BILL ANALYSIS
AB 1655
Page 1
Date of Hearing: April 21, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1655 (Evans) - As Introduced: January 15, 2010
Policy Committee: Human
ServicesVote:6 - 0
Judiciary 9 - 0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill establishes a pilot in three counties to add
requirements to the court approval process for the
administration of psychotropic medications to foster children
and increase oversight following approval. Specifically, this
bill:
1)Requires the Department of Social Services (DSS), in
consultation with the California Welfare Directors
Association, Judicial Council, and the California Mental
Health Directors Association, to select three counties to
participate in the pilot.
2)Adds the child's medical history, additional information
regarding side effects and risks associated with medications,
and a description of recommended therapy to the information
that must be submitted to the court as a basis for the
authorization of psychotropic medications.
3)Requires the juvenile court officer to make the following
findings prior to authorizing the administration of
psychotropic medication:
a) The child's caregiver and the child have been informed
about the recommended medications and the anticipated
benefits and side effects, as well as the right to request
a hearing prior to the authorization; and,
b) A plan is in place for the physician to monitor the
effectiveness and side effects of the child's medication in
AB 1655
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consultation with the child's caregiver, mental health
provider and others, as appropriate.
4)Requires DSS to report to the Legislature on the demographic
data of foster youth prescribed psychotropic medications as
part of the pilot and mental health outcomes for these youth,
with input from stakeholders before July 1, 2014.
5)Sunsets provisions of this bill on January 1, 2015.
FISCAL EFFECT
Annual costs likely in the range of $500,000 ($250,000 GF) for
the workload associated with three counties conducting the pilot
project and the final report by the Department of Social
Services.
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,
researchers found that of foster children who had been
dispensed psychotropic medication, 41.3% received three
different classes of psychotropic drugs , 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
AB 1655
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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 . In 2009, AB 82 (Evans), a substantially
similar bill, was vetoed. In his veto message the governor
noted his concern with the costs associated with implementing
a new pilot project in this fiscal climate.
AB 2117 (Evans, 2008) contained provisions similar to the
original version of AB 82. AB 2117 was held in the Senate
Appropriations Committee.
In 2006, AB 1330 (Evans) 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