We are Kathey and Rob Raskin of Las Vegas, and the care of our nation’s children is our top priority. Claims against Missouri are surviving challenges in federal court. They are alleging that the state has unconstitutionally failed foster children by administering psychotropic drugs.

In a news release from St. Louis University School of Law, a group of plaintiffs on behalf of “all minor children […] in Missouri foster care” are welcoming a federal court judge’s choice to uphold some of their claims, while rejecting others.

Filed in June by Children’s Rights, National Center for Youth Law, the St. Louis University School of Law Legal Clinics, and global law firm Morgan Lewis & Bockius, the defendants include officials within the Missouri Department of Social Services.

US District Judge Nanette K. Laughrey chose not to dismiss claims alleging Missouri may be violating foster children’s 14th Amendment due-process rights regarding medical records and prescription drug information. The first hearing is scheduled for Jan. 14, 2019.

Laughrey stated, “There are […] plausible allegations that [Missouri…] knew of the serious risk of harm. Yet they have not adopted any systematic administrative review because [they] can’t [locate] the medical records of the children. […T]he absence of the medical records itself creates an unreasonable risk of harm and the defendants are aware of that risk.”

Laughrey did however dismiss some claims related to informed consent procedures and alleged violation of the Adoption Assistance and Child Welfare Act. Those allegations stated that Missouri’s 13,000 foster children are continually exposed to unnecessary risk of serious physical and psychological harm because of a failure to sustain adequate oversight systems to assure psychotropic medications are dispensed safely and only when required.

A teenager among the plaintiffs alleges he was prescribed up to seven psychotropic medication at one time during his two-and-a-half-year stay in the custody of Missouri’s Children’s Division. He also alleges some serious side effects.

Laughrey also wrote that another plaintiff, who was 12, was allegedly placed on up to five medications at a single time. Her caregivers “had three […] understandings of what daily dose of a particular […] medication she was to receive. [T]hey had no medical records to resolve the confusion.”

Following a prescription change, the girl “… began acting angry, aggressive, and violent” and began getting into fights, Laughrey wrote. The judge also wrote that her caregivers “failed to note the correlation between [the] behavior and the medication change.”

A volunteer contacted the girl’s physician, according to Judge Laughrey and when the girl was taken off the medication, “[the] aggressive behavior ceased.”

The story of another 12-year-old girl was also presented. Plaintiffs stated she spent six years in Missouri’s custody. During that time, her medical and mental health history supposedly had “become fragmented and dispersed between her assigned caseworker, foster caretakers, and health providers.”

Allegedly, she was brought to a facility by a foster parent, who failed to provide any medical records or prescription data. Consequently, the girl was hospitalized for nearly a week following a “severe reaction” to taking the incorrect amounts of medication.

Two additional plaintiffs are toddlers who, at the ages of 3 and 2 years old, were allegedly on psychotropic medications while being placed in several foster homes.

Among the material the plaintiffs cite is Missouri’s own report to the federal government where they admit to management issues with psychotropic drugs, including antipsychotics and antidepressants.

Missouri’s report states, “[Several] foster […] children are prescribed multiple psychotropic medications without clear evidence of benefit and with inadequate safety data. The use of multiple medications […] creates the potential for serious drug interactions.”

Children can also be especially vulnerable to harmful side effects because of using psychotropic medications, and those harms could be made worse by inadequate prescription practices, wrote Judge Laughrey. The judge notes, “the full risk posed to children by psychotropic [medications] is not yet […] fully understood.”

Earlier, lawyers in Attorney General Josh Hawley’s office stated the difficulties going along with the state’s efforts to obtain comprehensive medical records and criticized physicians for allegedly offering ill-timed, poor-quality records in response to state inquiries.

The state argued, “These unsuccessful efforts are not the equivalent of criminal recklessness, particularly when the cause of failure was physician non-compliance… attempts to twist these efforts into evidence of deliberate indifference strains common sense and raises the […] possibility that state agencies [would] forego attempts to systematically improve for fear of constitutional liability should they not immediately succeed.”

Court documents filed by the state say the Missouri Children’s Division has access to a web-based tool that allows workers to track prescription drug history for foster children.

Hawley’s office also contended there was inadequate evidence that Missouri’s foster children are exposed to more damaging prescribing practices within the state than they would have undergone outside of it, and doubted the state’s alleged faults regarding foster children cited by the plaintiffs.

The plaintiffs’ attorneys argue that this is the first 14th Amendment case to effectively challenge a state’s “failure to oversee the administration of […] psychotropic medications to children in foster care.”

A statement from the attorneys reads, “[C]hildren continue to be prescribed powerful and potentially dangerous [medications], often with unacceptable dosages and at alarming rates, without the proper oversight and coordination. Even worse, these medications are prescribed as a [cure-all] for difficult behavior, rather than out of medical [necessity]. We are continuing to build our case and are prepared to protect these vulnerable youth at trial.”

When you see a problem with foster care, regarding medications or any other issue, report it on our Kathey and Rob Raskin Stop DHR webpage. You can also do your part to get your state officials to give our children fighting chance. Contact your state representatives here.