Dosed in juvenile jail: Investigators focus on antipsychotic doses for kids and possible fraud


By Michael LaForgia Palm Beach Post Staff Writer

On alert for signs of fraud, state Attorney General Pam Bondi's office said months ago it was looking into the
Medicaid billing habits of doctors who worked in Florida's juvenile jails.

But the inquiry largely consisted of just one step, according to records and interviews: sending an email to the
Florida agency that oversees Medicaid.

At issue was whether the government insurer pays pharmacy bills for kids in state custody, a question first raised in
May by a Palm Beach Post investigation. The answer, from state health care regulators, was no.

That apparently satisfied the attorney general's investigators, who stopped asking questions.

But it wasn't true.

In fact, most children in state custody are eligible for Medicaid coverage, a circumstance the Department of Juvenile
Justice is eyeing as its own, in-house probe enters its fourth month.

Alerted to this distinction by The Post, the attorney general's Medicaid Fraud Control Unit made follow-up calls,
spokeswoman Jennifer Davis said. Then investigators concluded that other agencies, namely DJJ and the Florida
Agency for Health Care Administration (AHCA), needed to review records before the attorney general could respond

"Once we figured out that they needed to pull the data before we could move forward, we were on hold," Davis said.
She added that investigators still were monitoring the situation closely.

Stories prompted probe

The state's scrutiny of its juvenile justice system stems from stories The Post published in May, which showed that
powerful antipsychotic drugs were flowing freely into state jails for kids. The stories also showed that doctors who
medicated delinquents accepted huge payments from companies that make antipsychotic pills.

Responding, the juvenile justice department designed a detailed, four-part plan to investigate, according to a
document obtained by The Post.

The department's inspector general is focusing on whether DJJ doctors are prescribing an "excessive amount" of
mind-altering drugs to kids; whether the department can adequately track prescriptions; and whether DJJ doctors
have taken payments from drugmakers.

To answer these questions, department investigators are studying a third of the kids in state custody who were
prescribed mind-altering drugs, including children housed at DeSoto Dual-Diagnosed Correctional Facility in
Arcadia, the Arthur G. Dozier School for Boys in Marianna and St. Johns Juvenile Residential Facility near St.
Augustine.

The department announced plans to close both DeSoto and Dozier in May as it slashes its budget by $67 million.

The probe will pay special attention to whether there's a pattern of prescribing antipsychotics and other drugs
among specific companies hired by the state to run programs, the document says.

It also will examine whether DJJ doctors billed Medicaid for antipsychotics and other drugs "while state funds are also
paying for medications."

As the juvenile justice department's review got under way, the attorney general started asking questions, too.
Bondi's spokeswoman said her office responded "pro-actively" by approaching AHCA with this question: "Does
Medicaid pay the pharmacy bills for the DJJ kids in custody?"

AHCA's reply, from Anne Wells, bureau chief of Medicaid Pharmacy Services, was no. "Medicaid does not pay for
prescriptions for kids in custody," Wells wrote in a May 24 email.

Kids covered by Medicaid

Children held in the state's 22 juvenile jails and 20 high- and maximum-risk centers don't qualify for the state-federal
insurance. But kids housed in the remaining 48 residential programs - or the majority of children in live-in programs -
are eligible for Medicaid, DJJ spokesman C.J. Drake said.

Asked why AHCA didn't tell the attorney general that kids in state custody are, in fact, covered by Medicaid, an
agency spokeswoman didn't provide a direct answer.

"Medicaid does not reimburse for DJJ residents in secure facilities," spokeswoman Shelisha Coleman said. "That
policy is what was referenced in the email."

Months later, no answers

Soon after the DJJ review began, the chief inspector general in Gov. Rick Scott's office weighed in "to facilitate the
exchange of information" between agencies, spokesman Lane Wright said.

Three months later, nothing yet has come of any official inquiry into DJJ's drugging practices. And, just this summer,
the stakes got a little higher.

Drugmaker AstraZeneca in June added a new warning to the label for its blockbuster antipsychotic, Seroquel. At the
urging of the federal Food and Drug Administration, the pharmaceutical company now is cautioning that Seroquel
can cause serious heart problems.

During a two-year period reviewed by The Post, Florida's juvenile justice department bought more than 215,000
tablets of Seroquel for juvenile jails and programs that can house no more than 2,300 kids on a given day.

Drake, the DJJ spokesman, said DJJ's probe still is "active and ongoing."

"There are no easy answers in terms of the questions raised by the

investigation," Drake said. "It's a case where there are numerous sources of information and documentation that
require careful analysis. There are a lot of moving parts to this issue."


Fla. juvenile jails probe continues
August 15, 2011 9:35 AM
Associated Press

WEST PALM BEACH, Fla. (AP) — Further scrutiny of Florida's juvenile justice system is underway following
published reports that powerful anti-psychotic drugs were flowing freely into state jails for kids.

The Palm Beach Post reported Sunday http://bit.ly/pthcYD that the juvenile justice department's inspector general is
focusing on whether department doctors are prescribing an "excessive amount" of mind-altering drugs to kids,
whether the department can adequately track prescriptions, and whether department doctors have taken payments
from drugmakers.

A document obtained by the newspaper said the probe will pay special attention to whether there's a pattern of
prescribing anti-psychotics and other drugs among specific companies hired by the state to run programs.

A department spokesman said the probe still is active and ongoing.

State Attorney General Pam Bondi's office said months ago it was looking into the Medicaid billing habits of doctors
who worked in Florida's juvenile jails. As it turns out, most children in state custody are eligible for Medicaid
coverage, a circumstance the Department of Juvenile Justice is eyeing as its own, in-house probe enters its fourth
month.

The drugs at issue are very powerful, and can have harmful side effects.

Drugmaker AstraZeneca in June added a new warning to the label for the anti-psychotic drug Seroquel that cautions
that the drug can cause serious heart problems. The move came at the urging of Food and Drug Administration.

The Post reported that during a two-year period it reviewed, Florida's juvenile justice department bought more than
215,000 tablets of Seroquel for juvenile jails and programs that can house no more than 2,300 kids on a given day.

“There are no easy answers in terms of the questions raised by the investigation,” DJJ spokesman C.J. Drake said.
“It's a case where there are numerous sources of information and documentation that require careful analysis.
There are a lot of moving parts to this issue.”
http://www.crestviewbulletin.com/news/fla-15039-juvenile-palm.html
http://www.wptv.com/dpp/news/state/dosed-in-juvenile-jail%3A-investigators-focus-on-antipsychotic-doses-for-kids-and-possible-fraud
DOSED IN JUVENILE JAIL:
INVESTIGATORS FOCUS ON
ANTIPSYCHOTIC DOSES FOR KIDS AND
POSSIBLE FRAUD YOUTUBE VIDEO
TWO ARTICLES: To answer these questions, department
investigators are studying a third of the kids in state
custody who were prescribed mind-altering drugs, including
children housed at DeSoto Dual-Diagnosed Correctional
Facility in Arcadia, the Arthur G. Dozier School for Boys in
Marianna and St. Johns Juvenile Residential Facility near
St. Augustine.
How The State of Florida Is Attempting to Coverup The Worst Case of
Institutional Child Abuse in America Click This Text For Expose'