Report 2015-131 Recommendation 22 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 #22 To: Sonoma 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

FY&C policy requires that any foster youth receive authorization before taking a medication. A JV220 must be approved before medication is provided. In addition to the PMOC that monitors and tracks clients taking medications—a .5 PHN has been tasked with ensuring accurate data around start and end dates of medications in CMS/CWS. The PHN is reviewing all JV220s for accuracy in start date. Case managing PHNs are following up directly with Social Workers and Caregivers to obtain and verify the accurate medication start date in CMS/CWS. FY&C and Probation have implemented policies and procedures that require authorization by the court and parental consent be obtained before any foster child starts a medication.

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

6-Month Agency Response

FY&C has convened a Psychotropic Medication Monitoring Workgroup that is developing, among other monitoring issues related to use of psychotropic medications by foster youth, policies and procedures to ensure that court authorization and parental consents are obtained before foster youth begin taking any prescribed psychotropic medications as well as developing practices with caregivers to ensure that the actual date that foster youth begin taking medication is accurately known and accurately documented in CWS/CMS. It is anticipated this policy and procedure, as well as practice, will be updated and in effect by August 1, 2017. In the meantime, measures have been implemented to assist social workers in obtaining and accurately documenting this information: caregivers will be sent a letter 75-60 days prior to the expiration of authorizations advising them of steps they need to take to schedule an appointment with the prescribing doctor, obtain a new JV-220(A) or (B), submit to the social worker, etc.; and a guide for content of and documenting monthly contacts between social workers and foster youth has been developed that includes topics related to psychotropic medication and entry into CWS/CMS. This new guide for documenting monthly contacts will be effective March 2017.

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

60-Day Agency Response

FY&C has convened a Psychotropic Medication Monitoring Workgroup that is developing, among other monitoring issues related to use of psychotropic medications by foster youth, policies and procedures to ensure that court authorization and parental consents are obtained before foster youth begin taking any prescribed psychotropic medications as well as developing practices with caregivers to ensure that the actual date that foster youth begin taking medication is accurately known and accurately documented in CWS/CMS. It is anticipated this policy and procedure, as well as practice, will be updated and in effect by March 1, 2017.

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

All Recommendations in 2015-131

Agency responses received are posted verbatim.