Report 2015-131 Recommendation 13 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 #13 To: Riverside, County of

To better ensure that foster children only receive psychotropic medications that are appropriate and medically necessary, counties should implement processes to ensure that foster children receive any needed mental health, psychosocial, behavioral health, or substance abuse services before and concurrently with receiving psychotropic medications.

1-Year Agency Response

Both RUHS-BH and Department of Public Social Services - Children's Services Division (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. In addition, this is also part of the Child and Family Team Policy, Attachment 1: CFTM Matrix dated 7/17/2017.

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


6-Month Agency Response

In addition to giving psychiatrists guidelines requiring that treatment options be provided when psychotropic medications are used, Riverside County is including this recommendation wherever psychotropic medications are discussed or reviewed. Treatment options could be further explored when child's mental health concerns are the focus of the Child and Family Team Meetings. DPSS has also developed an e-learning training for social workers on psychotropic medication that stresses the importance of mental health, psychosocial, behavioral health, or substance abuse services both before and concurrently with psychotropic medication. A new Psychotropic Medication Policy is being drafted that will include this recommendation. The Child and Family Team (CFT) meetings will also have this as a regular topic at CFTs with those children on psychotropic medication.

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


60-Day Agency Response

. The County workgroup has been discussing how best to use child and family teaming (CFT) to ensure appropriate services are provided prior to or in conjunction with psychotropic medications. The package with the guidelines psychiatrists receive explains that treatment options are to be provided when psychotropic medications are used, and only when necessary.

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


All Recommendations in 2015-131

Agency responses received are posted verbatim.