UPDATE: Check out Child Welfare Information Gateway's webpage providing resources on the use of psychotropic medicines for children and youth in fostercare.
With the newly-released Government Accountability Office report, "Foster Children: HHS Guidance Could Help States Improve Oversight of Psychotropic Prescriptions," there has been a flurry of activity recently on the issue of over-medicating youth in foster care. I don't want to reiterate what several other reputable sources have already published (see blog posts from Child Welfare League of America's Children's Monitor and Congressional Coalition on Adoption Institute), but as I've been following this, I grew curious about Minnesota's own policies related to medical care for children in foster care.
After doing some keyword searches and browsing of Minnesota statutes, I discovered that Minnesota law requires that a foster child's out-of-home placement (OHP) plan include how the worker intends to ensure oversight of the child's medical care (see below for actual statutory language). This includes things like clearly defining who is responsible for monitoring a child's medications and ensuring proper medical treatment, as well as how medical information will be shared to provide for effective treatment. The law also states that the OHP plan should include how physicians will be consulted so as to provide for the best medical treatment; to me, this implies that a worker could get multiple opinions so as to ensure that a foster child is not overly medicated. Finally, it makes the local child welfare agency responsible for ensuring that the child in care has an annual physical exam while in care.
Minnesota law also states that upon exit from foster care, caregivers and children (if appropriate) should be given complete health (and education) records.
Administrative or court reviews of the OHP plan are only required once every six months after the initial review (which is supposed to be within 180 days of placement). This is the time in which the OHP plan is visited and updated to ensure that services are being effectively delivered to youth in care. For those ordered to be in long-term foster care, the court must annually review the OHP plan to ensure the youth's physical and mental health needs are met.
Knowing all this, what do you think about Minnesota's Statutes on providing oversight of medical care for youth in foster care? I'd love to hear your thoughts. (Comment box can be found after the statutory language.)
Subdivision 1.Out-of-home placement; plan. (c) The out-of-home placement plan shall be explained to all persons involved in its implementation, including the child who has signed the plan, and shall set forth:
(9) the efforts by the local agency to ensure the oversight and continuity of health care services for the foster child, including:
(i) the plan to schedule the child's initial health screens;
(ii) how the child's known medical problems and identified needs from the screens, including any known communicable diseases, as defined in section 144.4172, subdivision 2, will be monitored and treated while the child is in foster care;
(iii) how the child's medical information will be updated and shared, including the child's immunizations;
(iv) who is responsible to coordinate and respond to the child's health care needs, including the role of the parent, the agency, and the foster parent;
(v) who is responsible for oversight of the child's prescription medications;
(vi) how physicians or other appropriate medical and nonmedical professionals will be consulted and involved in assessing the health and well-being of the child and determine the appropriate medical treatment for the child; and
(vii) the responsibility to ensure that the child has access to medical care through either medical insurance or medical assistance;
(10) the health records of the child including information available regarding:
(i) the names and addresses of the child's health care and dental care providers;
(ii) a record of the child's immunizations;
(iii) the child's known medical problems, including any known communicable diseases as defined in section 144.4172, subdivision 2;
(iv) the child's medications; and
(v) any other relevant health care information such as the child's eligibility for medical insurance or medical assistance;
(12) for a child in voluntary foster care for treatment under chapter 260D, diagnostic and assessment information, specific services relating to meeting the mental health care needs of the child, and treatment outcomes.
Upon discharge from foster care, the parent, adoptive parent, or permanent legal and physical custodian, as appropriate, and the child, if appropriate, must be provided with a current copy of the child's health and education record.
Subd. 4.Agency responsibilities for parents and children in placement. (d) When an agency accepts a child for placement, the agency shall determine whether the child has had a physical examination by or under the direction of a licensed physician within the 12 months immediately preceding the date when the child came into the agency's care. If there is documentation that the child has had an examination within the last 12 months, the agency is responsible for seeing that the child has another physical examination within one year of the documented examination and annually in subsequent years. If the agency determines that the child has not had a physical examination within the 12 months immediately preceding placement, the agency shall ensure that the child has an examination within 30 days of coming into the agency's care and once a year in subsequent years.