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Is South Dakota Over-Prescribing Drugs to Native American Foster Kids?

Is South Dakota Over-Prescribing Drugs to Native American Foster Kids?

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Published by Rick Thoma

On January 25th, 2013 the Coalition of Sioux Tribes for Children and Families—which is composed of the nine Indian Child Welfare Act (ICWA) Directors from South Dakota’s American Indian tribes—submitted the below reports to Congress. The purpose of the main report, “Reviewing the Facts: An Assessment of the Accuracy of NPR’s Native Foster Care: Lost Children, Lost Families,” is to provide to Congress an affirmation of NPR’s reporting in October, 2011 about egregious ICWA violations by the State of South Dakota. This, the second report, raises concerns held by the Coalition about possible over-prescribing of pharmaceutical drugs to Sioux foster children. 2 of 3 files.

On January 25th, 2013 the Coalition of Sioux Tribes for Children and Families—which is composed of the nine Indian Child Welfare Act (ICWA) Directors from South Dakota’s American Indian tribes—submitted the below reports to Congress. The purpose of the main report, “Reviewing the Facts: An Assessment of the Accuracy of NPR’s Native Foster Care: Lost Children, Lost Families,” is to provide to Congress an affirmation of NPR’s reporting in October, 2011 about egregious ICWA violations by the State of South Dakota. This, the second report, raises concerns held by the Coalition about possible over-prescribing of pharmaceutical drugs to Sioux foster children. 2 of 3 files.

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Published by: Rick Thoma on Feb 07, 2013
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09/17/2013

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 Is South Dakota Over-PrescribingDrugs to Native AmericanFoster Kids? 
1/29/12 South Dakota ICWA Directors’ Special Report
 
Native American Children and Prescription Drug Use in the South Dakota Foster Care System
Page
1
 
 Preamble
After an initial investigation we, the South Dakota Indian Child Welfare Act directors, arealarmed by the possibility that Native American foster children in South Dakota arereceiving harmfully excessive amounts of prescription drugs designed to treat mentalillness. The following quantitative data is cause for concern and an indication that further research is needed: a majority of South Dakota’s foster children are Native American
1
, andSouth Dakota spent eleven times more on prescription drugs for Native American foster care children in 2009 than it did in 1999
2
. The number of prescriptions for NativeAmerican foster children more than tripled during the period
3
.
1
Administration for Children and Families; “Adoption and Foster Care Analysis and Reporting System (AFCAR)”; 1998-2001, 2002-2005, 2006-2009: http://www.acf.hhs.gov/. For each year, the Administration for Children and Families, adivision of U.S. Health and Human Services, prepares a summary report on child foster abuse and neglect statistics. Bylooking on page 364/501 of the CWO 2000 Annual Report, page 380/512 of the CWO 2001 Annual Report, page 420/532 of the CWO 2002-2005 Annual Report, and page 327/416 of the CWO 2006-2009 Annual Report, we can see that between2000-2009 over 50% of the Children in South Dakota Foster Care were Native American.
2
United States Health and Human Services Center for Medicaid Services; “The Medicaid Statistical Information System”;http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MSIS-Mart-Home.html. To access the data cited above within the MedicaidStatistical Information System, there are 3 different filter categories to apply: the 'Basis of Eligibility' (BOE), the'Race/Ethinicity, and the 'Service Type' (e.g. 'pharmaceutical drugs'). In the annual 1999 datamart, we can see that SouthDakota was reimbursed $110,014 for prescription drugs for Native American children. In the 2009 datamart, we can see thatSouth Dakota was reimbursed $1,227,783, which is more than eleven times the amount from 1999.
3
IBID; When viewing the MSIS data through the filters given in footnote # 2, we can see that the total number of NativeAmerican Children who are receiving prescription drug benefits (claim count from 1999 MSIS Datamart) is 841 in 1999,whereas by the year 2009 the datamart shows that 3,112 Native American children are receiving those drug benefits, which ismore than three-fold increase the 1999 levels.
 
Native American Children and Prescription Drug Use in the South Dakota Foster Care System
Page
2
 
Fig.1
 Findings
 
Finding #1
: The State of South Dakota has dramatically increased funding from 1999 to2009 to support its Department of Social Services (D.S.S.), particularly its Medical ServicesDivision. There was a massive spike in spending on pharmaceuticals for foster carechildren in the middle of these same years. As a consequence of this spending, SouthDakota has the fifth highest ratio of prescriptions to Native American foster children in thecountry, when small-sample states (those with fewer than 50 Native American fosterchildren) and states with a Native American foster child population of less than 0.1% areexcluded
4
(see spreadsheet at end of document).
4
United States Health and Human Services Center for Medicaid Services; “The Medicaid Statistical Information System”;http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MSIS-Mart-Home.html. ALSO Administration for Children and Families; “Adoptionand Foster Care Analysis and Reporting System (AFCAR)”; 1998-2001,2002-2005, 2006-2009: http://www.acf.hhs.gov/. To
02004006008001000120014001999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Number of Children(blue)Number of Claims(red)Year
Number of Native AmericanChildren in Foster Care onSept. 30th of given year(Source- Administration forChildren and Families ChildWelfare Outcome Reportdata compiled 1999-2009)Number of Prescription DrugClaims for Native AmericanChildren in Foster CareAnnually (Source- MedicaidStatistical Information System,Center for Medicaid Services,Department of Health andHuman Services, datacompiled 1999-2009)

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