- abcnews.go.com/2020/video/foster-kids-prescribed-psychotropic-drugs-heavy-duty-drug-treatments-neglect-2020-15077792
- abcnews.go.com/2020/video/foster-kids-meds-finding-solutions-congress-hearing-foster-care-psychotropic-drugs-2020-15077829?tab=9482930§ion=1206863&playlist=15078211
- abcnews.go.com/2020/video/alfonsi-confronting-doctors-risky-prescriptions-children-foster-kids-2020-15077950?tab=9482930§ion=1206863&playlist=15078211
- abcnews.go.com/2020/video/foster-children-reason-hope-maryhurst-treatment-center-therapy-2020-15078019?tab=9482930§ion=1206863&playlist=15078211
Provide names of other journalists involved.
Diane Sawyer, Sharyn Alfonsi, Sarah Koch, Joseph Diaz, Keturah Gray, Joan Martelli, Jessica Velmans, David Sloan
List date(s) this work was published or aired.
11/30/2011- abcnews.com, ABC World News with Diane Sawyer 12/1/2011- abcnews.com, ABC World News with Diane Sawyer 12/2/2011- abcnews.com, ABC 20/20 special
Provide a brief synopsis of the story or stories, including any significant findings.
ABC News spent over a year investigating the overmedication of foster children with powerful, mind-altering psychiatric drugs including antipsychotics, the most potent class of psychotropics. ABC News profiled dozens of affected foster children across the country, tracked down doctors who overprescribe medications to vulnerable children- often after very short visits and without an accurate psychiatric diagnosis, extensively reviewed FDA documents revealing problems with drug trials some of which involved foster children, found a program in Kentucky where providers are fighting hard against over-medicating foster children, and confronted government officials accountable for foster care system shortcomings. In the end, ABC News showed millions of viewers the myriad of problems that foster children face when over medicated on mind-altering drugs to the extremes of sedation, submission, and defeat. ABC News acknowledged the appropriate use of psychiatric medications while sensitively exposing the impact of inappropriate use of medications. ABC News got answers from experts and our reporting propelled a government agency into action demanding change in the monitoring of these drugs by June 2012. A few significant findings: * Foster Children are up to 13 times more likely to receive psychotropic medication compared to non-foster children and 9-times more likely to receive antipsychotics, the most powerful class of psychotropics. This despite very limited data on the long-term safety of these drugs or what the lasting impact of these drugs has on a child’s developing brain. * Some doctors spend less than 5 minutes before prescribing or managing psychiatric medications for foster children * Foster children were more than nine times more likely than non-foster children to be prescribed drugs for which there was no FDA-recommended dose for their age. * Medicaid spends at least $6 billion a year, nearly 30 percent of its entire drug budget, on psychiatric drugs, more than double what was spent in 1999, according to Centers for Medicaid and Medicare Services data reviewed by ABC News. * Hundreds of foster children were on five or more powerful psychiatric drugs in just the 5 states included in the GAO report.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
* Exclusive access to a 2-year long Government Accountability Office foster care investigation which paralleled ABC News’ investigation. * Used FOIA to obtain Medicaid prescribing patterns for Medicaid physicians in Louisiana. * Reviewed CMS/Medicaid nationwide drug expenditure data revealing Medicaid and states spend more on antipsychotic medications than on any other class of medications * Reviewed nearly all the published medical literature regarding the rates and patterns of psychotropic medications in foster children. The variety and reach of our sources confirmed the widespread, nationwide problem of over-medicated foster children and helped reveal the complexity of the problem, including the key conclusion that the government has failed to oversee this issue. Foster children are overmedicated due to a convergence of shortcomings across multiple systems including HHS, the medical community, pharmaceutical companies, reimbursement patterns, and sometimes even foster parents themselves.
Explain types of human sources used.
* Profiled dozens of foster children who have been overmedicated, abandoned, abused, adopted, and amazingly survived. * Interviewed state Medicaid officials including a state Medicaid Director who described for ABC News the insidious reasons why many foster children end up on expensive foster children and the numerous political and bureaucratic pressures which contribute to increased use of psychotropics. * Interviewed dozens of foster care experts including those who have conducted extensive research on the rates and patterns of use of psychotropic medications in the foster care population. * Interviewed whistleblowers including psychiatrists, a former Abilify sales representative, and several other pharmaceutical insiders who described in detail the off-label marketing practices used to target children. * Interviewed the Chair of the American Academy of Child and Adolescent Psychiatry Adoption and Foster Committee who is in a position to set nationwide policy, but also provided key information on the court approval process San Francisco foster children must go through before being prescribed psychotropics. ABC News discussed similar procedures with Florida officials as well. * Interviewed the CEO of Court-Appointed Special Advocates for Children (CASA) * Reviewed police records and interviewed investigators and detectives involved in the key Florida case where a 7-year old foster child on multiple psychiatric medications committed suicide in his foster home * Interviewed former foster children who became summer interns on Capitol Hill, including one who dedicated her time in Washington to enlightening Washington politicians on the problem of overmedicated foster children.
Results:
* ABC News requested an interview with HHS Secretary Sebelius on numerous occasions for this story, given she was the only one who could speak on behalf of the numerous agencies intertwined in this problem: FDA, CMS, and ACF. Our request was repeatedly denied and HHS would only put forth an FDA official for our program. However, our relentless requests and questioning resulted in HHS sending a letter TO ALL 50 states regarding a change in policy by JUNE 2012 regarding the administration and monitoring of psychotropic drugs in foster care. THE HHS LETTER WAS SENT OUT JUST DAYS BEFORE OUR REPORT AIRED AND ONLY AFTER HHS LEARNED OF OUR AIR DATE. A LEADING FOSTER CARE POLICY EXPERT TOLD ABC NEWS THAT HE WASN’T SURE EXACTLY WHAT ABC NEWS DID, BUT WE GOT THE GOVERNMENT MOVING ON THIS PROBLEM IN A WAY THAT NO OTHER ORGANIZATION OR EFFORT HAS BEEN ABLE TO DO.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
* American Academy of Pediatrics Statement: “The American Academy of Pediatrics (AAP) commends ABC News for highlighting the issue of children in foster care being prescribed psychotropic drugs at an alarming rate.” * The National Coalition for Child Protection Reform put out a statement saying the ABC News report exploited children by showcasing a residential treatment facility. Nearly all experts we spoke with did not feel our reporting exploited children in any way. * On a side note, pop star Justin Bieber saw our report and is sending a care package to one of the foster children profiled…despite being in foster care this young girl was thrilled to share the similarities she shares with Justin Bieber for our viewers. Apparently, he liked it too.
Advice to other journalists planning a similar story or project.
We were a small group of dedicated reporters who kept this story alive for more than a year. A few things we learned: – Meet often with involved colleagues…so many more great ideas and perspectives out of group meetings compared to solo reporting. – Talk to your sources often and openly…we stayed in touch with our sources even when we had no idea when or how the story would air. – Show your sources the dedication you have…we were able to gain exclusive access to GAO’s report by showing them ABC’s dedication to telling this moving story. – Remember why you do this…the hard work of a small group of reporters can move decision makers to act for the benefit of an entire vulnerable population. – Big stories take time, lots of it…stay with it if you think it’s worth it!