Amended in Senate March 28, 2016

Senate Bill No. 1220

Introduced by Senator McGuire

February 18, 2016

An act to amend Sections 369.5 and 739.5 of the Welfare and Institutions Code, relating to foster care.

LEGISLATIVE COUNSEL’S DIGEST

SB 1220, as amended, McGuire. Foster care: psychotropic medication.

Under existing law, only a juvenile court judicial officer may make orders regarding the administration of psychotropic medications for a dependent child or a ward of the court who has been removed from the physical custody of his or her parent, as specified. Existing law requires court authorization for the administration of psychotropic medication to be based on a request from a physician, indicating the reasons for the request, a description of the child’s or ward’s diagnosis and behavior, the expected results of the medication, and a description of any side effects of the medication. begin delete Existing law requires the officer to approve or deny the request for authorization to administer psychotropic medication, or set the matter for hearing, as specified, within 7 court days. end delete

This bill begin delete would instead require the officer to take one of those actions within 5 court days. end delete begin insert would, except under emergency conditions, authorize the juvenile court to make an order for the administration of psychotropic medication only if a treatment plan is attached to the physician’s request. The bill would, for these purposes, require a treatment plan to include, among other things, appropriate treatments and interventions to address root causes contributing to the child’s emotional, cognitive, or behavioral dysregulation. end insert

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

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) (1) 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.

(2) (A) On or before July 1, 2016, the Judicial Council shall
amend and adopt rules of court and develop appropriate forms for
the implementation of this section, in consultation with the State
Department of Social Services, the State Department of Health
Care Services, and stakeholders, including, but not limited to, the
County Welfare Directors Association of California, the County
Behavioral Health Directors Association of California, the Chief
Probation Officers of California, associations representing current
and former foster children, caregivers, and children’s attorneys.
This effort shall be undertaken in coordination with the updates
required under paragraph (2) of subdivision (a) of Section 739.5.

(B) The rules of court and forms developed pursuant to
subparagraph (A) shall address all of the following:

(i) The child and his or her caregiver and court-appointed special
advocate, if any, have an opportunity to provide input on the
medications being prescribed.

(ii) Information regarding the child’s overall mental health
assessment and treatment plan is provided to the court.

(iii) Information regarding the rationale for the proposed
medication, provided in the context of past and current treatment
efforts, is provided to the court. This information shall include,
but not be limited to, information on other pharmacological and
nonpharmacological treatments that have been utilized and the
child’s response to those treatments, a discussion of symptoms not
alleviated or ameliorated by other current or past treatment efforts,
and an explanation of how the psychotropic medication being
prescribed is expected to improve the child’s symptoms.

(iv) Guidance is provided to the court on how to evaluate the
request for authorization, including how to proceed if information,
otherwise required to be included in a request for authorization
under this section, is not included in a request for authorization
submitted to the court.

(C) The rules of court and forms developed pursuant to
subparagraph (A) shall include a process for periodic oversight by
the court of orders regarding the administration of psychotropic
medications that includes the caregiver’s and child’s observations
regarding the effectiveness of the medication and side effects,
information on medication management appointments and other
followup appointments with medical practitioners, and information
on the delivery of other mental health treatments that are a part of
the child’s overall treatment plan. The periodic oversight shall be
facilitated by the county social worker, public health nurse, or
other appropriate county staff. This oversight process shall be
conducted in conjunction with other regularly scheduled court
hearings and reports provided to the court by the county child
welfare agency.

begin insert

(3) (A) Except under emergency conditions, the juvenile court
may only make an order for the administration of psychotropic
medication if a treatment plan is attached to the physician’s
request.

end insert begin insert

(B) For purposes of this paragraph, a treatment plan shall
include all of the following:

end insert begin insert

(i) Appropriate treatments and interventions to address root
causes contributing to the child’s emotional, cognitive, or
behavioral dysregulation.

end insert begin insert

(ii) Evidence-based or best practice nonpharmacological
interventions that are linguistically, culturally, and developmentally
appropriate for the child’s needs and symptoms.

end insert begin insert

(iii) How, and by whom, symptoms and psychosocial functioning
will be monitored in order to evaluate treatment and intervention
effectiveness.

end insert

(b) (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.

(c) (1) Within begin delete five end delete begin insert seven end insert 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.

(2) Notwithstanding Section 827 or any other law, upon the
approval or denial by the juvenile court judicial officer of a request
for authorization for the administration of psychotropic medication,
the county child welfare agency or other person or entity who
submitted the request shall provide a copy of the court order
approving or denying the request to the child’s caregiver.

