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Agencies Unite for Mental
Health Medication Initiative
Hannah Report, Sept. 25, 2012.
Education, empowerment and safety -- that was the message from the Ohio Department of Job and Family Services' (ODJFS) Office of Medical Assistance (Medicaid) in announcing a new joint initiative Tuesday to improve practices related to prescribing antipsychotic and psychotropic medication to youth. The state is working with Best Evidence Advancing Child health in Ohio Now (BEACON) and a variety of health care leaders to launch a $1 million quality improvement initiative, which will last three years. The initiative will evaluate the prescription of these drugs to children on Medicaid. Medicaid Director John McCarthy laid out the goals of the initiative which included the improvement of overall care for Ohio's children, especially those in foster care, at the day's news conference. "Seeing as these young people are more likely to experience complex social, emotional, behavioral and mental health issues -- they're also more likely than other children in Medicaid -- to be prescribed atypical antipsychotic medications," explained McCarthy. Other groups joining Medicaid in the initiative include the Ohio Department of Mental Health (ODMH), Public Children Services Association of Ohio (PCSAO) and the National Alliance on Mental Illness of Ohio (NAMI Ohio). Over the next three years, the groups hope to develop technical resources, improve the use of best practices and advance parental and caregiver knowledge related to these medications. Parents and caregivers who face the possibility of placing a child on antipsychotic medications struggle with mixed feelings, according to NAMI Ohio Executive Director Terry Russell. He explained that caregivers can be relieved knowing that the medications can be helpful, and even lifesaving. On the other hand, Russell said they can be fearful of the potentially serious side effects. When it comes to prescribing atypical antipsychotic and psychotropic drugs, the federal Food and Drug Administration (FDA) has an age guideline of six-years-old and up. The point was made that older, medicated youth must be involved in the prescription process. "If young people are not part of the process the chance of them following through on their treatment after they turn 18 is quite low," said Russell. McCarthy said the initiative will help the agencies discover any problems that may exist within the prescription process, such as overprescribing to children. Another concern is the impact these medications may have on a child's ability to learn. Dr. Mary Applegate, Medicaid medical director, explained that they will evaluate educational factors along the way and in the third year of the initiative. She noted a situation a couple of decades ago when children were prescribed anticonvulsants for seizures. It was later determined that those drugs played a role in creating learning disabilities. Applegate added that giving medication to those with developing brains is a reason for concern. The education is an element of the initiative and the Ohio Department of Education (ODE) is involved as a member of BEACON. "We consider a child's success in school to be one of the outcomes that we're actually looking for -- for all the children, particularly foster children," explained Applegate who noted that a child's inability to learn may stem from an undiagnosed mental health condition. |
Saturday, September 29, 2012
Appreciation for Ohio Medicaid Director John McCarthy
Better oversight when it comes to medicating foster youth
State is tackling pills for foster kids.
Candisky, Catherine. Columbus Dispatch, Sept. 26, 2012.
Nearly 1 in 4 foster children in Ohio has been prescribed mind-altering drugs.
In Ohio and across the country, foster children are more likely than other youngsters to be prescribed psychotropic drugs, which can bring serious health risks and side effects. The medications also are expensive, costing millions to the tax-funded Medicaid program that insures foster children.
Yesterday, state officials announced a $1 million initiative to improve psychotropic-drug management by closely monitoring prescriptions and improving coordination of physical and mental-health care for Ohio’s 12,000 children insured through Medicaid.
“The rate of prescribing has gone up, but it’s not clear that the rate of mental illness has gone up to the same extent,” said Dr. Mary Applegate, medical director for Ohio’s Medicaid program.
“We are seeing kids who are taking two or three or four of the same type of drug at the same time.”
The effort comes about a year after a federal report based on a two-year investigation found higher prescription rates among foster children.
Psychotropic medications are used to treat mental illnesses such as depression and bipolar disorder. Although foster children tend to have a higher prevalence of such ailments because of a greater likelihood of trauma and stress, usage still appears too high.
Pam Harris of Greene County said her 13-year-old son was on eight medications at one point, and she was overwhelmed trying to coordinate care by pediatricians and psychiatrists while she looked after him.
