PURPOSE AND SCOPE

This standard and procedure establishes guidelines for out-of-home care providers and Children's Administration (CA) staff to follow when a child is in the custody of the department, placed in out-of-home care, and is or may be administered psychotropic medication. This interim policy applies to children placed in the department's custody, whether by voluntary placement agreement (VPA) or court order. It is prospective only. It applies only to children not receiving such medications on the effective date of this interim policy.

Children's Administration

Interim Policy 97-10

DEFINITIONS

"MEDICAL HISTORY" means health information on the child contained in the child's case record, as required by the CA Practices and Procedures Guide, chapter 4000, section 43092, Health and Education Record.

"PRN" stands for pro re nata and means "as needed."

"PSYCHOTROPIC MEDICATION" means medication, the prescribed intent of which is to affect or alter thought processes, mood, sleep, or behavior, including, but not limited to, anti-psychotic, antidepressant, and anxiolytic medications. The classification of a medication depends on its stated, intended effect when prescribed because it may have many different effects. Examples of some such medications are :

Amitriptyline/Elavil	Desipramine/Norpramine
Amoxapine/Asendin	Imipramine/Tofranil
Trimipramine/Surmontil	Fluoxetine/Prozac
Sertraline/Zoloft	Phenelzine/Nardil
Isocarboxazid/Marplan	Burpropion/Wellbutrin
Carbamaxepine/Tegretol	Lithium/Eskalith or Lithobid
Chlordiazepoxide/Librium	Diasepam/Valium
Lorazepam/Ativan	Propranolol/Inderal
Chlorpromazine/Thorazine	Halperiodal/Haldol
Trifluoperazine/Stelazine	Thioridazine/Mellaril
Methylphenidate/Ritalin	Pemoline/Cylert
Amphetamine Sulfate/Amphetamine

STANDARD

The Children's Administration (CA) social worker and the out-of-home care provider shall comply with the provisions of RCW 13,34.060(1) regarding authorization of routine medical and dental care of the child in the custody of CA.

For children who have been prescribed psychotropic medication, compliance with Chapter 71.34 RCW, Mental Health Services for Minors, is required.

Neither the CA social worker nor the out-of-home care provider shall authorize the administration of psychotropic medications to a child in the custody of CA, with the following exceptions :

The CA social worker may authorize the administration of such medications if the child is legally free and in the permanent custody of the department.

The CA social worker may authorize the administration of such medications when it is impossible to obtain informed parental consent after normal work hours, on weekends, or on holidays. In such instances, the social worker must obtain either informed parental consent or a court order within 72 work hours of authorizing administration of the medication.

The parent of the child in CA custody must provide informed consent for the administration of psychotropic medications to the child. If the parent is unavailable, unable, or unwilling to consent to the administration of medically necessary psychotropic medications, the social worker shall obtain a court order before the medications may be administered.

The informed parental consent or court order needs to be a general authorization for the administration of psychotropic medications at the direction of a qualified, licensed physician so that a change in the consent or court order is unnecessary when there is a need for the physician to adjust the medication.

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