BILL NUMBER: SB 253 AMENDED
BILL TEXT
AMENDED IN SENATE MARCH 23, 2015
INTRODUCED BY Senator Monning
(Principal coauthor: Assembly Member Chiu)
( Coauthor: Senator Beall
)
( Coauthor: Assembly Member
Gatto )
FEBRUARY 18, 2015
An act to amend Section 369.5 of the Welfare and Institutions
Code, relating to juveniles.
LEGISLATIVE COUNSEL'S DIGEST
SB 253, as amended, Monning. Dependent children: psychotropic
medication.
Existing law establishes the jurisdiction of the juvenile court,
which may adjudge children to be dependents of the court under
certain circumstances, including when the child suffered or there is
a substantial risk that the child will suffer serious physical harm,
or a parent fails to provide the child with adequate food, clothing,
shelter, or medical treatment. Existing law authorizes only a
juvenile court judicial officer to make orders regarding the
administration of psychotropic medications for a dependent child who
has been removed from the physical custody of his or her parent.
Existing law requires the court authorization for the administration
of psychotropic medication to a child be based on a
request from a physician, indicating the reasons for the request, a
description of the child's diagnosis and behavior, the expected
results of the medication, and a description of any side effects of
the medication.
This bill would require that an order authorizing
the administration of psychotropic medications to only
a dependent child be granted on
only upon the demonstration of clear and
convincing evidence of that specified
matters, and criteria are met, including a
requirement that the prescribing physician attest under penalty of
perjury that he or she has conducted a comprehensive evaluation of
the child, as specified. The bill would prohibit the court from
authorizing the administration of psychotropic medications
for to a child under other specified
circumstances, unless a 2nd independent medical opinion is
obtained from a child psychiatrist or a psychopharmacologist
if one or more specified circumstances exist, including if the
request is for any class of psychotropic medication for a child who
is 5 years of age or younger. psychopharmacologist.
The bill would prohibit the court from authorizing the
administration of a psychotropic medication unless the court is
provided documentation that appropriate screenings and tests for the
child have been completed no more than 30 days prior to submission of
the request to the court. The bill would impose additional
requirements on the court to implement these provisions and to
conduct review hearings, as specified. The bill would require the
Judicial Council to adopt rules to implement these provisions.
By requiring the attestation of the prescribing physician under
penalty of perjury, as described above, this bill would create a
crime and impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 369.5 of the Welfare and Institutions Code is
amended to read:
369.5. (a) If a child is adjudged a dependent child of the court
under Section 300 and the child has been removed from the physical
custody of the parent under Section 361, only a juvenile court
judicial officer shall have authority to make orders regarding the
administration of psychotropic medications for that child. The
juvenile court may issue a specific order delegating this authority
to a parent upon making findings on the record that the parent poses
no danger to the child and has the capacity to authorize psychotropic
medications. Court authorization for the administration of
psychotropic medication shall be based on a request from a physician,
indicating the reasons for the request, a description of the child's
diagnosis and behavior, the expected results of the medication, and
a description of any side effects of the medication. On or before
July 1, 2000, 2016, the Judicial
Council shall adopt rules of court and develop appropriate forms for
implementation of this section. Whenever the court authorizes
the administration of a psychotropic medication, it shall ensure that
the administration of the psychotropic medication is only
one part of a comprehensive treatment plan for the child that shall
include and specify the psychosocial services the child will receive
in addition to any authorized medication.
(b) (1) An order authorizing the
administration of psychotropic medications pursuant to this section
shall only be granted on clear and convincing evidence of all of the
following:
(1)
(A) The medication is not being used as a
chemical restraint. punishment, for the convenience of
staff, as a substitute for other, less invasive
treatments, or in quantities or dosages that interfere with the child'
s treatment program.
(2)
(B) If the child is 12 years of age or older, the
child, after being advised of alternative treatments and informed of
the benefits and risks of the medication, understands his or her
right to refuse the medication, and has given his or her
written informed consent.
