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October 2014Vol. 15, No. 9State Policies Regarding Psychotropic Medications

The use of psychotropic medications by children in foster care has come to the forefront of child welfare over the past 10 years, with especially heightened attention in the past several years. Studies have shown that children in foster care are much more likely to be prescribed psychotropic medications than their peers not in care. A 2006 Government Accountability Office report noted that one-third of States identified the use of psychotropic medications as a pressing issue, and 2 years later the Federal Fostering Connections to Success and Increasing Adoptions Act indirectly addressed the issue by requiring States to provide health-care coordination and oversight for children in foster care. The Children's Bureau later released several policy documents directly addressing psychotropic medication use by children in foster care (e.g., ACYF-CB-PI-09-06, ACYF-CB-IM-12-04), and many States have developed or are developing their own policies to address this issue. An article in the August 2014 issue of the Hastings Law Journal presents a review of 16 States' policies.

The article describes how the authors could not locate many State policies that were reported in previous studies, indicating that they were not widely available or generated through a transparent rulemaking process, with no notice or comment period. The authors also found that many of the policies were underdeveloped and did not address elements essential to protecting children, such as the use of medications by young children, dosage levels, and multiple, simultaneous prescriptions, or prior authorization. Only two States incorporated all four elements; seven States did not include any of the elements.

"Fostering Transparency: A Preliminary Review of 'Policy' Governing Pediatric Psychotropic Medications in Foster Care," by Noonan, K., & Miller, D., Hastings Law Journal, 65(6), 2014, is available here: (510 KB)