Federal judge finds Texas use of psychotropic drugs on foster children 'appalling'
A federal judge called Texas' use of psychotropic drugs on foster children appalling and in violation of the state's own standards.
Speaking at a Wednesday hearing in the 12-year old federal foster care litigation, Judge Janis Jack said she was saddened by a report filed last month by court monitors on the use of psychotropic drugs in the Texas foster care system.
The report filed last month was based on multi-day visits to 14 group homes, or residential treatment facilities.
“Were you not shocked with this Ms. Muth?” Jack inquired of new department of Family and Protective Services Commissioner Stephanie Muth. “The massive amount of drugs that are given to these children just because these group homes really can't handle the children?”
Jack noted that in one case a child under the age of three was on multiple psychotropic drugs and that no best practice analysis had ever been done.
The judge pointed to details showing kids were overprescribed drugs, that medical logs showed some weren't given drugs as scheduled, and to other numerous medication log errors.
The state could provide no list of corrective actions against highlighted bad actors since the report came out.
Attorneys for the state argued that the use of psychotropic drugs and monitoring them were outside the scope of the current foster care litigation. They added that there was no remedial order based on fixing how the state monitors prescriptions.
“I want the record to be clear that there is no remedial order that specifically addresses the use of psychotropic medications,” said Reynolds Brissenden, representing the Health and Human Service Commission.
The claim drew immediate fire from Paul Yetter, an attorney representing plaintiff children, as well as from Jack, who said the issue dealt with child safety and was well within her purview and was affirmed by the Fifth Circuit Court of Appeals.
“I guess you expect a remedial order for every little single thing. That's not going to happen,” Jack said.
The state continued to object to the court's insistence.
Karl Neudorfer, an assistant attorney general representing DFPS, said he disagreed with the characterization that the state doesn't care about the misuse of psychotropic drugs.
Jack fired back: "Yes or no," does the state believe it is bound by the injunction to monitor and keep kids safe from drug misuse?
“These children are being repeatedly raped in your care. They're being drugged in your care if they complain. If their behavior is not up to snuff, they're getting psychotropic drugs. And that is not safe,” she said.
According to the report, the total percent of children in the Texas foster care system taking psychotropic drugs has fallen between 2002 and 2019 by 12%.
But the report from court monitors showed dozens of errors in the process in just the 161 youth files reviewed. More than 9,000 youth in Texas’ care are on psychotropic drugs more than 60 days a year.
“This could just be the tip of the iceberg,” Yetter said.
Yetter and the court expressed concern that no one was adequately monitoring whether the drugs were being used judiciously.
One tool that can be used to see if a youth’s drugs are in line with best practices is called a Psychotropic Medication Utilization Review (PMUR). Yetter said the court had found the tool is underutilized, with 75% of the eligible youth reviewed in the recent report not being given one.
To that end, Yetter requested that all eligible youth covered by the lawsuit who haven’t had a PMUR in the past five months be given one. The judge said it would be done in 30 days. The move came over the objections of state attorneys, and the order could set up a fight later on with the state over what the Fifth Circuit Court ruling in the case covers.
Yetter said he would file to force the state to deal with psychotropic drug monitoring or face penalties.
“They simply can't turn a blind eye to this," he said.
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