Section 325.40  Medication Approval Standards

a)         Authorized agents may, at their discretion, approve the administration of any psychotropic medication whose use and dosage is listed in the Pharmacy and Therapeutic Manual, provided that children for whom the Department is legally responsible are not taking any other psychotropic medications and subject to the provisions of Section 325.30(a).  Authorized agents may approve the administration of any psychotropic medication which does not meet the criteria listed in this subsection only following consultation with the Department's psychiatric consultant.  The authorized agent shall note on the consent form when consent has been given for the administration of a psychotropic medication which is not listed in the Pharmacy and Therapeutic Manual.

b)         Additionally, whenever the authorized agent is advised that a child for whom the Department is legally responsible objects to the administration of psychotropic medication, the authorized agent must consult with both the physician who is recommending the medication and the psychiatric consultant employed or contracted by the Department prior to approving or denying the medication.  Authorized agents shall assess the basis for the child's objection to the psychotropic medication.  This assessment may include asking the child's caseworker to interview the child to determine the basis for his/her objection.  The reason for the child's objection must be fully documented on the approval form provided for in Section 325.50(a) below.

c)         Every authorization for the administration of psychotropic medication shall be limited in time.  Under no circumstance may psychotropic medication be authorized for a period exceeding 180 days.  At the expiration of the period set forth in the authorization, psychotropic medication may be reauthorized pursuant to the standards and procedures contained in this Part.

d)         Whenever a physician recommends the administration of psychotropic medication to a child for whom the Department is legally responsible, the child shall be advised of the purposes and effects of the medication and of the potential side effects of the medication to the extent that such advice is consistent with the nature and frequency of the side effects and the child's ability to understand the information communicated.  The child shall also be provided written information concerning the medication and its side effects, unless it has been determined that such information could not be understood by the child.  This written information shall be provided in the child's primary language.  Nothing in this Section shall be deemed to create any liability on the part of the physician or the residential facility based upon the failure to provide the child with complete and accurate information.

e)         Authorized agents retain the authority to deny consent to the administration of psychotropic medications whether or not they are among those listed in the Pharmacy and Therapeutic Manual or whether they have been approved by the psychiatric consultant.  Authorized agents may only deny consent to the administration of psychotropic medication after consulting both the prescribing physician and the psychiatric consultant.   The Pharmacy and Therapeutic Manual shall contain a statement setting forth this authority.  In the event of a denial of a medication request, the specific reasons for the denial shall be set forth on the Psychotropic Medication Approval form provided for in Section 325.50(a) below.

f)          Authorized agents must render their oral approval or denial of psychotropic medication within 24 hours from the time they receive the request for approval, and shall confirm their approval in writing within two working days, unless the reason for the delay is the unavailability of the prescribing physician to consult with the authorized agent.  If oral approval or denial of the request for medication is not rendered within 24 hours from the time the request was received, the requesting party shall contact the Office of the Guardianship Administrator or designee for assistance in obtaining a response.