Texas has counseling for over-prescribers

A Dallas News editorial says:

All eyes in the U.S. Senate committee room were fixed on the star witness as he carefully read his testimony from prepared text. Senators leaned forward, and cameras recorded the moment from all angles. Mom sat in the next chair for moral support.

Ke’onte Cook, 12, a seventh-grader from McKinney, had a story to tell that was as heartbreaking as it was uplifting.

He was invited to share his experiences as a former foster child who was kept on different regimens involving 20 mind-altering medications for more than four years, at times reaching five drugs at once, changing through a series of homes and mental hospitals. Ke’onte said he was sometimes in a falling-down stupor, irritable, with an aching stomach and no appetite. ...

The issue is a financial one, since Medicaid paid for more than $200 million in psychotropic drugs for children in Texas alone in 2008. Senators also made clear that the issue is one of child welfare, and they bored in on a new, five-state study, including Texas, showing that foster children are prescribed psychotropic drugs at rates far beyond those in the general population of Medicaid children.

This story has gotten a lot of press, including on this blog, but it turns out to be an old story:

The trend line in Texas, however, is a positive one. Even as the number of foster kids continues to climb — from 27,000 to 47,000 over the past 10 years — the rate of medicating these children has been declining. In 2003, nearly 30 percent of all foster children in Texas were on a mind-altering drug; that number fell to less than 20 percent this year. The potentially risky practice of putting kids on multiple drugs has been curtailed as well.

Credit a multi-agency network in Texas that tracks tax-paid drug prescriptions and triggers added scrutiny when a physician’s use of mind-altering medications strays from statistical bounds. That doctor may have his or her practices reviewed and may receive counseling. The state has also mapped out and circulated clear drug-use guidelines for medical professionals to consult.

So Texas recognized that this foster child drug problem was out of control in 2003, and took systematic steps to curtail it. They tracked the over-prescribing doctors and threatened to force them to get counseling!

Wow, I had no idea that a state agency could be so competent. But the system still seems corrupt to me. In 8 years, they only reduced the drug use from 30% to 20%. My guess is that they are effectively giving license to physicians to give bogus drugs to foster kids, as long as the rate stays below 20%.

Still, I am encouraged that there is at least some accountability in the Texas foster care system.