Washington State Medicaid, DSHS are leaders in preventing overdoses of mental health drugs for children

Washington State Medicaid, DSHS are leaders in preventing overdoses of mental health drugs for children:

News Release Listing

Contact: Jeff Thompson, M.D., Health Care Authority, 360-725-1611, thompj@hca.wa.gov
Contact: Gail Kreiger, Chief, Health Care Authority, 360-725-1611, gail.kreiger@hca.wa.gov
December 02, 2011
Washington State Medicaid, DSHS are leaders in preventing overdoses of mental health drugs for children
OLYMPIA – Washington State’s Medicaid program and the Department of Social and Health Services have been working together since 2004 on programs to promote safe prescribing of mental health medication and psychotropic drugs in Medicaid children, including those in foster placement.

More recently, Washington State has imposed controls on atypical anti-psychotics and Attention Deficit Hyperactivity Disorder (ADHD) medications at risk of being overprescribed. The state has also contracted with the University of Washington to train pediatricians in mental health treatments to address preventive and early care.

The federal General Accounting Office on Thursday released a five-state study that found psychotropic drugs were being administered to foster children at higher rates than non-foster children in Medicaid during 2008.

Washington State has worked with the community to establish "Red Flags" on mental health drugs that address the problem of "too many, too much and too young," said Dr. Jeffery Thompson, Chief Medical Officer for the Health Care Authority’s Medicaid program. Many of those cautions are also listed in the GAO report. As a result, the state has:

Reduced the number of children under five years of age receiving anti-psychotic medications – all have been screened by a contracted child and adolescent psychiatrist at the University of Washington
Reduced doses of anti-psychotic and ADHD medications exceeding recommended ranges
Improved medication adherence
Started a second opinion process for poly-pharmacy (e.g. when children are getting greater than two anti-psychotics or greater than 4 mental health medication)
The Health Care Authority also led a project with 16 state Medicaid Medical Directors, Rutgers University, National Association of Medicaid Directors and the National Association of State Mental Health Program Directors funded by Agency for Healthcare Research and Quality (AHRQ). The study represented a combined enrollment of 12 million children and adolescents in Medicaid.

Findings showed:

In 2007, pooled results of state analyses indicate that a total of 193,178 children or adolescents received an anti-psychotic prescription, representing 1.6 percent of the total FFS population under 19 years of age. This rate represents about a 10 percent relative increase over the comparable rate in 2004 of 1.45 percent.
Children in foster care (12.4 percent) were prescribed anti-psychotic medications at much higher rates than non-foster care (1.4 percent). Washington had the lowest rates of use.
Pharmacy claims data can be used to explore utilization of anti-psychotic medications and mental health drugs across multiple Medicaid programs.
States varied in terms of the populations covered, organizational structure, mental health contracts, statutes and codes.
These efforts represent important first steps in a collaborative effort with considerable potential for public health impact in improving pediatric mental health treatment and outcomes in the vulnerable populations served by the Medicaid programs.
"As a result, our use of anti-psychotics in children and foster care has been reduced significantly in collaboration with the community," said Dr. Thompson. "Overall, we have better access to quality mental health prescribing at more affordable costs."

In Washington, foster children are supervised by the Children’s Administration in the Department of Social and Health Services. However, foster children are automatically eligible to receive medical coverage from the Health Care Authority’s Medicaid program.

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EDITORS: The 16-state study is posted on the Rutgers University at http://rci.rutgers.edu/cseap/MMDLNAPKIDS.html. The findings show Washington as a leader state in reducing mental health dosing for children. Copies of a fact sheet on anti-psychotic medications in Washington State are available by e-mailing stevejh2@hca.wa.gov.

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The Health Care Authority does not discriminate and provides equal access to its programs and services for all persons without regard to race, color, gender, religion, creed, marital status, national origin, sexual orientation, age, veteran’s status or the presence of any physical, sensory or mental disability.

FOR ADDITIONAL BACKGROUND, CONTACT:

Jim Stevenson, Communications, HCA, 360-725-1915 stevejh2@hca.wa.gov(Pager: 971-4067)

Sharon Michael, Communications, HCA, 360-923-2764 sharon.michael@hca.wa.gov

Sherry Hill, Communications, DSHS, 360-902-7892, sherry.hill@dshs.wa.gov