new psychotropic medication.

1-Year Agency Response

Riverside University Health System - Behavioral Health (RUHS-BH) informed psychiatrists of these requirements by letter from the Medical Director dated April 5, 2017. To track compliance, RUHS-BH created a report, MHS 8029, to track the 30-day follow up requirement.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

Fully implemented - Riverside County has hired additional child psychiatrists and has communicated the expectation of a 30 day follow-up to prescribing doctors. County Behavioral Health is recommending to their Psychiatrists that they schedule appointments for foster children every four weeks which is in process. Behavioral Health is continuing to address increasing appointment availability to ensure more flexibility for 30 day appointments.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Riverside County has not yet fully implemented this recommendation. Riverside County stated that it communicated the state guidelines and the results of the audit, including the expectation of a 30-day follow up, in psychiatrist staff meetings. However, it further stated that it commissioned a performance improvement project regarding its "medication declaration process/medication monitoring" of foster children and that to assess how it is doing in regards to the 30-day follow up, it has been internally developing a new report. Finally, Riverside County stated that it plans to formalize the verbal directions it provided to psychiatrists and will provide this information in its next update.

60-Day Agency Response

Riverside County has improved on thirty-day follow-up appointments by hiring additional child psychiatrists, communicating the expectation as part of the psychotropic medication package distributed to prescribing doctors, and developing innovative ways to build the pool of available child psychiatrists.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

All Recommendations in 2015-131

Agency responses received are posted verbatim.