“The pediatrician wants to prescribe to help keep everyone safe, and then we may wait six weeks to see the psychiatrist. They don’t coordinate, and it’s frustrating to see the side effects,”Harris said. “I asked the psychiatrist about side effects and he said ‘Ask the pediatrician.’ I asked the pediatrician and he said ‘Ask the psychiatrist.’ ”
Then 5, her son suffered tremors and other problems after he started taking medication for what doctors believed was an attention-deficit disorder. When his behavior turned aggressive, he was given more drugs and immediately gained 10 pounds. Problems persisted, and he had to move out to ensure the safety of his siblings.
“Any parent or caregiver of a child with severe emotional disorder facing the prospects of having their child or foster child placed on psychotic medications struggles with very mixed feelings,” said Terry Russell, executive director of the National Alliance on Mental Illness of Ohio.
“On one hand, knowing that such medications can literally be lifesaving ... and improve their child and their family’s quality of life. ... On the other hand, parents are also fearful because they know such medications can cause serious side effects if they are not properly used or monitored.”
Advocates for children and the mentally ill joined state officials at a Statehouse news conference yesterday to support the initiative, saying it will help ensure safe use of psychotropic drugs and improve overall care.
“Through the initiative, the state will determine which children are receiving more than two psychotropic drugs at a time, their ages and their diagnosis, the maximum dosage, dosage for children,” said Crystal Ward Allen, executive director of the Public Children Services Association of Ohio.
“These are all big unknowns, and it’s often a challenge in the child-welfare system to be the custodian without the medical expertise.”
State officials said they will monitor prescriptions of such drugs and inform doctors when multiple medications have been prescribed or when safe dosage has been exceeded. Often, Applegate said, more than one doctor is involved in a child’s care because a child moved, and the physician is unaware of other prescriptions.
Last year, taxpayers spent nearly $37.7 million on prescription-drug costs for foster children, with some prescriptions costing as much as $500 a month. Officials have not projected any savings through the initiative, but avoiding duplicative prescriptions, lowering usage of such medications and increasing use of alternative treatments such as counseling will reduce costs.
Candisky, Catherine. Columbus Dispatch, Sept. 26, 2012.
Nearly 1 in 4 foster children in Ohio has been prescribed mind-altering drugs.
In Ohio and across the country, foster children are more likely than other youngsters to be prescribed psychotropic drugs, which can bring serious health risks and side effects. The medications also are expensive, costing millions to the tax-funded Medicaid program that insures foster children.
Yesterday, state officials announced a $1 million initiative to improve psychotropic-drug management by closely monitoring prescriptions and improving coordination of physical and mental-health care for Ohio’s 12,000 children insured through Medicaid.
“The rate of prescribing has gone up, but it’s not clear that the rate of mental illness has gone up to the same extent,” said Dr. Mary Applegate, medical director for Ohio’s Medicaid program.
“We are seeing kids who are taking two or three or four of the same type of drug at the same time.”
The effort comes about a year after a federal report based on a two-year investigation found higher prescription rates among foster children.
Psychotropic medications are used to treat mental illnesses such as depression and bipolar disorder. Although foster children tend to have a higher prevalence of such ailments because of a greater likelihood of trauma and stress, usage still appears too high.
Pam Harris of Greene County said her 13-year-old son was on eight medications at one point, and she was overwhelmed trying to coordinate care by pediatricians and psychiatrists while she looked after him.
“The pediatrician wants to prescribe to help keep everyone safe, and then we may wait six weeks to see the psychiatrist. They don’t coordinate, and it’s frustrating to see the side effects,”Harris said. “I asked the psychiatrist about side effects and he said ‘Ask the pediatrician.’ I asked the pediatrician and he said ‘Ask the psychiatrist.’ ”
Then 5, her son suffered tremors and other problems after he started taking medication for what doctors believed was an attention-deficit disorder. When his behavior turned aggressive, he was given more drugs and immediately gained 10 pounds. Problems persisted, and he had to move out to ensure the safety of his siblings.
“Any parent or caregiver of a child with severe emotional disorder facing the prospects of having their child or foster child placed on psychotic medications struggles with very mixed feelings,” said Terry Russell, executive director of the National Alliance on Mental Illness of Ohio.
