Given the distressing fi ndings contained in this report, I hope that the state will not delay in
adopting recommendations, which have been crafted to help mend this broken system. My
hope is that the state leadership and the health and human service agencies will work to make
things better for our state’s most vulnerable children.

Barry was a ten-year-old minority foster child who had just come into foster
care in an urban area. During his fi rst three months in the foster care system,
he resided at an emergency shelter.
While at his fi rst placement, he was diagnosed with HIV, oppositional disorder
and manic depression, and began receiving one prescription medication
(Videx) for HIV infection, along with two diff erent mood stabilizers (Trileptal
and Depakote) and one antipsychotic (Abilify). The same physician a general
practioner (GP), prescribed all of these medications.
During his second month in care, Barry was diagnosed with convulsions, and
received additional prescriptions from two doctors, the GP and a psychiatrist.
The GP wrote another prescription for Videx, Trileptal and Abilify while the
psychiatrist wrote two separate prescriptions for Depakote (250mg and 125mg),
another prescription for Trileptal and a new prescription for Lexapro.
The next month Barry was sent to a residential treatment center in another
city, where he was prescribed Depakote, Abilify, Trileptal, Lexapro and Seroquel.
What was conspicuously missing was any prescription medication to treat HIV.

Multiple Moves and High-Risk Pregnancy
Lannie was a 15-year-old foster girl who entered the foster care system in May 2002. During fi scal 2004, Lannie was
shifted among four diff erent homes.
She was living in an emergency shelter in East Texas during January 2004, and then was moved more than 150 miles to
a Central Texas foster home. She was moved again in April, to another foster home 170 miles away in East Texas. In July,
she was moved to an emergency shelter 23 miles away from her previous home. In the same month, she was moved once
again, to a Central Texas residential treatment center more than 180 miles away.
Lannie was pregnant or a new mother during all of these moves. She was not prescribed any prenatal vitamins during
fi scal 2004, and the constant moves prevented her from having a regular physician. Instead, she received her prenatal care
from hospitals and health clinics.
Lannie had a rather diffi cult pregnancy. She was diagnosed as having a high-risk pregnancy, with poor fetal growth,
insuffi cient prenatal care and an early onset of delivery. She was admitted to the hospital twice during her pregnancy,
once two months prior to the baby’s birth, due to poor fetal growth.
In February 2004, she was taken in an ambulance to a Central Texas hospital for early onset delivery. She did not give birth on
this occasion, but was sent home instead. Four days later, she was taken to the hospital where she delivered her baby. She was
diagnosed with obstetrical trauma and injury to pelvic organs. The baby remained in foster care while Lannie lived in another
home during February and March. In April, Lannie and her baby briefl y lived in the same foster home until they were moved to
two separate homes about 40 miles apart from each other.