EDITORIAL: Are Missouri's foster care families being set up for failure?

June 17--Being entrusted with the lives of children abandoned or uncared for by their parents is a difficult job that requires patience, care and dedication. The Missouri Department of Social Services might be setting up many foster children and caregivers for failure.

A federal lawsuit, filed by St. Louis University law school legal clinics and two child advocacy groups, alleges the agency dopes up kids on too many prescription drugs, at too young an age, and fails to provide foster parents with adequate information about the medication.

The class-action lawsuit on behalf of five children, ages 2 to 14, says about 30 percent of children in state foster care or group homes are overprescribed powerful psychotropic drugs that most of them do not need. The rate of overprescription is twice the national rate of 18 percent for such a population.

That means roughly 4,000 of the 13,000 children in Missouri's foster care system are zoned out on drugs intended for psychotic behaviors but that are being used to treat diagnoses like conduct disorder and attention deficit hyperactivity disorder. The lawsuit alleges that the agency is withholding crucial information needed to ensure that only the children who need such drugs are receiving them.

Doctors are not able to verify that treatment is occurring as prescribed, and foster parents can't provide informed consent for care when they lack basic information about the children in their homes, the suit contends.

Sara Bartosz, deputy director of litigation strategy at Children's Rights, one of the groups that filed the lawsuit, said children are passed from one caregiver and one medical provider to the next without their medical records accompanying them. Bartosz says other states routinely provide these safeguards for children, according to Post-Dispatch reporter Robert Patrick.

Using medications off-label -- meaning for purposes other than what they have been approved for by the Food and Drug Administration -- can pose risks of "psychosis, seizures, irreversible movement disorders, suicidal thoughts, aggression, weight gain, organ damage, and other life-threatening conditions," the lawsuit says.

Bartosz also said the inadequate medical information means children are sometimes taking multiple psychotropic medications and antipsychotic drugs that can cause myriad health and behavioral problems. The lawsuit gave as an example a 12-year-old girl who was handed to a relative with her medications wrapped in tissue paper and no instructions on their use. The girl had a "severe reaction" to getting a wrong dose of the medicine and was hospitalized for six days.

Few children are more vulnerable that these. Someone has to look out for them.

That's supposed to be the job of the state's foster care system. These children don't have wealthy political donors or highly paid lobbyists to advocate for them in Jefferson City, but there's no justification for letting them fall through the cracks.

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