“On one hand, knowing that such medications can literally be lifesaving ... and improve their child and their family’s quality of life. ... On the other hand, parents are also fearful because they know such medications can cause serious side effects if they are not properly used or monitored.”
Advocates for children and the mentally ill joined state officials at a Statehouse news conference yesterday to support the initiative, saying it will help ensure safe use of psychotropic drugs and improve overall care.
“Through the initiative, the state will determine which children are receiving more than two psychotropic drugs at a time, their ages and their diagnosis, the maximum dosage, dosage for children,” said Crystal Ward Allen, executive director of the Public Children Services Association of Ohio.
“These are all big unknowns, and it’s often a challenge in the child-welfare system to be the custodian without the medical expertise.”
State officials said they will monitor prescriptions of such drugs and inform doctors when multiple medications have been prescribed or when safe dosage has been exceeded. Often, Applegate said, more than one doctor is involved in a child’s care because a child moved, and the physician is unaware of other prescriptions.
Last year, taxpayers spent nearly $37.7 million on prescription-drug costs for foster children, with some prescriptions costing as much as $500 a month. Officials have not projected any savings through the initiative, but avoiding duplicative prescriptions, lowering usage of such medications and increasing use of alternative treatments such as counseling will reduce costs.
Thursday, September 13, 2012
Mustard Seed Foundation in Dayton, Ohio
Young mothers get a chance to thrive
WDTN.Com, 9/11/2012
DAYTON, Ohio (WDTN) - A woman's dysfunctional past leads to a passion that saves teen girls from the same fate.
A local non-profit organization helps young mothers, giving them faith as small as a seed.
D'Shara Farrell is doing her best to return what she calls a very big blessing She's helping with day care at the Mustard Seed Foundation.
"I had been through a lot, foster homes... I didn't care about what my kids did. I think it was pretty much faith brought me here," said Farrell.
That faith for the teen mother meant she and her two young children stepped into a rambling home on the grounds of the Church of the Precious Blood in Trotwood.
All four floors here house teen mothers and their children. They come from all over Ohio, referred by social service agencies.
One of the people who consistently encouraged D'Shara is Mustard Seed founder, Shondale Atkinson-Hale.
The Mustard Seed Foundation was her dream and two years ago, it finally became a reality.
Atkinson-Hale has a soft spot for these young girls. Like many of them, she, as a teen mother, suffered emotional, physical and sexual abuse.
"When they walk through the door, I assume they are me because they are," said Atkinson-Hale.
D'Shara now works, goes to college and lives on her own with her children. She attributes her new, small, successful steps to the faith of the tiny mustard seed and Shondale Atkinson-Hale.
The Mustard Seed Foundation is one of the non-profit charities supported by the Women in Business Networking and its fifth annual Professional Development Conference on September 19, 2012 at the Sinclair Community College Ponitz Center.
A local non-profit organization helps young mothers, giving them faith as small as a seed.
D'Shara Farrell is doing her best to return what she calls a very big blessing She's helping with day care at the Mustard Seed Foundation.
"I had been through a lot, foster homes... I didn't care about what my kids did. I think it was pretty much faith brought me here," said Farrell.
That faith for the teen mother meant she and her two young children stepped into a rambling home on the grounds of the Church of the Precious Blood in Trotwood.
All four floors here house teen mothers and their children. They come from all over Ohio, referred by social service agencies.
One of the people who consistently encouraged D'Shara is Mustard Seed founder, Shondale Atkinson-Hale.
The Mustard Seed Foundation was her dream and two years ago, it finally became a reality.
Atkinson-Hale has a soft spot for these young girls. Like many of them, she, as a teen mother, suffered emotional, physical and sexual abuse.
"When they walk through the door, I assume they are me because they are," said Atkinson-Hale.
D'Shara now works, goes to college and lives on her own with her children. She attributes her new, small, successful steps to the faith of the tiny mustard seed and Shondale Atkinson-Hale.
The Mustard Seed Foundation is one of the non-profit charities supported by the Women in Business Networking and its fifth annual Professional Development Conference on September 19, 2012 at the Sinclair Community College Ponitz Center.
Tuesday, September 11, 2012
Ohio worst in nation for foster-care funding
Ohio worst in nation for foster-care funding
Millea, Meghan. Times Reporter, Sept. 2, 2012.
