Washington Takes Giant Step Forward: New Legislation Orders Curbs on Psychotropic Medication of Foster Children

The State of Washington’s legislature has passed, and on May 18 its Governor signed, far-reaching legislation to reduce over-medication of foster children with psychotropic drugs.

House Bill 1879 mandates:

  • “. . . the [state health care]authority shall require a second opinion . . . for all prescriptions of one or more antipsychotic medications of all children under eighteen years of age in the foster care system. . . . The second opinion . . . must include discussion of the psychosocial interventions that have been or will be offered . . . .”
  • “The [state health care] authority shall track prescriptive practices with respect to psychotropic medications with the goal of reducing the use of medication.”
  • The [state health care] authority shall review the psychotropic medications of all children under five and establish one or more mechanisms to evaluate the appropriateness of the medication . . . including but not limited to obtaining second opinions . . . .”
  • “the [state health care] authority shall promote the appropriate use of cognitive behavioral therapies and other treatments which are empirically supported or evidence-based, in addition to or in the place of prescription medication where appropriate and such interventions are available.”

The psychotropic medication portion of the law is embedded in a legislative mandate for development of an “integrated” mental health system for foster children:

  • “The [state health care] authority shall issue a request for proposals to provide integrated . . . behavioral health care for foster children . . . [including] a service delivery system, benefit design, reimbursement mechanisms . . . and standards. The . . . services [shall] . . . begin on October 1, 2016.

Key elements in Washington’s new law include:

  • The legislature states unequivocally that it is directing state agencies to reduce inappropriate medication of foster children.
  • Non-pharmacological interventions are to be substituted whenever possible. The goal is “reducing the use of medication.”
  • Second opinions are to be a major component of Washington’s program.
  • Reduction of medication is to be embedded in a comprehensive plan for “integrated managed health and behavioral health services for foster children.”

So far as we know, the State of Washington’s new law is far ahead of other states. Readers: please let us know what is underway—or already accomplished—in your state.

The full text of the State of Washington’s HB 1879 is here.

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