Sample letters

Sample letters

DIRECTIONS:  To send a letter of support for one or both of the 2 proposed bills, and/or the budget request, copy the appropriate sample letter directly onto your organizational letterhead. Be sure to change the highlighted items (the date, your organization’s name and the signatory information at the bottom). You can send a PDF file of your signed letter to ajohnson@youthlaw.org, fax it to attn: A Johnson at (510) 835-8099, or mail it to A. Johnson at NCYL, 405 – 14th Street, 15th floor, Oakland, CA 94612. We will deliver the original along with copies to the committee members in the appropriate legislative offices.

Alternatively, you can send your letters of support directly via email or fax to committee consultants who are preparing the analyses. Please be sure to cc Ajohnson@youthlaw.org

For Letters of Support for SB 1174

Email to Brendan McCarthy Senate Appropriations Committee

Brendan.mccarthy@sen.ca.gov

State Capitol, Room 2206
Sacramento, CA 95814
Phone: (916) 651-4101


 

<Association/Group Header>

April XX, 2016

The Honorable Mike McGuire, author
State Capitol Building, Room 5064
Sacramento, CA 95814

RE: SPONSOR/SUPPORT SB 1174 (McGuire) — Support

Dear Senator McGuire,

Organization is proud to support SB 1174. Nearly 1 in 4 California foster teens are prescribed psychotropic drugs; of those nearly 60 percent were prescribed an anti-psychotic – the powerful drug class most susceptible to debilitating side effects. While the Child and Family Services Improvement and Innovation Act of 2011 requires each state to oversee and monitor the use of psychotropic medications with children in care, there are currently no requirements to identify those who are over prescribing medication to foster youth.

The vast majority of doctors prescribing medication are doing so appropriately, but California still needs an oversight mechanism (among other reforms including funding robust trauma care services). Currently, we have no system for evaluating the medical soundness of high rates of prescribing; and no way to measure the efficacy of these practices.  Last year, the Department of Health Care Services (DHCS) and the Medical Board of California adopted a one-year trial Data Use Agreement that allows for the sharing of prescriber data in order to identify outlying prescribers. Such data sharing practices should not be on a one-time basis, but rather an ongoing process for improving the quality of prescribing for our children.

This bill enables the Medical Board of California to confidentially collect and analyze data, and, when warranted, conduct investigations of physicians who frequently prescribe over the recognized safety parameters for children.

<Add in a sentence or two why your organization supports>

Thank you for your support of SB 1174.

Sincerely,

<Signature> 

<Name>

<Title>

Cc:       Members, Senate Appropriations Committee

Senator McGuire, author


 

For Letters of Support for SB 1291

Email to Brendan McCarthy Senate Appropriations Committee

Brendan.mccarthy@sen.ca.gov

State Capitol, Room 2206
Sacramento, CA 95814
Phone: (916) 651-4101


 

<Association/Group Header>

April XX, 2016

The Honorable Jim Beall, author
State Capitol Building, Room 5066
Sacramento, CA 95814

RE: SPONSOR/SUPPORT SB 1291 (Beall) — Support

Dear Senator Beall,

Organization is proud to support SB 1291. The vast majority of California’s children and youth in foster care do not receive safe, quality mental health services during their time in care despite a well-documented need. An August 2011 report found California’s child welfare system found only 34.7% of foster children and youth received mental health services, excluding medication and case management – well below national prevalence rates showing need in 60% of the foster care population. At the same time, 25% of foster children ages 6-17 are receiving one or more psychotropic medications and more than 50% of children in group homes are receiving these powerful drugs.

According to state guidelines the decision to treat children with psychotropic medications cannot be taken lightly, the benefits must outweigh the risks, and other treatments must have been tried prior to their use. Unfortunately, it is common for foster children to be quickly referred for medication without providing other supports that will help address their underlying mental and behavioral health needs.

This bill requires county mental health plans to create a subsection for foster youth and include an annual foster care mental health plan detailing the service array-from prevention to crisis services-available to these children and youth. SB 1291 will enable the state and county to track access, quality and outcomes specific to foster children.

<Add in a sentence or two why your organization supports>

Thank you for your support of SB 1291.

