07:38 PM CDT on Tuesday, June 22, 2004

By SHELLEY KOFLER / WFAA-TV

A leading Texas pediatrician tells News 8 he's seen evidence that hundreds, perhaps thousands, of the state's foster children are being overmedicated.

The doctor, the state and a worried mother are all speaking out on the issue.

Elaine Philpott said at age 9, her daughter Krystin read at the second-grade level. Even with learning disabilities, she still made the A-B honor roll.

That, however, was before public school officials claimed Philpott was abusive to Krystin, and wasn't controlling her erratic behavior. A short time later, state caseworkers placed Krystin in foster care.

Now, six years later, Krystin still reads at the second-grade level. For the population, 90 is considered a normal IQ; state documents show Krystin had an IQ of 86 when she entered foster care, but it has since dropped to 68, which indicates mental retardation.

"I don't believe she's mentally retarded," Philpott said. "I believe the pills have a lot to do with her functioning ... it's making her worse."

Medical records show that last fall, when Krystin was hospitalized for an unexplained broken hip, doctors had prescribed at least six strong prescriptions: an anti-depressant, bipolar medication, hyperactivity medicines, a daily laxative and Zyprexa, a powerful anti-psychotic.

"That is a lot of medication for any person an adult or a kid," said pharmacist Jeffrey Warnken.

Philpott said all that medication is taking a toll.

"Within several weeks of going into the system, she became suicidal ... she started hallucinating," Philpott said. "I've seen her barely able to lift her head up and open her eyes. I've seen her on so many psycho-stimulants she digs holes in her body."

Records collected by the staff of state comptroller Carole Keeton Strayhorn show other foster children also receive questionable quantities of drugs.

Dr. Ben Raimer reviewed those records, which contained Medicaid prescriptions for 6,000 foster children. Raimer is a senior pediatrician who has treated neglected children for more than 20 years at the University of Texas Medical Branch in Galveston.

While medication may help many traumatized foster children, Raimer said what he saw in the state's own records is "outrageous."

"I was stunned - I truly was," Raimer said. "I reviewed one chart that had 11 different medications, 11 different psychotropics ... I was like, 'this has got to be a mistake.' I think by any physician's standards these children are overmedicated."

When asked if these children could be in danger, Raimer's response was an immediate "yes."

"All these medications have side effects," he said.

Raimer is especially concerned about the overuse of psychotropics, which are neurological drugs that affect the brain. The side effects of psychotropic drugs include everything from permanent twitching to irregular heartbeats, hormone suppression and suicidal tendencies. No one knows the long-term effects on children, because clinical studies haven't been done.

"If a child is receiving medication that they shouldn't be receiving, we need to take care of that," said Thomas Chapmond, who heads the Texas Department of Family and Protective Services, the agency responsible for foster children.

Chapmond admits his caseworkers give consent for drugs to be administered, even though they have little medical training.

"We rely on the physician to monitor the medication," he said. "Our caseworkers aren't going to go up against a doctor because they don't have that expertise."

So why, then, do the caseworkers sign the consent forms?

"(For) the same reason parents sign the consent forms ... that's how you get the care," Chapmond said.

Chapmond said his agency has set up a task force to determine whether overmedication is a problem. But critics note the task force was announced one week before the comptroller's office issued a blistering report on foster care.

Last July, another task force overseen by the same agency administrator chose not to act on the medication issue.

"I don't think as a state we have anyone watching over these children," Raimer said.

Raimer believes Texas, like Florida, needs a medical review team to catch overmedication and insure foster children receive appropriate therapy.

Philpott hopes the changes come in time for Krystin.

"She is either going to end up dead or locked away in a facility for the rest of her life," Philpott said. "And from what I've seen of the facilities, it's the same thing."

Raimer said the state's system may encourage overmedication, because children who receive more drugs are placed in specialized care, and those foster providers are paid more.

State officials said that's not so, adding that providers are paid for the services they render.