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JEFFERSON CITY — Missouri officials and advocates for foster children have agreed to overhaul the way that powerful psychotropic drugs are given to foster children.

U.S. District Judge Nanette Laughrey on Monday gave preliminary approval to a settlement agreement reached last month. The agreement should settle a federal class action lawsuit filed in Jefferson City in 2017 on behalf of five children ages 2-14 that claimed Missouri had overused the drugs on foster children and exposed them to “unreasonable risk of serious physical and psychological harm.”

The suit said antipsychotics were being used to treat diagnoses like conduct disorder and attention deficit hyperactivity disorder, or ADHD. Proper records were not being kept, meaning children were sometimes prescribed multiple psychotropic drugs at the same time. Use of the drugs risks “psychosis, seizures, irreversible movement disorders, suicidal thoughts, aggression, weight gain, organ damage, and other life-threatening conditions,” the suit said.

The suit was filed against Missouri Department of Social Services officials by the St. Louis University law school legal clinics, the Morgan, Lewis & Bockius law firm and two nonprofit child advocacy groups, Children’s Rights and the National Center for Youth Law, on behalf of five children ages 2-14.

More than 13,000 children are in the foster care system in Missouri. Sara Bartosz, deputy director of litigation strategy at Children’s Rights, said at the time the suit was filed that a past state estimate said roughly 30% of foster children are on the drugs.

The settlement says all children will get a mental health assessment before being prescribed a psychotropic drug and “monitoring appointments” at least every three months. The Children’s Division must also obtain “informed consent” from the child’s case manager in consultation with parents or other authorized decision-makers.

State officials will create a statewide medical records system, and the Children’s Division “shall exercise reasonable and diligent efforts to compile and maintain” those records, the settlement says. A child psychiatrist will review the use of certain drugs, and all case management and resource provider staff will undergo mandatory training on the appropriate use and potential side effects of psychotropic medications on children. A state Psychotropic Medication Advisory Committee will also be formed.

Laughrey set a deadline of Oct. 23 for objections or comments and a final approval hearing for Nov. 20 in Kansas City. State officials, group homes, court officials, caregivers and others will be notified before then.

The Department of Social Services, through a spokesperson, declined to comment on the settlement.

“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 in a statement announcing the settlement. “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.”