Alternative Consenter
Any member of the child’s Family Support Team who has a juvenile court order to serve as the consenting authority for the administration of psychotropic medications to a child.
Assent
Assent is permission, by a child twelve (12) – seventeen (17) years of age or a child’s attorney/guardian ad litem (for a child of any age) in Children’s Division legal custody and in foster care who is not legally able to give informed consent, indicating that they agree with the proposed psychotropic medication treatment. Assent is an on-going developmentally and behaviorally appropriate discussion between the child, parents, health care providers and others involved in the child’s care.
Case Manager
The Children’s Service Worker or other designee who is responsible for the child’s health care while the child is in the legal custody of Children’s Division.
The case manager is required to document any and all services provided to the child in the Family and Children Electronic System (FACES) and upload any paper documents to the document imaging system (OnBase) immediately.
Extraordinary Care Treatment
Extraordinary care services include, but are not limited to, extraordinary dental treatment, sterilization, experimental/hormonal drug treatments, invasive or extensive medical testing, any elective body modification requiring general anesthesia i.e., gender reassignment , and any other procedures governed by local court rule or as otherwise directed by the local juvenile court. The case manager will consult with the Division of Legal Services to assist in obtaining a court order for extraordinary care services.
Health Information Specialist
The Health Information Specialist (HIS) is part of the HIS team implemented in January 2019 in advance of the Psychotropic Medication Joint Settlement Agreement (Agreement). The Agreement outlines that CD shall maintain an adequate number of full time staff members statewide for the purpose of gathering and maintaining full and accurate medical information and history for each child in CD custody. The HIS team is responsible to ensure that all elements of the Agreement are monitored, documented and that CD is in compliance with the Agreement requirements.
The HIS team members are under the direction of the Health Specialist Coordinator and two Unit Managers. A HIS team member is located in each region throughout the State.
Informed Consent
Informed consent is the agreement to any medical or behavioral health treatment (such as a medical service or procedure) given after the child, parent, and/or legal custodian has had the opportunity to receive sufficient information about its risks and benefits. Consent must be given, after receiving all necessary information, based upon what is in the best interests of the child.
To make an informed decision about behavioral health treatment or medications without undue influence/coercion, which means that the consenter is deciding based on what is best for the child, not because of pressure to consent to the medication or treatment services. For example, a decision must not be made based on a school’s or other entity’s insistence that a child take medication in order to participate or receive services, or continue placement.
The case manager cannot provide informed consent for psychotropic medications until he/she completes the psychotropic medication management and informed consent trainings.
Non-Routine Treatment
Non-routine treatment includes, but is not limited to: surgery, inpatient hospitalization, behavioral therapy or behavioral health services and psychiatric treatment.
Psychotropic Medication
In this section the following classes and medications are considered psychotropic medications:
- Antipsychotics;
- Antidepressants;
- Lithium;
- Stimulants;
- Alpha agonists (e.g., clonidine or guanfacine);
- Anxiolytics/hypnotics (e.g., benzodiazepines and nonbenzodiazepines); and
- Anticonvulsants/mood stabilizers.
A psychotropic medication may be any medicine that affects the mind, emotions or behavior. In addition to the categories above, other medicines, including herbal remedies, may be used that affect mind, emotions or behavior. Some of the medications above may be prescribed for physical health reasons. If a case manager or other team member has questions about whether a medication should be considered a psychotropic, even after discussing it with the prescriber, the case manager should consult with a HIS for direction.
Routine (Standard) Treatment
Routine (Standard) Treatment includes, but is not limited to: ordinary illnesses, routine dental care, immunizations, well child visits, preventative health services, on-going treatment for chronic medical health conditions, and necessary routine testing for those chronic conditions, such as asthma, diabetes, and ear infections.
Related Practice Points and Memos:
7-9-19 – PP19 CM-01 – Timely Informed Consent – Inpatient Hospitalizations and Medication Management Checkups
7-26-19 – CD19-47 – Informed Consent for Psychotropic Medication (Form CD-275)
4-9-20 – PP20-CM-03 – Mandatory Psychotropic Medication Reviews
7-23-20 CD20-34 –Introduction to Child Welfare Manual policy updates to align with best practices and comply with Joint Settlement Agreement requirements.
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