(3)
(C) The prescribing physician submitting the request
for psychotropic medication attests under penalty of perjury
that he or she conducted a comprehensive examination of the
child in compliance with Section 2242 of the Business and Professions
Code that takes into account the child's trauma history.
and medication history and is based upon multiple
sources, including, among others, the child's medical records, the
child, the child's parents, relatives, teacher, caregiver or
caregivers, pa st prescribers of psychotropic medication,
or other health care providers. The prescribing physician shall also
attest that the dosage or dosage range requested is appropriate for
the child.
(4) The prescribed dosage is appropriate for the child's age.
(5)
(D) The short- and long-term risks associated with the
use of psychotropic medications by the child does not outweigh the
reported benefits to the child.
(6)
(E) There are no less invasive and effective
treatment options available other than the administration
of psychotropic medications. to meet the needs of the
child.
(2) The person or entity submitting the request for authorization
of the administration of psychotropic medication shall bear the
burden of proof established in this section.
(c) A court shall not issue an order authorizing the
administration of psychotropic medications for a child unless a
second independent medical opinion is obtained from a child
psychiatrist or a psychopharmacologist if one or more of the
following circumstances exist:
(1) The request is for any class of psychotropic medication for a
child who is five years of age or younger.
(2) The request would result in the child being administered
multiple three or more psychotropic
medications concurrently.
(3) The request is for the concurrent administration of any two
drugs from the same class unless the request is for medication
tapering and replacement that is limited to no more than 30 days.
(4) The request is for a dosage that exceeds the amount
recommended for children.
(5) The request is for the administration of a psychotropic
medication for a use that is not approved by the federal Food and
Drug Administration for children or adolescents.
(d) The court shall not authorize the administration of the
psychotropic medication unless the court is provided documentation
that all of the appropriate lab screenings,
measurements, or tests for the child have been completed in
accordance with the accepted medical guidelines no
more than 30 days prior to submission of the request to the court.
(e) (1) No later than 45 days after the authorization of a new
psychotropic medication is granted or at the next review hearing
scheduled for the child pursuant to Section 366, 366.21, 366.22, or
366.31, whichever is earlier, the court shall conduct a review
hearing to determine all of the following:
(A) Whether the child is taking the medication or medications.
(B) To what extent the symptoms for which the medication or
medications were authorized have been alleviated.
(C) What, if any, adverse effects the child has suffered.
(D) Any steps taken to address those effects.
(E) The date or dates of follow-up visits with the prescribing
physician since the medication or medications were authorized.
(2) If based upon this review, the court determines that the
proffered benefits of the medication have not been demonstrated or
that the risks of the medication outweigh the benefits, the court
shall reconsider, modify, or revoke its authorization for the
administration of medication.
(e)
(f) (1) In counties in which the county child welfare
agency completes the request for authorization for the administration
of psychotropic medication, the agency is encouraged to complete the
request within three business days of receipt from the physician of
the information necessary to fully complete the request.
(2) Nothing in this subdivision is intended to change current
local practice or local court rules with respect to the preparation
and submission of requests for authorization for the administration
of psychotropic medication.
(f)
(g) Within seven court days from receipt by the court
of a completed request, the juvenile court judicial officer shall
either approve or deny in writing a request for authorization for the
administration of psychotropic medication to the child, or shall,
upon a request by the parent, the legal guardian, or the child's
attorney, or upon its own motion, set the matter for hearing.
(g)
(h) Psychotropic medication or psychotropic drugs are
those medications administered for the purpose of affecting the
central nervous system to treat psychiatric disorders or illnesses.
These medications include, but are not limited to, anxiolytic agents,
antidepressants, mood stabilizers, antipsychotic medications,
anti-Parkinson agents, hypnotics, medications for dementia, and
psychostimulants.
(h)
(i) Nothing in this section is intended to supersede
local court rules regarding a minor's right to participate in mental
health decisions.
(i)
(j) This section shall not apply to nonminor
dependents, as defined in subdivision (v) of Section 11400.
SEC. 2. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.