Children in Residential Facilities and/or Psychiatric Hospital Settings

Section 325 Section 325.50  Children in Residential Facilities and/or Psychiatric Hospital Settings Residential facilities licensed by the Department shall have a written policy, approved by each facility's on-call physician and governing body, for the safe and accurate administration of medications to all children and youth in the facility. a)         Residential facilities and psychiatric hospitals that provide care to children for whom the Department is legally responsible shall submit a Psychotropic Medication Request Form when requesting consent from Centralized Consent Unit or Emergency Reception Center staff for the administration of psychotropic medications.  When consent is granted, the authorized agent shall ensure that a copy of the Psychotropic Medication Consent Form is provided to the child welfare worker and the residential facility or hospital that submitted the request.  The residential facility and/or hospital shall place a copy of the Psychotropic Medication Consent Form in the child's case or medical record.  For after hours consent requests, authorized agents at the ERC shall send a copy of the Psychotropic Medication Consent Form to the Department's psychiatric consultant. b)         Prior consent from an authorized agent at the Centralized Consent Unit or ERC is not required when an emergency exists as defined in this Part, or for the administration of a one-time non-emergency medication.  However, the Centralized Consent Unit shall be notified in writing of the administration of medication within one week of its initial administration. The Psychotropic Medication Request Form shall be used by the residential facility or psychiatric hospital to report the administration of emergency medication or for the administration of one-time non-emergency medication.  When used for notification of the use of a psychotropic medication due to an emergency or a one-time non-emergency situation, the Request 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 Section 325.30(h).  Additionally, the Request Form shall require a brief explanation of the nature and circumstances for the administration of the emergency medication or for the administration of a one-time non-emergency medication.  A copy of the Request Form shall be placed in the child's case record or medical file.  Emergency or one-time non-emergency medications may only be administered on a one-time basis.  Each administration of an emergency or one-time non-emergency medication requires submission of the Psychotropic Medication Request Form, notifying the Department of the use of the one-time emergency or  non-emergency medication. c)         PRN medications are prohibited under this Part. d)         The administration of psychotropic medication shall be monitored as follows: 1)         The medical director of each residential facility or hospital, or designee who has been licensed in accordance with the provisions of the Nurse Practice Act [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 licensed prescriber'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 or hospital; D)        psychotropic medications are dispensed in accordance with the requirements of the prescription; E)        written consents for administration of psychotropic medications have been received from the parent or guardian, as appropriate; F)         any medications for children who have left the facility or hospital or who have been on runaway status 14 days or longer have been properly disposed. 2)         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 or hospital and that the facility/setting is in compliance with this Part.  Such reviews shall include an investigation into whether the Psychotropic Medication Approval Forms, whether for notification of emergency administration, one-time non-emergency administration or routine use, accurately reflect those children/youth who have objected to the administration of medication. e)         The Department shall offer training at least once a year for personnel employed by residential facilities and/or hospitals concerning the content of this Part and the procedures through which psychotropic medication may be authorized. This training shall also encompass medical consultation, consent, general psychiatric admission processes, and review of the Guidelines for the Utilization of Psychotropic Medications for Children in Foster Care and the DCFS Psychotropic Medications List as training resources and informational tools.