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"House Bill 23 hits a rare political sweet spot. The
proposal to create an independent clinic review of the drugs foster children
are given has support from Democrats and Republicans because of its efforts to
protect the vulnerable — and projections that it will save the state millions
of dollars."
Florida's Gabriel Myers is
mentioned in this article.
Atlanta
Journal-Constitution
Review of kids’ psych drugs urged
By April
Hunt
While in foster care, Giovan Bazan, now 20, says he was put
on Ritalin, anti-depressants and sleeping pills. At 18, he elected to stop all
drugs, and says he learned he didn't
need them. Giovan Bazan was 6 when a doctor first gave
him medicine to treat his diagnosis of hyperactivity.
Bazan admits he was unruly at the time. Perhaps it was because the
only parent he had ever known, his foster mother since he was an infant, had
just died.
No one asked about that. Nor did anyone check years later to see
that he was on a double dose of Ritalin when another physician, seeing a boy so
mellowed out that he barely reacted, prescribed an antidepressant. “They start
you on one thing for a problem, then the side effects mean you need a new
medicine,” Bazan said. “As a foster kid, I’d go between all these doctors,
caseworkers, therapists, and [it] seemed like every time there was a new drug
to try me on.”
When he turned 18, Bazan elected to stop all medications. It
turned out he didn’t need any of them.
Now, the Georgia House is weighing an idea to better track the
psychotropic drugs foster children take at a far greater rate than other kids.
House Bill 23 hits a rare political sweet spot. The proposal to
create an independent clinic review of the drugs foster children are given has
support from Democrats and Republicans because of its efforts to protect the
vulnerable — and projections that it will save the state millions of dollars.
The state spends $7.87 million per year in Medicaid funds on those
mind-altering drugs for foster kids. “This is an idea I’m very open and willing
to have a discussion about,” said Speaker David Ralston, R-Blue Ridge, adding
his main concern is the cost of the review.
The issue is a national one. Only half of state child welfare
systems — not including Georgia — have a policy to review usage of
mind-altering drugs, even though as many as 52 percent of kids in foster care
are taking them.
By comparison, about 4 percent of the general youth population is
on the medications, according to a 2010 Tufts Clinical and Translational
Science Institute study.
“These drugs are not something you take like an aspirin,” said
state Rep. Judy Manning, a Marietta Republican and chairwoman of the House
Children & Youth Committee who is co-sponsoring HB 23 with Rep. Mary
Margaret Oliver, D-Decatur.
“We want to monitor it and make sure the treatment is correct,”
she said. “You don’t want a tragedy.”
Lack of oversight can prove deadly. Gabriel Myers, a 7-year-old
foster child in Florida, hanged himself in 2009 while taking three powerful
psychotropic medications, none of which had been approved for use in children.
There have been no similar high-profile cases in Georgia. Still,
one in three foster
children on Medicaid was
prescribed mind-altering psychotropic drugs last year, according
to a January report from the state Department of Community Health. More than
half of them were on a daily cocktail of more than two of the drugs — some of
which lack approval for treatment in children.
Oliver argues that both the cost and number of foster children on
such drugs will drop if her proposal succeeds.
Her plan calls for an independent review to kick in on red-flag
cases in the system, such as when a very young child is prescribed drugs for
mental health or when a youngster is on multiple medications at once.
It would be up to the Human Services or Behavioral Health
departments to decide what would flag cases and how to best manage the
independent psychiatrists who would monitor them.
Oliver said private foundations have expressed interest in funding
the idea as a national pilot program.
“Foster children are more traumatized, for horrible reasons, and
that’s why their medical care has to be better,” Oliver said. “I am excited
about the number of stakeholders who want to work on solving this problem with
us.”
The issue may extend to lack of oversight on what drugs foster
kids are being prescribed and taking. A 2010 investigation by The Atlanta
Journal-Constitution revealed several companies operating foster care homes in
the state had repeatedly used psychotropic medications to “subdue” children.
“Medications dispersed often aren’t to help the child with their
problems but to make the child more docile for the caregivers,” said Richard
Wexler, who heads the National Coalition for Child Protection and Reform. “And
the paradox of child welfare care has always been the worst thing for the kids
is what costs the most.”
That seems to have been the case for Bazan. Now 20, he can recall
a brief period in high school when prescriptions had run out and his foster
mother didn’t keep him on the stew of mind-altering drugs.
Fellow students noticed the no-nonsense boy was suddenly joking
around and friendly.
“When I was off the medicines, everyone kept asking me why I was
so happy,” Bazan said. “There was a real difference.”
The medications quickly
returned,
however. But Bazan said they didn’t help with the loss he felt over the death
of
his first foster mother or his feelings of being unwanted
and under attack in the foster home he repeatedly ran away from.
He spent time in Department of Juvenile Justice facilities, where
the medications kept coming, sometimes provoking seizures because some of them
didn’t mix.
No one, he said, ever asked about his feelings. “They would have
gotten a better response if someone had just taken a look at what was really
going on in my life,” he said.
Bazan did that himself when he quit all medications cold turkey at
age 18. But the years of medication already have hurt his future: His plan to
enter the military to pay for college is blocked by the diagnosis of
hyperactivity. He is ineligible to serve.
Bazan now works part time at the Division of Family and Children
Services, acting as
a liaison with community
organizations and state agencies.
He also has started his own security company to provide nighttime
patrols at his church in DeKalb County and others.
His goal is to get a full-time job with DFCS and persuade Gov.
Nathan Deal to appoint him to the Georgia National Guard. With that, he could
pay for college.
First, though, he is sharing his story in the hope that lawmakers
and others will see him as a cautionary tale for what can happen when someone
isn’t monitoring care of foster kids.
“I ask them, ‘Would you give all these people carte blanche with
your kids, without any scrutiny of their medical history and a review of their
life?’” Bazan said. “We’re just children. Someone has to look out for us. We
need the same care and attention you give your own children.”
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