CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Improving the Use of Psychotropic Medication among Children and Youth in Foster Care: A Quality Improvement Collaborative

Start Date:
April 2012
Annie E. Casey Foundation

Use of psychotropic medications among children and adolescents in the child welfare system is a high-priority, public sector concern. Rates of psychotropic medication use are especially high among children and youth in child welfare, who typically rely on Medicaid to cover their physical and mental health service needs. Recent legislation requires that plans for the oversight and coordination of health care services for children in foster care — to be developed jointly by child welfare and state Medicaid agencies — include protocols for the appropriate use and monitoring of psychotropic medications.

To help states address this complex issue, CHCS is conducting a three-year quality improvement collaborative. Illinois, New Jersey, New York, Oregon, Vermont and Rhode Island (a Casey Special Interest Site) will each convene a cross-agency team — including state Medicaid, child welfare, and behavioral health agencies — as well as families, youth, and providers, to develop and implement new approaches to psychotropic medication use for this child population. The state teams will work to strengthen: (1) inter-agency partnerships; (2) appropriate data-sharing among agencies; (3) coordination of oversight and quality assurance processes; and (4) care coordination. The collaborative will provide intensive technical assistance to assist states in developing and adopting more effective protocols for psychotropic medication use.

Peer faculty from other states will be invited to share best practices throughout the course of the three-year collaborative. Lessons identified through the collaborative activities will be disseminated broadly to guide other states in developing effective policies and practices for the appropiate use of psychotropic medications, so as to improve care and outcomes for children in foster care with behavioral health needs.


New Virtual Learning Community for States on Reducing Inappropriate Use of Psychotropic Medications for Children and Youth in Foster Care

With support from the Substance Abuse and Mental Health Services Administration, CHCS is creating a virtual "learning community" of states focused on reducing the inappropriate prescribing of psychotropic medications to children and youth in foster care. Starting in fall 2012, CHCS will provide technical assistance to the learning community of states through a webinar series targeted to the issues identified by the participants and create a SharePoint site resource center for their use. The webinars will feature faculty presentations from experts in the field, foster peer exchange among the states, and disseminate promising best practices.

Medicaid, Child Welfare, and Behavioral Health directors and medical directors are invited to participate. To join, please email Jessica Lipper at


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