Report 2015-131 Recommendation 24 Responses

Report 2015-131: California's Foster Care System: The State and Counties Have Failed to Adequately Oversee the Prescription of Psychotropic Medications to Children in Foster Care (Release Date: August 2016)

Recommendation #24 To: Sonoma County

To improve its oversight of foster children prescribed psychotropic medications, Sonoma County should within six months, implement a process to review psychotropic medications that receive parental consent rather than court authorization.

Annual Follow-Up Agency Response From October 2018

FY&C and the County of Sonoma DHS MH Division have an existing contract that requires a review by psychiatrist of all JV220 applications regarding psychotropic medication prescriptions that are an order of the court. The contract also includes the review of JV220 A and B for any medication with parental consent. This policy has been in effect for over 18 months.

Probation implemented a contract with DHS MH in 2018 that also requires review by psychiatrist of all JV220 applications and/or "Non Court-Ordered Foster Youth Medication Statement" for parental consent cases. Probation implemented a Psychotropic Medication Policy which outlines procedures regarding the administration of psychotropic medication to wards of the court. Additionally, in 2017 Probation implemented protocols to conduct monthly audit updates of foster care wards on psychotropic medication which are forwarded to the PHNs for monitoring purposes.

  • Completion Date: January 2018

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented


Annual Follow-Up Agency Response From November 2017

Please refer to our one year response

  • Estimated Completion Date: May 2018

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented


1-Year Agency Response

FY&C and the County of Sonoma DHS MH Division have an existing contract that requires a review by psychiatrist of all JV220 applications regarding psychotropic medication prescriptions that are an order of the court. The contract also includes the review of JV220 A and B for any medication with parental consent. This policy has been in effect for over 6 months.

Probation is developing a contract with DHS MH that also requires review by psychiatrist of all JV220 applications and/or "Prescribing Physician Statements" for parental consent cases. Probation is also drafting a Psychotropic Medication Policy which will outline procedures regarding the administration of psychotropic medication to wards of the court. Additionally, Probation is developing protocols to conduct monthly audit updates of foster care wards on psychotropic medication which will be forwarded to the PHNs for monitoring purposes.

  • Estimated Completion Date: December 2017
  • Response Date: August 2017

California State Auditor's Assessment of 1-Year Status: Partially Implemented


6-Month Agency Response

FY&C has an existing contract with County of Sonoma DHS MH for review of all JV-220 applications regarding psychotropic medication prescriptions that require order of the court for administration. This contract was enhanced effective December 5, 2017 to include review of all JV-220(A) and (B) applications for prescriptions for which a parent can consent. Effective that date, all prescriptions for psychotropic medications provided to foster youth monitored by Family, Youth & Children's Services are being reviewed by an additional psychiatrist.

However, prescriptions for foster youth monitored by Juvenile Probation are not yet undergoing this same secondary review. Discussion toward development of a process to make this review occur are now underway. It is expected that a process will be in place by July 1, 2017.

  • Estimated Completion Date: July 1, 2017
  • Response Date: February 2017

California State Auditor's Assessment of 6-Month Status: Partially Implemented


60-Day Agency Response

FY&C has an existing contract with County of Sonoma DHS MH for review of all JV-220 applications regarding psychotropic medication prescriptions that require order of the court for administration.

Board of Supervisors approval was required before enhancement of the existing contract could occur to include review of all parental consent prescriptions. That approval has been granted and an amendment to the existing contract is underway. Effective December 5, 2016, a child and adolescent psychiatrist will begin reviewing all psychotropic medication prescriptions for FY&C foster youth that are authorized via parental consent.

  • Estimated Completion Date: December 5, 2016
  • Response Date: October 2016

California State Auditor's Assessment of 60-Day Status: Partially Implemented


All Recommendations in 2015-131

Agency responses received are posted verbatim.