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Fostering Psychotropic Medication Oversight for Children in Foster Care: A National Examination of States’ Monitoring Mechanisms

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Abstract

To describe state responses to psychotropic medication safety concerns among children in foster care, this study proposes a taxonomy for state-level psychotropic medication monitoring mechanisms and highlights state variations. Seventy-two key informants, representing state child-serving agencies within the 50 states and DC, completed semi-structured interviews. We employed modified grounded theory to develop the taxonomy, and then generated state-specific summaries that were validated by key informants. Nationally, 88.2 % of the states employed at least one of seven mechanisms. For the most frequently implemented mechanisms (collegial secondary review, prior authorization, database review), over half were implemented between January 2011 and July 2013.

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Acknowledgments

Throughout its development, this article benefited tremendously from reviews provided by Peter Conrad, Dominic Hodgkin, Constance Horgan, and Sara Shostak. We thank Samantha Sliwinski and Alie Caro for their research assistance. This research was supported by a health services dissertation grant issued by the Agency for Healthcare Research and Quality (Grant Number 1R36HS021985-01) to the first author and a Grant from the W.T. Grant Foundation (PI: Laurel K. Leslie). Drs. Leslie and Mackie also received a contract from the Casey Family Foundation to conduct a one day forum providing training and resources on psychotropic monitoring mechanisms to medical doctors who serve as state medical and mental health directors and consultants for children in foster care.

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Authors and Affiliations

  1. Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA

    Thomas I. Mackie

  2. Department of Health Systems and Policy, School of Public Health, Rutgers University, Piscataway, NJ, USA

    Thomas I. Mackie

  3. Institute for Community Health, Cambridge Health Alliance, Cambridge, MA, USA

    Justeen Hyde

  4. School of Social Work, University of Southern California, Los Angeles, CA, USA

    Lawrence A. Palinkas

  5. Tufts University School of Medicine, 800 Washington Street, MC 345, Boston, MA, 02111, USA

    Emily Niemi & Laurel K. Leslie

  6. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA

    Laurel K. Leslie

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  1. Thomas I. Mackie
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  2. Justeen Hyde
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  3. Lawrence A. Palinkas
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  4. Emily Niemi
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  5. Laurel K. Leslie
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Correspondence to Thomas I. Mackie.

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Mackie, T.I., Hyde, J., Palinkas, L.A. et al. Fostering Psychotropic Medication Oversight for Children in Foster Care: A National Examination of States’ Monitoring Mechanisms. Adm Policy Ment Health 44, 243–257 (2017). https://doi.org/10.1007/s10488-016-0721-x

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