Report 2015-131 Recommendation 5 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 #5 To: Los Angeles County

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

We are also working with the Department of Children and Family Services, Probation, and other stakeholders (constituting the proverbial "village") to routinely inquire of children and caregivers on the use of medications and to fully document their answers. Our goal is to ensure that we are aware of every child involved in our systems who is being administered psychotropic medications, and to ensure that every one who is being medicated has in fact been the subject of the approval process designed to make sure that the use of these medications is appropriate.

(Please see supporting documentation. The revised approval and monitoring protocols were submitted as attachments to our February 23, 2017, response. Attached to this response are newly revised policies and procedures from the Department of Children and Family Services regarding psychotropic medication, and newly revised policies and procedures from the Department of Public Health on the role of public health nurses in the new approval and monitoring protocols.)

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

The documents that Los Angeles County mentions are available from our office.


6-Month Agency Response

The Workgroup has redrafted protocols for the approval and monitoring of the use of psychotropic medications, and has attached these protocols to this submission.

(Please see supporting documentation.)

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


60-Day Agency Response

Over the next year, the Workgroup detailed in our response to Recommendation 1 will develop strategies to implement a process for county staff and caregivers to work together to ensure that psychotropic medications are authorized before being provided to foster children, and to ensure that Los Angeles County obtains accurate medication start dates from caregivers.

The Workgroup's discussions on the California Judicial Council's new forms have focused on clarifying which persons or agencies will be responsible for completing each form and the timelines for doing so. We have also focused on these issues with respect to the new optional forms for youth and the new optional forms that can be completed by parents, caregivers, attorneys for the parties, and others.

It is also important to note that it is the Workgroup's intent to ensure training for all segments of the community who interact with our children with respect to all of the initiatives developed by the Workgroup.

(Please see supporting documentation.)

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


All Recommendations in 2015-131

Agency responses received are posted verbatim.