Psychotropic drugs take center stage in Texas foster care fight

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AUSTIN (KXAN) — Jackie Juarez remembers taking pills – lots of pills.  

“They would make me sleepy, and I would throw up every night,” Juarez told the courtroom, recounting memories from her seven years in the Texas foster care system.  

She said she remembers being prescribed psychotropic drugs, which are medications that alter mood, perceptions, and behavior. She remembers missing class often because she was tired, but doesn’t remember exactly how many different schools she attended while bouncing from placement to placement.

She testified she remembers being treated “poorly.”

About one specific placement, she recalled, “When we misbehaved, they would tell us that our family didn’t want us, or we were bad kids, and nobody wants bad kids.”

Juarez, 18, has since aged out of foster care, but told the court she spent time in five different unlicensed placements – at times sleeping at a church, in three different state office buildings, and in a hotel.

The state designates foster children living in these types of unlicensed placements as Children Without Placement (CWOP) — a designation that has been a central focus of the ongoing federal lawsuit against the state of Texas over the treatment of children in its care.

On Monday, Juarez testified as a witness in the latest hearing in the twelve-year-old case.

Her voice broke while telling the court that she ran away from one of these locations because she was afraid for her safety. After taking a moment to collect herself, Juarez looked at U.S. District Judge Janis Jack and said, “I’m ready.”

“I don’t know how you could ever be ready,” the judge said.

“Because I’m trying to fight for kids in CPS,” Juarez replied.

Paul Yetter, an attorney representing thousands of foster children in the lawsuit, asked Juarez a series of questions and read off a list of eight different medications he said she received. These ranged from Benadryl to stronger psychotropic drugs — as well as Keppra, a seizure medication, and Albuterol, an asthma drug that “was given to kids for panic attacks.”

During the hearing, which is expected to last all week, Judge Jack will consider a request from Yetter and his team to consider holding the state in contempt of court for failing to comply with certain court-ordered reforms – called remedial orders.

  • Catch up on KXAN coverage of the hearing here

One of these orders deals with the state’s system for receiving, screening, and investigating reports of abuse and neglect. Yetter’s team asserts that children may be in danger of medical abuse and neglect, in part because of the “mismanagement of powerful prescribed drugs for children,” according to a November court document filed ahead of the December hearing.

The filing cites previous reports from the court-appointed monitors, who were appointed by Judge Jack several years ago to help supervise parts of the child welfare system. According to a report filed in March, the monitors noted youth staying in “poorly supervised residential settings” where children were exposed to the risk of abuse and other dangers, including “administering arrays of psychotropic medications to children and youth without regard to the State’s protocols for psychological diagnosis and medical oversight.”

Their report, based on observations from 14 different site inspections in 2022, also noted medication log errors and violations of the state’s own parameters for the use of psychotropic medication for children.

In 2005, several state agencies released the first “best practices” guide for using these kinds of medications, and the latest version of this guide was published in 2019. According to those parameters, a child’s case would need further review if they were prescribed four or more psychotropic medications simultaneously.

The monitors’ March report found 75 – or half — of the 161 children whose files were reviewed had been prescribed four or more psychotropics. Of those, only 21 had received the required review.

At a previous hearing in the spring, the parties in the case discussed the use of these medications at length. At the time, attorneys defending the state agencies noted that none of the judge’s remedial orders specifically address the administration of psychotropic drug prescriptions.

Juarez no longer takes any medications for mental health. She said she is more able to focus on sports, and arts and reading. She earned a round of applause from the Dallas courtroom when she described how she has been working toward obtaining her GED.  

Still, she remembers complaining about the medications. She said a doctor told her to give them time.

She testified from the stand, “No one ever questions the medications.”

The hearing in Judge Jack’s courtroom is expected to last through the week. KXAN will be monitoring the proceedings.

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