California Assembly to vote on diminished bill package to curb psychotropic drug use on foster children

By Karen de Sá kdesa@mercurynews.com

POSTED:   09/06/2015 04:54:40 PM PDT

With less than a week left before the end of the legislative session, intensive lobbying by physicians groups and cost concerns have undermined progress on the centerpiece of a bill package designed to end the excessive use of psychotropic drugs on California's foster youth.

The bills scheduled for the Assembly floor as early as Tuesday have already been whittled down through amendments and the sting of budget realities.

Now, the author of Senate Bill 253 -- which would strengthen court oversight of foster care prescribing and demand more safety measures from doctors -- has pulled his legislation back from consideration this year. State Sen. Bill Monning's bill passed the Senate unanimously but won't go through the Assembly until next year, while three other bills inspired by the newspaper's investigation "Drugging Our Kids" move toward Gov. Jerry Brown's desk.

Sarah Pauter, 25, testifies about her experiences growing up in San Diego's foster care system during a February hearing on the misuse of psychotropic medication in foster care at the Capitol in Sacramento. Former foster youth Rochelle Trochtenberg is at right. (Dai Sugano/Bay Area News Group) ( Dai Sugano )

The Democrat from Carmel says his action represents only a temporary delay while he smooths out sticking points with the Brown administration, allowing time to relaunch the bill in January with a better guarantee of passage. But advocates fear the heart of the hard-fought reforms may now be in jeopardy.

"SB 253 is really key -- it's the linchpin of this whole package because the courts are the gatekeepers, and if the gatekeepers are not doing their job, everything else is not going to come together to solve the problem," said Bill Grimm, senior attorney with the National Center for Youth Law, a major backer of the bills. "The opposition that's been mounted by the medical community is unconscionable."

Monning's bill is supported by the state's Judicial Council, but opposition has been building: On Wednesday, the California Medical Association, the California Psychiatric Association, the California Academy of Child and Adolescent Psychiatry and the California Alliance of Child and Family Services, representing residential group homes, released a surprising last-minute "Assembly floor alert" calling for a no vote.

The groups charge the bill would hamstring doctors by requiring proof to the juvenile court that they had reviewed foster children's medical records, obtained lab results, and confirmed there were no "less invasive" treatments available. The physicians also balk at being subject to second medical opinions, which under Monning's bill would be triggered by requests for multiple medications or prescriptions for kids ages 5 and younger.

According to filings with the California Secretary of State, the groups opposing the bill have spent more than $1.4 million between Jan. 1 and June 30 lobbying the Legislature, an amount equal to more than $11,000 per business day. The alliance representing residential facilities alone spent more than $325,000.

In contrast, the National Center for Youth Law has provided former foster youth a $10-per-meal stipend and travel costs to testify in the state Capitol. Speaking to lawmakers before packed hearing rooms, they have shared stories of how they became obese and lethargic on antipsychotics, how they were punished in group homes for refusing meds, and how they were given drugs to replace what they really needed -- more effective therapy to treat the trauma they suffered as abused or neglected children. The newspaper documented how over the years the foster care system became dependent on psychiatric drugs to simply sedate these troubled youth.

Yet Randall Hagar, the California Psychiatric Association's lobbyist, said his group is the one that lost its voice during the legislative debate on how to address the problem. "The fact that we've opposed doesn't mean we don't care anymore," Hagar said. But he added: "It has become increasingly hard to have our concerns heard."

To be sure, the California Legislature has responded quickly to dial back the inappropriate drugging of foster youth, and the proposed laws would be groundbreaking in the nation. If signed by the governor, they would provide training on psychotropic drugs to judges, lawyers, social workers and caregivers, and channel more information to the courts on how medicated kids are faring.

Regular child-specific reports on prescriptions and counseling would be kept for the first time, and public health nurses would be newly empowered to monitor individual cases through access to children's medical files that is now restricted. In addition, residential group homes for youth -- where prescribing of dangerous drugs is typically the highest -- would be closely monitored, with facilities that allow excessive prescribing subject to corrective-action plans.

Yet the bills' original, more far-reaching goals have shrunk. Senate Bill 319, which would have expanded the number of public health nurses monitoring prescriptions, has been stripped of funding, although it still would improve oversight among the current nursing ranks. In some instances, changes to the bills broadened the goals, however, such as the inclusion of foster children who are also in the juvenile justice system.

Monning insists his bill will be "reactivated" in January, with minor changes that could not be made in time for this year's deadlines. He said he's confident that funding concerns, and clarifications needed for rural counties where there are fewer psychiatrists, will get worked out and added he has the "absolute commitment" from the Brown Administration that they share in the bill's objectives. "The issue is not going to go away," he said.

One of the former foster youth featured in the series, Rochelle Trochtenberg, has spent the summer shuttling from her Eureka home to Sacramento -- a five-and-a-half hour drive each way -- to testify in support of the bills. She estimates she's told her personal story of suffering on too many meds about 10 times so far in the state Capitol, sometimes twice in one day.

She applauds lawmakers for their progress but laments that the bills have been "watered down" and worries about the court-reform bill's demise.

"It's hard to believe they are acting with good intentions, because really these kids' lives are on the line," she said. "And we're still not willing to make the change today to put this on the governor's desk."