Report 2015-131 Recommendation 15 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 #15 To: Riverside, County of

To better ensure that foster children only receive psychotropic medications that are appropriate and medically necessary, counties should develop and implement a process for county staff and caregivers to work together to ensure the psychotropic medications are authorized before being provided to foster children. This process should also ensure that the counties obtain accurate medication start dates from caregivers.

1-Year Agency Response

Both RUHS-BH and DPSS-CSD have adopted these guidelines. RUHS-BH 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. The three Public Health Nurses working at DPSS-CSD are also in contact with caregivers.

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

6-Month Agency Response

In progress - a process has been developed. The Children's Services Psychotropic Medication policy is being drafted to include guidance for social workers, and will have a monthly Medication Administration Log for caregivers to use, which will allow for tracking of the start date of when the child began taking the medication(s). However, Riverside County is still awaiting the State's direction on how to determine and document the medication start date.

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

60-Day Agency Response

In the absence of State direction on how to determine and document the medication start date, the County team is developing a working date to use. DPSS sent a letter to caregivers as a reminder not to start administering medications without parental consent or court authorization. Agency policies and procedures are being updated to provide workers guidance as to informing caregivers on: general uses for and side effects of psychotropic medications, how to document frequency and dosage, and behavioral observations while the youth is receiving medication. The social worker is to review this process for psychotropic medication administration with caregivers upon placement, and reinforce at each visit.

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

All Recommendations in 2015-131

Agency responses received are posted verbatim.