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February 24, 2016

Pa. trying to clamp down on use of psych drugs by children on Medicaid

Department of Human Services announces new hotline and training program to reduce over-prescription

Pennsylvania is trying to reduce the use of psychiatric drugs by children enrolled in Medicaid, especially those in the foster care system, with a set of new initiatives announced on Tuesday.

After a 2015 study from the PolicyLab at the Children's Hospital of Philadelphia found that in 2012 a whopping 43 percent of kids age 6 to 18 in foster care were using psychiatric drugs, the state Department of Human Services promised that it would take steps to reduce its reliance on these powerful medications.

One particularly concerning finding from the report was that 22 percent of youth in foster care were on antipsychotic medications, yet one-third of those kids were diagnosed with nothing more than attention-deficit disorder.

The department published a list of recommendations this past June that it promised to follow, including:

  1. Requiring managed-care organizations (which serve almost 98 percent of children in foster care) to get pre-authorization for prescriptions from the department.
  2. Developing guidelines to help doctors and psychiatrists in diagnosing and treating children.
  3. Creating an electronic dashboard to allow welfare officers to monitor the use of psychiatric drugs in foster-care children.

This week, DHS announced two more initiatives: a hotline for doctors and nurses and a new training program for caseworkers, parents and foster parents.

The telephone hotline, which will offer health care professionals guidance in prescribing medication, will be set up by April. The training program, being developed by the University of Pittsburgh, should be available by July. It will help educate caregivers on the appropriate use of psychiatric medication.

DHS has had success before in clamping down on over-prescription. It managed to reduce the use of psychiatric medication by 75 percent over two years for children in its Medicaid fee-for-service program. However, only 2 percent of children on Medicaid are covered under that program, according to the Philadelphia Inquirer. The vast majority are enrolled in managed-care organizations instead. 

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