California foster children are frequently prescribed psychotropic medications, but oftentimes dosages exceed state guidelines and the children don’t receive follow-up services.

And, too often, no one notices.

That’s the grim news from State Auditor Elaine Howle in a report released Tuesday.

“This issue is of particular importance to California, which has the largest population of foster children in the country,” the report states. “In fact, our analysis of the available state data found that nearly 12 percent of California’s more than 79,000 foster children were prescribed psychotropic medications during fiscal year 2014-15, whereas studies suggest that only about 4 to 10 percent of nonfoster children are prescribed these medications.”

The report found that although some foster children were prescribed high does of antidepressants, mood stabilizers and antipsychotics, California counties often didn’t follow up with the prescribers to ensure that the prescriptions were appropriate.

Although psychotropic meds can significantly help children with mental illnesses, the drugs can have serious side effects and need to be monitored closely.

Many foster children didn’t get follow-up visits or other recommended psychosocial services, such as talk therapy, according to the audit.

Investigators found that counties didn’t always get court or parental approval before giving foster children these medications, even though such approval is required by law.

The state and counties should do a better job of monitoring foster children’s medications, the audit reports. The California Department of Social Services and the Department of Health Care Services, which are jointly responsible for oversight, have flawed data systems and can’t even fully identify which foster children are prescribed psychotropic meds.

Investigators reviewed case files for 80 foster children in Los Angeles, Madera, Riverside, and Sonoma counties.

The report recommends that the state legislature require state and county agencies to better oversee psychotropic medication prescriptions to foster children. State agencies need to increase coordination with county workers, the report states.