WORTHWHILE INVESTMENT’
Even with Tuscarawas County’s local contribution, Tope said it’s not enough to cover all the needs. She said people may find the contribution high, but there are several aspects to consider, including the type of treatment needed and the agency’s ability to find suitable matches for children.
Children enter the system as early as the day they are born and may stay in the system until they are 18, sometimes 21, if there’s a developmental disability. Placement can be hard, especially for older children. The median age for children in foster care in Tuscarawas County is 9.
Forty-nine new children came into the foster-care program this year. Veronica Spidell, JFS social services department manager, explained that $2.03 million may seem like a large amount of money to care for 121 children, but there are several aspects to consider, namely the severe cases.
Spidell said there are a number of children who are placed in residential treatment, which is a group home with tight security and supervision for children with the most severe issues.
“We’ve had children as young as 8 playing with gasoline, harming animals,” Spidell said.
Another aspect is placement. Many children are part of sibling groups. “We’re very committed to keeping sibling groups together,” said Gayle Hahn, the placement service supervisor for foster care and adoption.
Hahn said people may be frustrated by the cost of foster care and children’s services, however, the cost will be higher if the community does nothing. Children from abusive or negligent homes are more likely to end up homeless, in jail or prison, use mental health services and hospital services as adults, she explained.
“We still, as a community, will be paying for them,” Hahn said.
Tope contends the children in the system are just a fraction of those who need help.
“It’s a worthwhile investment,” she said, “to stabilize a child now while we can make improvements.”
Local Trends on Abuse and Neglect
In 2009, new allegations of child abuse and neglect totaled 725. Ohio law requires children services to begin investigations on new reports within 24 hours. A comprehensive assessment of safety and risk also is required.
The number of new allegations in 2009 and the percentage of total reports it represents fall within the following five categories:
Physical abuse 57 8%
Neglect 292 40%
Sexual abuse 92 13%
Emotional maltreatment 9 1%
Family in Need of Services 275 38%
Total 725 100%
Public Expenditures, 2009
Total: $6,136,622 100%
Federal $2,970,947 48%
State $830,267 14%
Local* $2,335,409 38%
* Of Ohio’s 88 counties, Tuscarawas County was not among the 45 that maintained a children services levy in 2009.
Source: Public Children Services Association of Ohio, 2011-2012 report
Millea, Meghan. Times Reporter, Sept. 2, 2012.
Every year, Michelle Tope receives complaints of horrific child abuse
and neglect, such as sexual and physical abuse and abandonment.
As director of the Tuscarawas County Jobs and Family Services, Tope works with caseworkers to conduct investigations, communicate with families and place children in safe environments.
The agency, she said, often is overrun with complaints. Last year, JFS received 547 complaints about child abuse or neglect. Only the most severe cases go before a judge.
That’s because most of the resources for child welfare are directed toward foster care. Little funding is left for preventive issues and family education. Tope said state funding is minimal; however, Tuscarawas JFS has local support.
County commissioners are generous with the foster-care budget, according to Tope, given the organization is contending with several other county-funded groups, such as the courts, sheriff and street departments.
The commissioners allotted $2.03 million for foster care in 2012. But Jobs and Family Services is nearly over budget, already having gone through more than $1.8 million this year. Why? Because they have received more children in the system than anticipated, Tope explained.
On average, there have been 121 children in the system each month. That’s up from the number JFS budgeted for — 110 children per month. Many of the children also have special needs and must be placed in intensive group homes for behavioral issues and developmental needs. And that costs money.
While JFS tries to keep families together, Tope said it’s difficult without the resources for family education and early prevention programs. She said there aren’t enough caseworkers — or enough time — to solely devote to at-risk families.
Federal and state funds help offset costs, but not much, said Crystal Ward Allen, executive director for the Public Children Services Association of Ohio.
She said the lack of state funding for foster care programs is an issue.
“Ohio has the lowest investment in the nation,” Allen said, explaining that the state provides between 5 to 10 percent of a county’s child welfare budget. “Since the state gives such a little piece of it, it’s really inequitable. If you don’t have local resources, that state piece gets really big, but the whole pie is so small.”
Allen said the state’s contribution to child welfare has remained fairly consistent for the last 20 years. There have been budget cuts in other areas that have hurt child welfare, including assistance to drug and alcohol abusers, and rent and cash-assistance to families in need.