(d) 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.

(e) Nothing in this section is intended to supersede local court
rules regarding a minor’s right to participate in mental health
decisions.

(f) This section does not apply to nonminor dependents, as
defined in subdivision (v) of Section 11400.

SEC. 2.  

Section 739.5 of the Welfare and Institutions Code is
amended to read:

739.5.  

(a) (1) If a minor who has been adjudged a ward of the
court under Section 601 or 602 is removed from the physical
custody of the parent under Section 726 and placed into foster
care, as defined in Section 727.4, only a juvenile court judicial
officer shall have authority to make orders regarding the
administration of psychotropic medications for that minor. 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 minor 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 minor’s diagnosis and behavior, the expected
results of the medication, and a description of any side effects of
the medication.

(2) (A) On or before July 1, 2016, the Judicial Council shall
amend and adopt rules of court and develop appropriate forms for
the implementation of this section, in consultation with the State
Department of Social Services, the State Department of Health
Care Services, and stakeholders, including, but not limited to, the
County Welfare Directors Association of California, the County
Behavioral Health Directors Association of California, the Chief
Probation Officers of California, associations representing current
and former foster children, caregivers, and minor’s attorneys. This
effort shall be undertaken in coordination with the updates required
under paragraph (2) of subdivision (a) of Section 369.5.

(B) The rules of court and forms developed pursuant to
subparagraph (A) shall address all of the following:

(i) The minor and his or her caregiver and court-appointed
special advocate, if any, have an opportunity to provide input on
the medications being prescribed.

(ii) Information regarding the minor’s overall mental health
assessment and treatment plan is provided to the court.

(iii) Information regarding the rationale for the proposed
medication, provided in the context of past and current treatment
efforts, is provided to the court. This information shall include,
but not be limited to, information on other pharmacological and
nonpharmacological treatments that have been utilized and the
minor’s response to those treatments, a discussion of symptoms
not alleviated or ameliorated by other current or past treatment
efforts, and an explanation of how the psychotropic medication
being prescribed is expected to improve the minor’s symptoms.

(iv) Guidance is provided to the court on how to evaluate the
request for authorization, including how to proceed if information,
otherwise required to be included in a request for authorization
under this section, is not included in a request for authorization
submitted to the court.

(C) The rules of court and forms developed pursuant to
subparagraph (A) shall include a process for periodic oversight by
the court of orders regarding the administration of psychotropic
medications that includes the caregiver’s and minor’s observations
regarding the effectiveness of the medication and side effects,
information on medication management appointments and other
followup appointments with medical practitioners, and information
on the delivery of other mental health treatments that are a part of
the minor’s overall treatment plan. This oversight process shall be
conducted in conjunction with other regularly scheduled court
hearings and reports provided to the court by the county probation
agency.

begin insert

(3) (A) Except under emergency conditions, the juvenile court
may only make an order for the administration of psychotropic
medication if a treatment plan is attached to the physician’s
request.

end insert begin insert

(B) For purposes of this paragraph, a treatment plan shall
include all of the following:

end insert begin insert

(i) Appropriate treatments and interventions to address root
causes contributing to the minor’s emotional, cognitive, or
behavioral dysregulation.

end insert begin insert

(ii) Evidence-based or best practice nonpharmacological
interventions that are linguistically, culturally, and developmentally
appropriate for the minor’s needs and symptoms.

end insert begin insert

(iii) How, and by whom, symptoms and psychosocial functioning
will be monitored in order to evaluate treatment and intervention
effectiveness.

end insert

(b) (1) The agency that completes the request for authorization
for the administration of psychotropic medication 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.

(c) (1) Within begin delete five end delete begin insert seven end insert 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 minor, or
shall, upon a request by the parent, the legal guardian, or the
minor’s attorney, or upon its own motion, set the matter for hearing.

(2) Notwithstanding Section 827 or any other law, upon the
approval or denial by the juvenile court judicial officer of a request
for authorization for the administration of psychotropic medication,
the county probation agency or other person or entity who
submitted the request shall provide a copy of the court order
approving or denying the request to the minor’s caregiver.

(d) 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.

(e) Nothing in this section is intended to supersede local court
rules regarding a minor’s right to participate in mental health
decisions.

(f) This section does not apply to nonminor dependents, as
defined in subdivision (v) of Section 11400.