Report 2015-131 Recommendation 14 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 #14 To: Riverside, County of

To better ensure that foster children only receive psychotropic medications that are appropriate and medically necessary, counties should implement a systemic process for ensuring that court authorizations or parental consents are obtained and documented before foster children receive psychotropic medications and that court authorizations for psychotropic medications are renewed within 180 days as state law requires. The process should also ensure that the counties better document the court authorizations and parental consents in the foster children's case files.

1-Year Agency Response

Both RUHS-BH and DPSS-CSD have adopted these guidelines. Behavioral Health informed psychiatrists of these requirements through a letter from the Medical Director dated April 5, 2017 and DPSS-CSD within the Authorization for Psychotropic Medications Policy dated July 19, 2017. DPSS-CSD has three Public Health Nurses funded by SB 319 to assist with ensuring, documenting and tracking compliance.

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

6-Month Agency Response

Once funding from SB319 is available, the county expects to hire two Public Health Nurses to oversee the administration of psychotropic medications. The scope of practice will include: ensuring that court consents are obtained and documented, tracking their renewal within 180 days, and improving documentation of the above in the foster children's case files. In addition, the Children's Services Psychotropic Medication policy which is in development will have a monthly medication log for caregivers to use, allowing for tracking of the start date of when children began taking their medication. However, one of the barriers that currently prevents DPSS from implementing this process is pending clarification from the State on whether the start date entered in CWS/CMS is reflective of the medication administration, or the date of court approval.

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

60-Day Agency Response

DPSS sent a letter to all caregivers as a reminder not to start administering the child/youth psychotropic medications until they have received permission due to emergency placement or court/parental authorization. The County workgroup continues to develop the protocol to account for and document parental consent, and where to document the consent.

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

All Recommendations in 2015-131

Agency responses received are posted verbatim.