Today, Sen. Tom Carper (D-Del.), Chairman of the Subcommittee on Federal Financial Management, highlighted recent progress on the Administration's response to a troubling Government Accountability Office (GAO) report on the potential over-medication of our nation's foster care children with mental health drugs known as psychotropics. Sen. Carper requested the GAO report as part of his ongoing efforts to investigate and effectively oversee the integrity of Medicare and Medicaid.
Today, the U.S. Department of Health and Human Services (HHS) completed its two-day summit, "Because Minds Matter: Collaborating to Strengthen Management of Psychotropic Medications for Children and Youth in Foster Care." The meeting provided state and federal leaders, as well as child health care and Medicaid experts, with an opportunity to improve and strengthen oversight and monitoring of mind-altering medications prescribed to children in our nation's foster care system. Prior to the meeting, each state was required to submit detailed steps and plans for ensuring that the prescription drug use of foster care children is appropriate and properly monitored.
"This is a deeply disturbing problem that demands immediate attention. Bringing together Department of Health and Human Services officials, the state Medicaid agencies, the state agencies that oversee foster care programs, and other key experts and stakeholders is a crucial step to determine the policy and program changes necessary to best serve our foster children and their families. It is encouraging to see the Administration taking this initial action," said Sen. Carper. "But despite our progress, there is room to further strengthen our efforts to respond to this growing problem. We must ensure that medical standards are met and best practices are followed. Unless our Medicaid policies properly reflect best medical practices, the result will damage not only the program's financial bottom line but, more importantly, the health and welfare of our nation's foster care children. I look forward to continuing to work with Secretary Sebelius, health experts, state foster care agencies and other stakeholders to develop and implement meaningful solutions to this critical issue."
This week's two-day summit was organized in response to oversight work by Congress and the GAO. In December 2011, Sen. Carper's Subcommittee on Federal Financial Management held a hearing that examined a GAO multi-year investigation of the mind-altering psychotropic drugs prescribed for children in the foster care system, which revealed problems stemming from inadequate monitoring and oversight. The investigation -- requested by Sen. Carper -- found that hundreds of children in the foster care system, who are covered by Medicaid, were concurrently prescribed five or more psychotropic drugs even though highly-regarded medical experts have found no evidence to support this level of medication for adults, let alone young children. The GAO also found that thousands of children, including infants, were prescribed psychotropic drugs in dosages that far exceed levels recommended by the Food and Drug Administration and medical literature. The GAO has further reported that nearly one in three states identified the overuse of psychotropic medications in their foster care populations as one of the most pressing issues facing the child welfare system nationwide.
In May, Sen. Carper wrote to Secretary Kathleen Sebelius urging her to follow through with her commitment that the Department of Health and Human Services pursue, as a high priority, solutions to the systemic problems of faulty oversight and misguided health practices highlighted in the GAO report. And on August 24, partly in response to Sen. Carper's letter, the Centers for Medicare and Medicaid Services (CMS) released an informational bulletin that describes a series of steps and additional resources for state agencies and others to address the challenges of over-medication of vulnerable populations, including foster care children.