65C-35.011. Medication Monitoring and Administration

(1) The monitoring of the use of psychotropic medication provided to children will be the joint responsibility of the prescribing physician or psychiatric nurse, the caregiver, the child protective investigator (CPI) or case manager, and the CPI or case manager’s supervisor. Child protective investigator supervisors and case manager supervisors shall provide ongoing review and oversight of children prescribed psychotropic medications.

(2) The caregiver and CPI or case manager are responsible for implementing the medication plan developed by the prescribing physician or psychiatric nurse. The case manager or child protective investigator shall ensure any additional medical evaluations and laboratory tests required are completed. The CPI or case manager shall add all information to the child’s Resource Record and report the results of evaluations and tests to Children’s Legal Services, all parties, and the prescribing physician or psychiatric nurse.

(3) Psychotropic medications will be administrated only by the child’s caregivers. Children who are age and developmentally appropriate must be given the choice to self-administer medication under the supervision of the caregiver or school personnel. Children assessed as appropriate to self-administer medication must be educated by the physician or psychiatric nurse or caregiver on the following:

(a) The method of administering the medication;

(b) The recognized side effects, risks and contraindications of the medication;

(c) Drug-interaction precautions;

(d) Possible side effects of stopping the medication; and,

(e) How medication administration will be supervised by the caregiver.

(4) The Department, community-based care agency or its contracted service provider will develop locally approved medication logs for documenting the administration of psychotropic medications and any side effects or adverse reactions.

(a) The caregiver is responsible for filling out the medication administration logs.

(b) The case manager shall obtain the medication logs at each home visit and include the medication logs in the child’s FSFN record.

(5) Any person with information that questions the child’s health and safety, including the signs or symptoms of side effects or adverse reactions to the medication, shall as soon as possible bring that information to the attention of the prescribing physician or psychiatric nurse, CPI or case manager, the CPI or case manager’s supervisor, and emergency services shall be arranged to protect the child’s safety and well-being. The child’s CPI or case manager shall provide this information to Children’s Legal Services. Children’s Legal Services shall notify the court and all parties within three (3) business days of the reported concerns.

(6) The case manager or designee who has received training on psychotropic medications in accordance with Rule 65C-35.014, F.A.C., shall attend medication reviews.

(7) All details about prescribed psychotropic medications, updates (including changes in dosage or physician or psychiatric nurse prescribed cessation of the medication) and all actions taken by the CPI or case manager will be entered into the Florida Safe Families Network (FSFN) by the CPI or case manager within three (3) business days of the action.

(8) Whenever a child in out-of-home care is receiving psychotropic medications pursuant to expressed and informed consent by the parent or legal guardian or as authorized by an order of the court, the Department shall fully inform the court of the child’s medical and behavioral status at each subsequent Judicial Review hearing and shall furnish copies of all pertinent medical records contained in the child’s Resource Record that have been generated since the previous court hearing, including the Medical Report, incorporated by reference in Rule 65C-35.001, F.A.C.

(9) If a child on psychotropic medication is moved from an out-of-home placement and placed into another out-of-home placement, the CPI or case manager must obtain the child’s Resource Record and any prescription psychotropic medication currently taken by the child.

(10) The CPI or case manager shall explain to the current and previous caregivers the importance of communication regarding the child’s medication monitoring and administration and recommend that they exchange contact information.

(11) The CPI or case manager shall obtain the medication in original labeled medication bottles, inventory the medications provided, and transport the medications to the child’s new caregiver.

(12) To ensure that the medication is continued as directed by the prescribing physician or psychiatric nurse, the CPI or case manager shall provide the caregiver with the following information:

(a) The full name of the child for whom the medication is prescribed;

(b) The condition and purpose for which the medication is prescribed for the child;

(c) The prescribing physician or psychiatric nurse’s name and contact information;

(d) The pharmacy from which the prescription was obtained and the contact information;

(e) The prescription number;

(f) The drug name and dosage;

(g) The times, frequency and method of administration, and if the dosages vary at different times;

(h) Any identified side effects, risks and contraindications (including possible side effects of stopping the medication);

(i) Any other specific instructions regarding the medication;

(j) The physician or psychiatric nurse’s plan to reduce and/or eliminate ongoing administration of the medication; and,

(k) The dates and time of any follow-up appointments, including appointments for laboratory testing.

(13) If the child is moved from an out-of-home placement and placed in another out-of-home placement and the medication is in an unlabeled container or prescription information is insufficient, the CPI or case manager shall contact the prescribing physician or psychiatric nurse, if available, and dispensing pharmacist to ensure the proper identification and labeling of the medication by examining the pills (if unlabeled) or to arrange for a medical evaluation in order that treatment not be interrupted.

(14) Community-based care lead agencies shall develop and implement protocols which ensure collaboration among those responsible for a child’s care, specifically addressing the use of psychotropic medication and the need to share all relevant information with all parties involved in the child’s care.

Rulemaking Authority 39.407(3)(g), 39.0121 FS. Law Implemented 39.407(2), (3) FS. History–New 3-17-10, Amended 4-20-17, 5-28-18, 12-3-19.