Legal Clinics' Effort Results in Precedent-Setting Agreement to Benefit Children in Foster Care

08/20/2019

A federal judge gave preliminary approval last month to a groundbreaking settlement designed to ensure that children in foster care in Missouri are administered psychotropic medications only when safe and necessary.

Following two years of litigation, the settlement would resolve the civil rights lawsuit M.B. v. Corsi, the first federal class-action lawsuit in the country to focus singularly on the widespread and often dangerous use of psychotropic medications among youth in foster care.

The lawsuit was filed by the Saint Louis University School of Law Legal Clinics along with two national nonprofits, Children's Rights and the National Center for Youth Law, and the international law firm Morgan, Lewis & Bockius, against the Missouri Department of Social Services (DSS) and Children's Division (CD) on behalf of all minor children and youth who are or will be placed in Missouri foster care.

The agreement will benefit the more than 13,000 children in Missouri's foster care system and sets a strong legal precedent that may lead to greater safety in the use of psychotropics among youth in foster care nationwide. It is pending final approval after a period of time for public comment.

Filed in 2017, the complaint in M.B. v. Corsi alleged a longstanding failure by the state to provide adequate oversight in the administration of powerful psychotropic medications to children in foster care. These failures included placing children on psychotropic drugs without the benefit of an adequate medical history, a rigorous informed consent process, or the availability of a second opinion mechanism to review extreme cases, such as when a child is prescribed as many as seven psychotropic medications at one time. The misuse of psychotropic drugs among foster children can lead to serious side effects, including hallucinations, self-harm and suicidal thoughts, and chronic illnesses such as Type II diabetes.

The agreement calls for overhauling the state’s practices around the use of psychotropic medications in foster care through the following reforms:

• Medical record and medication monitoring: All children who receive psychotropic medications will have a comprehensive medical record on file. This record will include a full medication history and other key medical and mental health information. Children receiving psychotropic medications will receive monitoring appointments at least every three months.
• Informed consent: The state will require adherence to an updated informed consent policy that calls for prescribers and adults, with genuine input from youth, to consider fully the benefits and risks of psychotropic medications before authorizing prescriptions.
• Secondary reviews: The state will require a secondary review of specified psychotropic medication prescriptions by a child psychiatrist.
• Rigorous training for staff: All foster care case management and resource provider staff will be required to receive training regarding the appropriate use and potential side effects of psychotropic medications on children.

The settlement also calls for establishing a state Psychotropic Medication Advisory Committee to further inform policies related to the use of psychotropic medications in foster care. The state’s progress in meeting the settlement’s terms will be monitored by a third-party validator.

“It has been a privilege to work with these national partners on this litigation that will greatly impact some of our most vulnerable citizens,” said John Ammann, McDonnell Professor of Justice in American Society and director of the Litigation Clinic at Saint Louis University School of Law. “As a Jesuit institution, it has been a tremendous opportunity for our students to serve Missouri children and ensure accountability in the foster care system.”

“For too long, Missouri’s most vulnerable children have been subjected to powerful drugs with little state accountability or oversight,” said Samantha Bartosz, deputy director of litigation strategy at Children’s Rights. “We are pleased that we have been able to work with DSS to create meaningful guardrails to protect the health and well-being of children in foster care. We hope that this lawsuit will generate significant attention and serve to improve the lives of children in foster care across the country.”

“Children in foster care across the country are being administered dangerous dosages and combinations of psychotropic medications instead of receiving appropriate mental health services to address complex trauma,” said Leecia Welch, senior director of child welfare and legal advocacy at the National Center for Youth Law. “We are hopeful that Missouri’s willingness to address these harmful practices will shine a spotlight on the need for reform and help ensure that children in foster care have the support they need to thrive in their homes, schools, and communities.”

For more information about M.B. v. Corsi, visit childrensrights.org/class_action/m-b-v-corsi.

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About Saint Louis University School of Law Legal Clinics
For more than 40 years the Saint Louis University School of Law Legal Clinics have created a tradition of social justice by providing invaluable legal services to the greater St. Louis community. Dedicated to the University’s Jesuit mission of advocating for the disadvantaged and the betterment of the community at large, the Legal Clinics provide unique and challenging opportunities in a supportive experiential learning environment for every student who desires a clinical experience. For more information, visit slu.edu/law.

About Children’s Rights
Every day, children are harmed in America’s broken child welfare, juvenile justice, education, and healthcare systems. Through relentless strategic advocacy and legal action, we hold governments accountable for keeping kids safe and healthy. Children’s Rights, a national non-profit organization, has made a lasting impact for hundreds of thousands of vulnerable children. For more information, visit www.childrensrights.org.

About National Center for Youth Law
The National Center for Youth Law is a non-profit law firm that helps low-income children achieve their potential by transforming the public agencies that serve them. For more information, visit www.youthlaw.org.

About Morgan, Lewis & Bockius LLP
Founded in 1873, Morgan Lewis offers more than 2,200 lawyers, patent agents, benefits advisers, regulatory scientists, and other specialists in 30 offices across North America, Asia, Europe, and the Middle East. The firm provides comprehensive litigation, corporate, transactional, regulatory, intellectual property, and labor and employment legal services to clients of all sizes—from globally established industry leaders to just-conceived startups. For more information about Morgan Lewis or its practices, visit www.morganlewis.com.