Advocate: Texas needs new foster care laws

AUSTIN (KXAN) - Some children in foster care are being given mind-altering drugs in order to control their behavior, according to a volunteer with Texas CASA.

During a visit to the Texas State Capitol Wednesday aimed at garnering more funding from lawmakers, one volunteer said some foster agencies and families are using the drugs to control and care for more kids.

Andrea Calloway has volunteered with CASA of Denton County for 11 years. While she is not a psychiatrist or psychologist, in her time with CASA, she has seen the impact psychotropic drugs can have when possibly misused.

"One of my children was less than 3 years old," said Calloway. "[I] Went to do a surprise visit and he was drooling on the couch."

When she arrived for a planned visit, the child was perfectly fine.

Psychotropic drugs range from stimulants to manage ADHD like Ritalin to anti-psychotics. The Center for Medicaid and CHIP Services (CMCS) said children in foster care often have emotional and behavioral challenges caused by past trauma, and that the medications can sometimes help.

Nearly 20% of children in Texas foster homes received psychotropic drugs for 60 days or more in 2012.

Calloway did not talk about the proper use of the medications. Instead she focused on children given the drugs within days of entering foster care.

She said the caregivers sometimes use the drugs to control the child's behavior in order to bring in more children.

"I had a girl who came in at 12 and aged out," said Calloway. "They didn't take her off medications until she aged out. She didn't know what to do. She disappeared and ended up going into prostitution."

Calloway said she worked with that woman to her get her life back on track.

"The issue here is many of these placement agencies will place children on psychotropic drugs within 24 to 48 hours of placement," said Calloway. "There is no way they could know these children's true behaviors."

Calloway said this was not the case with every placement or agency. She simply wants more regulations that limit the use of psychotropic drugs to the children who need them.

"There needs to be, in my opinion, a team effort when determining whether or not these children should be on there."

In a report released by CMCS in 2011, federal officials said the use of the medications should be managed with care. Provisions in the Child and Family Services Improvement and Innovation Act require states to put in place standards and protocols for the use of prescription medications.

In Texas, the use of psychotropic drugs have decreased since 2004 , when approximately 30% of children in foster care received the medications. In that year, a report by the Office Of Inspector General raised concerns of overmedication.

The state put together new guidelines in 2005 for prescribing medications to foster children. The authors of the report said the state should use caution when singling out doctors.

State leaders were concerned that with so few doctors treating the children due to low Medicaid reimbursements and a difficult caseload, singling out the clinicians could encourage them to not do the work any longer. The authors also argued that non-pharmacological treatments could take too long when placement of a child is in jeopardy.

Instead the Texas Health And Human Services Commission distributed the guidelines to doctors. In the years that followed the amount of children taking the medications has decreased.