Report 2015-131 Recommendation 26 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 #26 To: Social Services, Department of

To better ensure that counties only use parental consent in place of court authorization when it is appropriate, Social Services should assess Sonoma County's practice of advocating to the juvenile court that it delegate to parents the authority to administer psychotropic medications to foster children.

6-Month Agency Response

CDSS met with representatives from Sonoma County Human Services and Probation Departments, Sonoma County Superior Court Juvenile Division including the judge, county counsel, minor's attorney and parents' attorney, Behavioral Health Division and the consulting Child & Adolescent Psychiatrist on December 2, 2016. The discussion included the following topic areas:

- Mental Health Services Screening and Referral Procedures

- Psychotropic Medication Court Authorization and Parental Consent Protocols

- Use of the California Guidelines for the Use of Psychotropic Medication with Children and Youth in Foster Care

- Talking with Children, Youth and Families about Psychotropic Medications

- Documentation

Prior to this audit, Sonoma County identified strategies to improve the oversight of Psychotropic Medication for children in Foster Care as part of the California Child and Family Services Review (C-CFSR) Self Improvement Plan. Psychotropic medications are now a standing item on all team meeting agendas if applicable, social workers received additional training on the topic, social workers are asked to maintain up-to-date client records on all psychotropic medication related issues, all JV-220 applications are reviewed by supervisors prior to court submission and a contract was executed for a consulting psychiatrist to review all JV-220 applications.

Sonoma County has now implemented a more efficient process for mental health referrals which are now processed by a centralized administrative unit to increase timeliness for the provision of services and increased follow-up to ensure children and youth are being taken for mental health treatment. Barriers to treatment are identified more promptly and staff are able to identify solutions expeditiously.

(The rest of the response could not fit in the textbox and will be emailed to the lead auditor.)

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

Social Services' complete response is available from our office.

60-Day Agency Response

CDSS has made partial corrections to this recommendation. CDSS staff has met with Sonoma County staff to discuss the availability of mental health services to the children in foster care as well as their progress towards the implementation of California Pathways to Mental Health. Initial conversations have been held with the Sonoma County leadership to make arrangements for an in-person meeting. During the meeting, CDSS will discuss the county's practice of advocating to the Juvenile Court that parents be given the authority to retain their rights to make final decisions about their child's usage of psychotropic medication. It is anticipated that a meeting with the Director and key staff will take place in November 2016.

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

All Recommendations in 2015-131

Agency responses received are posted verbatim.