Ask the GAL: Law strictly governs psychotropic medications for foster children

November 8, 2012 

Q: How many abused, abandoned, or neglected children in dependency are taking psychotropic medications?

A: Out of the estimated 1,100 children in care in the 12th Circuit, about 100 are being administered psychotropic medications. This number fluctuates as children come in and out of care.

Q: When children are in the care of the state, who gives permission for them to take psychotropic medications and who monitors their results?

A: According to Chapter 65C-35 of the Florida Statutes, a psychotropic medication is "any chemical substance prescribed with the intent to treat psychiatric disorders and those substances which though prescribed with the intent to treat other medical conditions have the effect of altering brain chemistry or involve any of the medications in the categories … which include antipsychotics, antidepressants, sedative hypnotics, lithium, stimulants, non-stimulant attention deficit hyperactivity disorder medications, anti-dementia medications and cognition enhancers, anticonvulsants and alpha-2 agonists, and any medication used to stabilize or improve mood, mental status, behavior or mental illness."

The law strictly prohibits the use of any medication for the sole purpose of chemical restraint to control behavior or restrict freedom of movement.

A child in state care may not be administered a psychotropic medication without the informed consent of the parent or legal guardian. Informed consent means that the parent or legal guardian has been given information, in plain language, without coercion, by the physician, about the medical condition of the child, the treatment plan and the side effects of the medication.

When a child comes into care and is already taking a psychotropic medication, the child protective investigator has to gather the information pertinent to the child's taking of the drug and written authorization from the parent or legal guardian for the child to continue taking the drug. If that parent or legal guardian is not available or willing to give con

sent, Children's Legal Services must file a motion for the court to hear the medical facts to authorize the medication to be administered.

If any party believes it is medically necessary and in the best interest of the child for them to be administered a psychotropic medication and the parent's rights have been terminated, their identity or whereabouts are unknown, or they decline to approve the medication, permission must be pursued through the court to allow the child to take the medication.

No system personnel can give the informed consent for a child to be prescribed a psychotropic medication. It is the responsibility of the dependency case manager to involve the parents or legal guardians in all of the child's medical care, which includes facilitating the parents attending medical appointments for the child and understanding the treatment plans and side effects of any medications.

One of the responsibilities of the guardian ad litem is to check medications and dosages on their monthly visits with the child to be sure the child is taking their medications and that the prescription or the dosage have not changed.

Caring for the medical and mental health needs of all children in out of home care is a huge responsibility taken very seriously by the dependency system, and every effort is taken to include parents or legal guardians in the care of the children.

Pam Hindman, director of the Guardian ad Litem program for the 12th Judicial Circuit, writes this weekly column for the Bradenton Herald. Email her at askthegal@12gal.org, or write to the Guardian ad Litem Program, 1051 Manatee Ave. W., Hensley Wing, Suite 330, Bradenton 34205.

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