As director of the Tuscarawas County Jobs and Family Services, Tope works with caseworkers to conduct investigations, communicate with families and place children in safe environments.
The agency, she said, often is overrun with complaints. Last year, JFS received 547 complaints about child abuse or neglect. Only the most severe cases go before a judge.
That’s because most of the resources for child welfare are directed toward foster care. Little funding is left for preventive issues and family education. Tope said state funding is minimal; however, Tuscarawas JFS has local support.
County commissioners are generous with the foster-care budget, according to Tope, given the organization is contending with several other county-funded groups, such as the courts, sheriff and street departments.
The commissioners allotted $2.03 million for foster care in 2012. But Jobs and Family Services is nearly over budget, already having gone through more than $1.8 million this year. Why? Because they have received more children in the system than anticipated, Tope explained.
On average, there have been 121 children in the system each month. That’s up from the number JFS budgeted for — 110 children per month. Many of the children also have special needs and must be placed in intensive group homes for behavioral issues and developmental needs. And that costs money.
While JFS tries to keep families together, Tope said it’s difficult without the resources for family education and early prevention programs. She said there aren’t enough caseworkers — or enough time — to solely devote to at-risk families.
Federal and state funds help offset costs, but not much, said Crystal Ward Allen, executive director for the Public Children Services Association of Ohio.
She said the lack of state funding for foster care programs is an issue.
“Ohio has the lowest investment in the nation,” Allen said, explaining that the state provides between 5 to 10 percent of a county’s child welfare budget. “Since the state gives such a little piece of it, it’s really inequitable. If you don’t have local resources, that state piece gets really big, but the whole pie is so small.”
Allen said the state’s contribution to child welfare has remained fairly consistent for the last 20 years. There have been budget cuts in other areas that have hurt child welfare, including assistance to drug and alcohol abusers, and rent and cash-assistance to families in need.
WORTHWHILE INVESTMENT’
Even with Tuscarawas County’s local contribution, Tope said it’s not enough to cover all the needs. She said people may find the contribution high, but there are several aspects to consider, including the type of treatment needed and the agency’s ability to find suitable matches for children.
Children enter the system as early as the day they are born and may stay in the system until they are 18, sometimes 21, if there’s a developmental disability. Placement can be hard, especially for older children. The median age for children in foster care in Tuscarawas County is 9.
Forty-nine new children came into the foster-care program this year. Veronica Spidell, JFS social services department manager, explained that $2.03 million may seem like a large amount of money to care for 121 children, but there are several aspects to consider, namely the severe cases.
Spidell said there are a number of children who are placed in residential treatment, which is a group home with tight security and supervision for children with the most severe issues.
“We’ve had children as young as 8 playing with gasoline, harming animals,” Spidell said.
Another aspect is placement. Many children are part of sibling groups. “We’re very committed to keeping sibling groups together,” said Gayle Hahn, the placement service supervisor for foster care and adoption.
Hahn said people may be frustrated by the cost of foster care and children’s services, however, the cost will be higher if the community does nothing. Children from abusive or negligent homes are more likely to end up homeless, in jail or prison, use mental health services and hospital services as adults, she explained.
“We still, as a community, will be paying for them,” Hahn said.
Tope contends the children in the system are just a fraction of those who need help.
“It’s a worthwhile investment,” she said, “to stabilize a child now while we can make improvements.”
Local Trends on Abuse and Neglect
In 2009, new allegations of child abuse and neglect totaled 725. Ohio law requires children services to begin investigations on new reports within 24 hours. A comprehensive assessment of safety and risk also is required.
The number of new allegations in 2009 and the percentage of total reports it represents fall within the following five categories:
Physical abuse 57 8%
Neglect 292 40%
Sexual abuse 92 13%
Emotional maltreatment 9 1%
Family in Need of Services 275 38%
Total 725 100%
Public Expenditures, 2009
Total: $6,136,622 100%
Federal $2,970,947 48%
State $830,267 14%
Local* $2,335,409 38%
* Of Ohio’s 88 counties, Tuscarawas County was not among the 45 that maintained a children services levy in 2009.
Source: Public Children Services Association of Ohio, 2011-2012 report
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