In recent years, the inappropriate use of psychotropic medication among children and youth in foster care — nearly all of whom are covered by Medicaid — has been identified as a concern by federal agencies. This high-risk population is five times more likely than the non-disabled Medicaid child population to receive psychotropic medications and has particularly concerning patterns of use for these drugs. While there are certainly children who need these medications, better mechanisms are needed to determine when this is the case. In response, states are strengthening their oversight and monitoring of psychotropic medication use, and the federal government has provided technical assistance to support those efforts.

This 90-minute webinar, made possible through support from the Annie E. Casey Foundation, featured four states that are using cross-agency partnerships to advance new psychotropic medication monitoring and oversight approaches. Medicaid, child welfare, and behavioral health agency representatives from Illinois, New Jersey, Oregon, and Vermont shared perspectives on strengthening inter-agency partnerships, facilitating appropriate data-sharing among agencies, coordinating oversight processes, and improving care coordination. The webinar also highlighted the impact of the states’ efforts to-date and key areas of opportunity for improvement moving forward. The four states were among those that participated in CHCS’ Psychotropic Medication Quality Improvement Collaborative, supported by the Annie E. Casey Foundation.

Agenda

I. Introduction and Background

Speaker: Kamala Allen, MHS, Vice President, Program Operations and Director, Child Health Quality, Center for Health Care Strategies

Kamala Allen welcomed participants, introduced speakers, and provided a contextual backdrop on the issue.

II. Perspectives from Cross-Agency Partnerships

Agency representatives from Medicaid, child welfare, and behavioral health shared their perspectives on inter-agency partnerships, data-sharing, and improving oversight and care coordination. They shared the impact of their partnership efforts to-date and key opportunities for future improvement.

Illinois

Speaker: Michael Naylor, MD, Associate Professor of Psychiatry and Medical Director/Coordinator of the Department of Children and Family Services Comprehensive Assessment and Treatment Unit/Response Training System, University of Illinois at Chicago

New Jersey

Speaker: Mary Beirne, MS, EdD, MD, Clinical Assistant Professor, Robert Wood Johnson Medical School, Rutgers Behavioral and Health Sciences, Chief Child and Adolescent Psychiatrist, New Jersey Department of Children and Families Office of Child and Family Health

Oregon

Speakers: Kevin George MSW, Foster Care and Youth Transition Program Manager, Office of Child Welfare Programs, Oregon Department of Human Services and Ajit Jetmalani, MD, Director, Division of Child and Adolescent Psychiatry, Oregon Health & Science University, Consultant, Oregon Health Authority

Vermont

Speaker: Brenda Gooley, Director of Operations, Family Services Division, Vermont Department for Children and Families

III. Q&A and Closing Remarks