Proposed Assembly Amendments to SB 253 Draft 6/24/2015

Amendments to Section 4:

Informed Consent of Youth

The following amendment is in response to concerns/issues about requiring the “informed consent” of youth 14 years of ages and older as a prerequisite to court authorization. These concerns were raised by AACAP, CBHDA, APA, and CMA in their June 2, 2015 letter and, according to Alan Herzfeld, shared by Judicial Council.

1. Amend Section 369.5 (b)(2)(A) (i) by moving the last sentence at the end of subsection (i) to a new subsection (ii) and modify to read:

The documentation shall confirm that the child has been informed of the right to object to the authorization of psychotropic medication and to request a hearing pursuant to subdivision (g).

2. Amend Section 369.5 (b)(2)(A) (ii) by creating new subsection (iii) and modify to read:

The documentation shall include the written assent or refusal to assent of a child who is 12 years of age or older.

3. Add new section (l) and renumber existing sections (l) and (m) as sections (m) and (n). New section (l) reads:

Nothing in this section grants any person the authority to administer psychotropic medication to a child who orally refuses or otherwise indicates a refusal of treatment with the authorized medication. A child’s objection to or non-compliance with, the approved psychotropic medication is a treatment issue to be resolved by the physician prescribing the medication. No person shall threaten, coerce, withhold privileges or otherwise penalize a child for refusing to take a psychotropic medication. A child cannot be forced to take psychotropic medication unless they are subject to an involuntary hospitalization or have a court appointed conservator. Prescribing Physician’s Information

The following amendment, while rejecting the suggestion that a “good faith effort” to obtain health care history, trauma history, and medication history by the prescribing physician is sufficient, make two other changes suggested by the medical associations. First, it deletes the requirement that the physician confirms that he/she has reviewed the child’s actual medical records and replaces it with a requirement that the physician have the child’s information about the child’s health care history. This allows for the information to be drawn from sources other than the written medical records for the child. Second, while maintaining the requirement that the physician based his/her recommendation on multiple sources of information, the amendment would make the list of sources exemplary and not mandatory

1. Amend Section 369.5 (b) (2) (B) to read:

The prescribing physician submitting the request for psychotropic medication has conducted a comprehensive examination of the child in compliance with Section 2242 of the Business and Professions Code and consistent with the Psychiatric Evaluation and Diagnosis provisions included in the Guidelines for the Use of Psychotropic Medication with Children and Youth in Foster Care issued by the state, which takes into account all of the following: (i) The child’s trauma history, (ii) The child’s health care history, including medication history, and, (iii) Multiple sources of information, that should include, but not be limited to, the child, the child’s parents, relatives, teacher, caregiver or caregivers, past prescribers of psychotropic medication, or other health care providers.

Required Laboratory Tests/Screenings

This amendment is rewording with no substantive change to 369.5 (d)

(d) The court shall not authorize the administration of the psychotropic medication unless the court is provided with documentation that all of the appropriate laboratory screenings, measurements, or tests for the child have been completed no more than 30 days prior to submission of the request to the court in accordance with accepted medical guidelines no more than 30 days prior to submission of the request to the court.