Citing continuous concern regarding the services and treatment provided to children in foster care with mental health conditions, the Government Accountability Office (GAO) recently examined the use of psychotropic medications and other mental health services for children in Medicaid, information on the use of psychotropic medications and other mental health services for children in foster care (as provided by the Department of Health and Human Services), and the amount HHS has invested in research on children’s mental health. The report, requested by Members of Congress, provides in-depth information on mental health services for children in the Medicaid program.
Based on data from 2007-2009, the GAO found that on average 6.2 percent of noninstitutionalized children in Medicaid nationwide and 4.8 percent of privately insured children took one or more psychotropic medications. For antipsychotics, which were taken at a much lower rate, data revealed that the rate of incidence for children in Medicaid was over twice the rate for privately insured children. In addition, HHS’s Administration for Children and Families (ACF) reported that almost one in five foster children were taking psychotropic medications, although use varied widely based on the child’s living arrangement (congregate vs. family based care). From FY 2008-2011, HHS agencies spent an estimated $1.2 billion on over 1,200 children’s mental health research projects during fiscal years 2008 through 2011.
In 2011, GAO recommended that the Centers for Medicare and Medicaid Services (CMS) identify options for collecting information from states on whether children in Medicaid have received services for which they were referred and the findings from this report seem to underscore the continued significance of CMS’s monitoring of children’s receipt of mental health services. Since GAO initially provided recommendations to HHS to improve the quality of care for children enrolled in Medicaid, HHS has taken steps to promote appropriate mental health treatments for foster children, including supplying information to states on psychotropic medication oversight practices.