State Rep. Mary Margaret Oliver (D-Decatur)
What initially drew your interest to this issue?
There are a lot of people doing preliminary work on this issue. The recent report conducted by Karen Worthington (prepared for the Supreme Court of Georgia Committee on Justice for Children – view the report here) gives a lot of background and is quite helpful in getting a handle on this issue. The report is a national study of other state practices in the area of psychotropic drugs. The Department of Community Health (DCH) has provided their payment patterns and recommendations for drugs. I learned a lot from Georgia’s Cold Case Project, a project sponsored by the Supreme Court of Georgia’s Committee on Justice for Children. That effort was about improving the legal process for abused and neglected children in the courts. The committee did an intensive file review of those cases of children who have been in the foster care system long-term and learned a lot about high psychotropic drug use among them. There needs to be some independent clinical oversight in regards to this. These are children with no parents or other adults to advocate on their behalf. There are caseworkers who don’t have the skill set or knowledge, being asked to approve medications for these kids. These children move around a lot; there’s a lack of consistent medical record keeping. We need to have a more uniform process for prescribing these drugs and to assess whether they’re needed in some cases at all.
How serious is this issue in Georgia?
First off let me say that this problem is not unique to Georgia; this is a national issue too. What we do know is that our state spends $7.8 million annually on psychotropic drugs for many of our foster children. That’s a huge expense and one that we can’t afford not to look at more closely. We have a huge obligation to provide better care for our foster children. There is an obligation for us to create a rule-making process to help us find out what are the needs here and how to address the situation. We need to identify the red flag cases and look at private psychiatrists who can help caseworkers do some troubleshooting. When you see Medicaid payment records showing thousands of children receiving multiple psychotropic drugs at one time, you’ve really got to look at whether this is necessary for these children.
What exactly are you hoping to achieve with HB23?
I am pushing for better medical records management for these children. My bill calls for the Department of Family and Children Services (DFCS) to implement rules creating a process for an independent medical review of the mental health treatment programs for foster care children. Who should decide and oversee psychotropic medications for these foster kids? There is no loving or competent parent? We know that we need a clinical review, but how do we do it? That’s one of the many questions that have to be answered. We have to be a part of the solution for these children. Significant changes could result in us spending a lot less money.
Now that you’ve introduced the legislation, what’s the next step?
It is now before Sharon Cooper’s Health and Human Services Committee. I have not asked for a hearing yet because I am waiting to collect more data. I want to hear from some private funders about what they want to provide. There are still a lot of questions that have to get answered. What problems do we anticipate? What are the costs? What are the solutions? We have to get those questions answered. I’m seeing a lot of attention brought to this issue. People are really paying attention to this. With the amount of money being spent and the number of children being affected, it’s a huge issue. I’ve been pleased with the process. I believe that we are going to be able to make a lot of progress on this issue.
View Rep. Oliver’s op-ed published in The Atlanta Journal-Constitution
Here’s what some other local child advocates had to say about Rep. Oliver’s bill:
State Rep. Glenn Baker, (D–Jonesboro)
“We need to have something in place to monitor how these drugs are being administered to children. We need to educate our foster parents more about these drugs, but we can’t place the blame on these folks. It’s my understanding is that there is only one druggist in the state that supplies these medications.”
Gerald Bostock, Child Welfare Services Coordinator, Clayton County Juvenile Court
“The problem with this psychotropic drug issue is that there is no oversight. These foster parents don’t understand the drugs that these children are on. You also have caseworkers who don’t understand these drugs either. Somebody has to take responsibility for these medications.”
Got a juvenile justice story idea? Contact JJIE.org staff writer Chandra R. Thomas at firstname.lastname@example.org. Thomas, a former Rosalynn Carter Mental Health Journalism Fellow and Kiplinger Public Affairs Journalism Fellow, is an award-winning multimedia journalist who has worked for Fox 5 News in Atlanta and Atlanta, People and Essence magazines.