Sincerely,

<Signature>

<Name>

<Title>

Cc:       Members, Senate Appropriations Committee

Senator Beall, author


For Letters of Support for PHN Budget Request

Email Therese Pena Senate Budget Subcommittee 3

Senate Budget Subcommittee 3:
Attn: Theresa Peña
theresa.Pena@sen.ca.gov
State Capitol, Room 5019
Sacramento, CA 95814
Fax: (916) 668-7004


 

<Association/Group Header>

April XX, 2016

Senator Holly Mitchell, Chair
Senate Subcommittee on Health and Human Services,
Senate Budget and Fiscal Review
State Capitol, Room 5019
Sacramento, CA 95814

 

Assembly Member Tony Thurmond, Chair
Subcommittee on Health and Human Services,
Assembly Committee on Budget
State Capitol, Room 6026

Sacramento, CA 95814 

SUPPORT FOR BUDGET REQUEST: Mental Health Services and Psychotropic Medication: Oversight, Coordination, and Monitoring

Dear Senator Mitchell and Assembly Member Thurmond:

We are a group of organizations invested in improving the physical and mental health outcomes of California’s foster youth. Children enter foster care when they have experienced abuse or neglect. Once involved, they become the state’s children, and the State is, therefore, responsible for their safety, health, and well-being, including their mental health needs.

More than 9000 California foster children are being administered psychotropic drugs. That’s nearly 25% of children between ages 6 and 18 in foster care, and 56 percent of children in group homes. The State has a responsibility to monitor the administration of these drugs and to ensure the health and well-being of foster children. Recognizing this responsibility fifteen years ago, the legislature created the Health Care Program for Children in Foster Care (HCPCFC) to oversee the health care of the state’s foster children, but funding has not kept pace with the duties assigned to the Public Health Nurses (PHNs).

Currently, many foster children are not provided initial health screenings due to increased caseloads and responsibilities of PHNs.  As a result, high risk health problems are not detected and opportunities for early intervention and prevention are lost. The impact of this is even graver for foster children who are on psychotropic drugs.

Absent adequate oversight, psychotropic drugs can cause crippling sedation, morbid obesity, memory loss, diabetes, heart disease, irreversible tremors, other long-term disabilities, and in extreme cases, death. In spite of clear guidelines by the American Academy of Child and Adolescent Psychiatrists and the American Diabetes Association, roughly two-thirds of foster children on psychotropic medications do not receive basic medical monitoring, follow up visits, or necessary labs. Without these basic services, the overmedication of our foster children can lead to chronic disease management with long-term and increased fiscal implications for the State.

Over the past 10 years, California has paid more than $226 million on psychotropics for foster children. Unfortunately little is known about the precise costs associated with the treatment of side effects and chronic health conditions associated with long-term psychotropic medication use, but nonetheless the figure is likely to be quite large.

For example the American Heart Association estimates that a person with heart disease is burdened by huge medical expenses, including diagnostic tests, surgery, hospital and doctor’s visits, physical therapy, and costly drugs. A conservative estimate of these costs for one person is $121,200 over 20 years. For those needing surgery or procedures and ongoing care, the cost can be more than 4.8 million over a lifetime.

California provides oversight of health care services for foster children primarily through HCPCFC in county child welfare agencies. HCPCFC is supported by an enhanced federal match rate of 75/25.

Since the program began the state has expanded the role of PHNs to include non-minor dependents and the oversight of psychotropic medications. These program expansions were undertaken without additional funding – straining the capacity of some counties to fulfill the obligations. At the same time many other state initiatives, including the Continuum of Care Reform, AB 403, will also increasingly rely on PHNs.

PHNs are one of the great resources of our child welfare system. SB 319 and SB 238 allow PHNs to review and monitor psychotropic medication and treatment, assist in scheduling and monitoring appointments and support court review of treatments. The projected General Fund cost associated with SB 319 and SB 238 is $1,650,000 for the additional staffing to ensure that there is appropriate psychotropic medication case management within HCPCFC. The federal match will bring in an additional $4,950,000.

Thank you for your consideration of this important issue. We look forward to continuing this conversation and working together to improve the health outcomes of youth in foster care. For more information, please contact Anna Johnson at ajohnson@youthlaw.org.

Sincerely,

cc:

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