BILL ANALYSIS
AB 82
Page 1
Date of Hearing: April 22, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 82 (Evans) - As Amended: April 14, 2009
Policy Committee: JudiciaryVote:10
- 0
Human Services 7 - 0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill changes requirements that must be met before and after
a juvenile court officer authorizes the administration of
psychotropic medications to foster children. Specifically, this
bill:
1)Authorizes judicial officers to make orders regarding the
administration of psychotropic medications to a child who is
in foster care.
2)Establishes the following findings that must be made prior to
the administration of psychotropic medications:
a) The minor's caregiver and the minor must be informed
about the recommended medications, the benefits and
potential side effects.
b) A plan must be in place for monitoring by a physician of
the minor's medication plan.
3)Requires the Department of Mental Health (DMH) to identify or
develop written materials by July 1, 2010 to assist in the
provision of age-appropriate information about psychotropic
medications to minors.
4)Requires that a dependent child or ward in foster care be
present in court for a hearing on the request to administer
psychotropic medications, unless the child waives the right to
attend.
5)Authorizes the court to inquire about the effectiveness and
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side effects of the medication, the child's progress, any
changes in behavior, and any concerns expressed by the child.
6)Requires the Judicial Council to adopt rules and forms to
implement the provisions of the legislation by July 1, 2010.
FISCAL EFFECT
1)If approximately 35% of foster children receive psychotropic
medications, there would be annual costs of approximately $2
million ($1 million GF) for the workload associated with
county child welfare agencies evaluating children,
coordinating with health care providers, and providing the
required information to the courts. (The percentage of
children receiving medication is based on a study of foster
children in Texas. Similar data is not available for children
in California.)
2)Costs of approximately $175,000 GF for DMH to identify,
develop, and disseminate age appropriate materials about the
effects of psychotropic medication.
COMMENTS
1)Rationale . This bill is an attempt to address concerns raised
by foster children and their caregivers during hearings of the
Assembly Select Committee on Foster Care and the Blue Ribbon
Commission on Foster Care. The author states that some foster
youth testifying in the hearings reported being prescribed
psychotropic medications from the time they were four or five
years old. By requiring courts and health care providers to
better monitor the use of psychotropic medication among foster
children in their care, the author hopes this bill will reduce
the number of children receiving psychotropic medications
unnecessarily and prevent the overmedication of foster
children.
2)Background . According to the Journal of the American Academy
of Pediatrics, studies show that nationally children in foster
care covered by Medicaid insurance are over three times more
likely to receive psychotropic medication than
Medicaid-insured children who qualify by low family income.
In a study published in the journal in December of 2007,
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researchers found that foster children who had been dispensed
psychotropic medication received three different classes of
psychotropic drugs 41.3% of the time , and 15.9% received four
different types of medications. Anti-depressants were the most
frequently used medications (56.8%), followed by
attention-deficit/hyperactivity disorder drugs (55.9%), and
with antipsychotic medication prescribed in 53.2% of the cases
studied. The use of two drugs within the same psychotropic
medication class was noted in 22.2% of those who were given
more than one psychotropic drug at a time. The study concluded
that the use of multiple psychotropic medications is frequent
for youth in foster care and lacks substantive evidence as to
effectiveness and safety.
3)Judicial and Medical Review . Under current law, the
administration of psychiatric medications to foster children
is addressed by Judicial Council Rule 1432.5, which requires
an application to a juvenile court judge signed by a physician
and/or social worker. Detailed information about the child,
the medication and diagnosis is included in the application.
The court may authorize a foster parent or group home provider
to oversee medications and mental health treatment.
4)Related Legislation . AB 2117 (Evans, 2008) contained
provisions similar to the provisions of AB 82. AB 2117 was
held in the Senate Appropriations Committee.
In 2006, AB 1330 (Evans) would have required the Department of
Social Services to collect and maintain data on all youth in
foster care that are prescribed psychotropic medication. That
bill was held in this committee.
Analysis Prepared by : Julie Salley-Gray / APPR. / (916)
319-2081