AACAP Policies Applauded by Congress & GAO
Published December 2, 2011
I'm very proud of AACAP today.
We were recognized several times by Congress for setting the standard of treatment for our most vulnerable children. Here is what happened.
AACAP's been aware that the Government Accountability Office (GAO) was investigating 2008 data from six states (MD, TX, FL, MA, OR, MI) comparing 1) rates of psychotropic drug prescriptions for foster children compared with non-foster children covered by Medicaid, including indicators of health risks, and 2) federal and state oversight policies as of October 2011 for psychotropic drugs prescribed to foster children. Earlier this year, we spoke to the GAO investigators about their limited study and shared with them AACAP practice guidelines and policies around this topic.
The report was discussed at a Senate hearing yesterday (12.1.2011). The study found that children in foster care were 2.7 - 4.5 times more likely to be on psychotropics. They also have data showing increased instances of polypharmacy, kids under 1 year on multiple medications, doses higher than the FDA recommended amounts, and medication gaps with this population. The second part of the report used AACAP's best principles (AACAP Position Statement on Oversight of Psychotropic Medication Use for Children in State Custody: A Best Principles Guideline) and graded each state monitoring system against our recommendations.
The report's conclusion requests HHS to issue formal guidance to state Medicaid and child welfare agencies on best practices of monitoring psychotropic medications in foster care children with guidance that will address informed consent, oversight consultation and information sharing. GAO consulted with two AACAP members who have been very interested in medications for kids, especially those in foster care, to analyze the data, Jon McClellan, M.D. and Mike Naylor, M.D.
Prior to the Senate hearing we had the opportunity to learn about the study and prepare for this. We put AACAP materials on our web site and released a press statement. Please be sure the check out AACAP's home page and our materials.
The Senate hearing included discussions regarding: 1) the need for increased research dollars on the use of psychotropic medications in children, 2) funding for more child and adolescent psychiatrists, and 3) funding for evidence-based psychotherapies. Dr. McClellan testified before the Senate Committee today, and both his testimony and a video of the hearing are available. You can also view a copy of the GAO testimony on their web site. Many news outlets have picked this story up and ABC will be airing a story on 20/20 Friday night about this topic.
I'm proud of AACAP members' and staff efforts to continually advocate for comprehensive mental healthcare for our most vulnerable children. I want to especially thank Kristin Kroeger Ptakowski for her spectacular leadership with preparing AACAP members who have helped with our media efforts, and Jon McClellan and Mike Naylor for their work with the GAO. I'm pleased the federal government is putting forth AACAP policy as a best practice for state governments to follow.
Our 8,500 members are the leaders in child and adolescent mental health practice and research, and we need to continue to advocate for appropriate quality care for all children with mental illnesses.
Martin J. Drell, M.D.