Section 325.50  Children in Residential Facilities

a)         The Department shall create and distribute a Psychotropic Medication Approval form.  Copies of the form shall be distributed to all residential facilities in which wards of the Department reside and to all authorized agents.  That form shall include the following information:

1)         the child's name, age, weight, and diagnosis;

2)         the medication to be administered;

3)         the dosage and frequency of the medication;

4)         the duration, which in no event shall exceed 180 days;

5)         target symptom(s) and behavior;

6)         other medication the child is receiving;

7)         the potential side effects of the medication which are of greatest concern;

8)         the name of the prescribing physician;

9)         in the case of children who are 14 years of age or older, whether the ward objects to the administration of the medication.

b)         Residential facilities which provide care to children for whom the Department is legally responsible shall be advised by the Department that, whenever they seek approval of an authorized agent for the administration of a psychotropic medication, they will be asked the questions on the Psychotropic Medication Approval form.  The residential facility shall complete a copy of the approval form which is to be kept in the child's medical record at the facility.  Whenever approval is granted by an authorized agent, the agent shall complete and sign three copies of the form, retain one copy for the child's case record and forward a copy to the Guardianship Administrator and to the residential facility where the child resides.

c)         Prior consent from an authorized agent is not required when an emergency exists as defined in this Part.  However, the authorized agent shall be notified in writing of the administration of medication within one week of its initial administration. The Department shall provide each residential facility with Emergency Psychotropic Medication forms to be used by the residential facility in reporting to the authorized agent the administration of emergency medication.  This form shall be completed by either a registered nurse or a physician who has examined the child and shall contain the information set forth in subsection (a) above.  Additionally, the form shall require a brief explanation of the nature and circumstances of the emergency.  A copy of this form shall be placed in the child's medical file at the residential facility and a copy shall be forwarded to the Guardianship Administrator and the authorized agent for the child.  Emergency medication may not continue for more than 48 hours, excluding Saturdays, Sundays and holidays.  The administration of psychotropic medication beyond this period may only occur if approved by an authorized agent as provided for in this Part.

d)         The administration of psychotropic medication shall be monitored as follows:

1)         The medical director of each residential facility, or designee who has been licensed in accordance with the provisions of the Illinois Nursing Act of 1987 [225 ILCS 65], shall conduct a monthly review of all psychotropic medications and record that review in writing.  This record shall be reviewed during the on-site inspections required by this Part.  During this monthly review, the medical director or designee shall conduct an inventory of all psychotropic medications and shall verify that:

A)        psychotropic medications are labeled with the child's name, directions for administering the medication, the date and prescribing physician's name, prescription number, and drug store or pharmacy;

B)        all medications are stored in a locked cabinet or within a locked refrigerator, if required for proper storage;

C)        all controlled substances are accounted for or, if any amount of a controlled substance is missing, an incident report has been filed with the Director of the facility;

D)        psychotropic medications are dispensed in accordance with the requirements of the prescription;

E)         written consents for the provision of psychotropic medications have been received from the parent or guardian, as appropriate;

F)         any medications for children who have left the facility or who have been on runaway status 14 days or longer have been properly disposed.

2)         The Guardianship Administrator's office shall collate all Emergency Psychotropic Medication forms and all Psychotropic Medication Approval forms in binders divided according to residential facility.  The Guardianship Administrator's office shall review these binders monthly.  The psychiatric consultant shall also review these binders every 90 days.

3)         The Department shall conduct unannounced on-site reviews at least annually to assure that the approval forms reflect the actual practice in the residential facility and that the residential facility is in compliance with this Part.  Such reviews shall include an investigation into whether the Emergency Psychotropic Medication Request forms and the Psychotropic Medication Request forms accurately reflect those minors who have objected to the administration of medication.

e)         The Department shall offer training at least once every six months for personnel employed by residential facilities concerning the content of this Part and the procedures through which psychotropic medication may be authorized.