BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 82|
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THIRD READING
Bill No: AB 82
Author: Evans (D), et al
Amended: 9/2/09 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-0, 6/23/09
AYES: Liu, Maldonado, Alquist, Yee
NO VOTE RECORDED: Runner
SENATE JUDICIARY COMMITTEE : 5-0, 7/14/09
AYES: Corbett, Harman, Florez, Leno, Walters
SENATE APPROPRIATIONS COMMITTEE : 13-0, 8/27/09
AYES: Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,
Price, Runner, Walters, Wolk, Wyland, Yee
ASSEMBLY FLOOR : 78-0, 6/2/09 - See last page for vote
SUBJECT : Dependent children: psychotropic medications
SOURCE : Childrens Law Center of Los Angeles
DIGEST : This bill establishes a pilot project that would
create additional requirements in the court approval
process for requests to administer psychotropic medications
to children in foster care. This bill requires the
Judicial Council to adopt specified rules and forms to
implement the project by July 1, 2010. The pilot project
will be operative until January 1, 2013, in three counties,
selected by the Department of Social Services (DSS) in
CONTINUED
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consultation with the California Welfare Directors
Association, California Mental Health Director Association
and the Judicial Council. This bill requires DSS, after
consultation with the Department of Mental Health, to
report to the Legislature before July 1, 2013, regarding
the findings of the pilot project, as specified.
Senate Floor Amendments of 9/2/09 remove selection criteria
and amend reporting requirements for the pilot program.
ANALYSIS : Existing law:
1.Establishes processes for a court to declare dependency
for juveniles who are abused or neglected or at risk of
abuse or neglect (dependents) and for juveniles who are
truant (wards).
2.Defines psychotropic medication as those administered for
the purpose of affecting the central nervous system to
treat psychiatric disorders or illnesses.
3.Authorizes only a juvenile court judicial officer to make
orders about the administration of psychotropic
medications to a child who was removed from his or her
parent's custody and declared a dependent of the court,
unless the court issues a specific order delegating that
authority to a parent or guardian after making specified
findings; establishes a similar authorization for a ward
of the court.
4.Requires that the juvenile court's authorization to
administer psychotropic medications be based on a
physician's request that includes 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.
5.Provides that judicial officers have seven days to
approve or deny the request, or to set the matter for a
hearing upon request by the parent, legal guardian, or
child's attorney.
6.Defines prescribing, dispensing, or furnishing dangerous
drugs without an appropriate prior examination and a
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medical indication as unprofessional medical conduct.
This bill:
1.Establishes a pilot project operative until January 1,
2013, in three counties. DSS, in consultation with the
County Welfare Directors Association, the Judicial
Council, and the California Mental Health Directors
Association, shall select the three counties to
participate in the pilot project from among those
counties expressing an interest in participating.
2.Authorizes juvenile court judicial officers to make
orders regarding the administration of psychotropic
medications to a child who has been removed from the
physical custody of a parent or guardian, pending
adjudication as a dependent child.
3.Specifies that the juvenile court may issue a specific
order delegating this authority to a parent or guardian
upon making findings on the record that the parent or
guardian poses no danger to the child and has the
capacity to authorize psychotropic medications.
4.Requires physicians requesting authorization to
administer psychotropic medications to a dependent child,
a child awaiting adjudication as a dependent child, or a
ward of the court in foster care to have conducted an
examination and to include information on the child's
medical history, the probability of side effects of the
medication, and a description of recommended therapy in
the request.
5.Requires the juvenile court judicial officer, before
authorizing the administration of psychotropic
medication, to make findings that:
A. The child's caregiver has been informed, and the
child has been informed in an age and developmentally
appropriate manner, about the recommended medications,
anticipated benefits, possible side effects and any
other recommended treatment;
B. The child has been informed of his or her right to
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request a hearing on the issue; and,
C. A plan is in place for the physician to monitor the
medication, in consultation with the child's
caregiver, mental health care provider, and others as
appropriate.
6.Requires that a dependent child or ward in foster care be
present in court for a hearing on the request to
administer psychotropic medications, unless the child
waives the right to attend after consulting with counsel
or the court finds good cause for his or her absence.
7.Authorizes the court, in proceedings following orders
regarding administration of psychotropic medication to
inquire about:
A. The effectiveness and side effects of the
medication, the child's progress toward treatment
goals, and any changes recommended, as reported by the
physician;
B. Any behavior changes and possible side effects
observed by individuals in regular contact with the
child; and,
C. Any statements or concerns expressed by the child
about the medication.
1.Requires the Judicial Council to adopt rules and forms to
implement the above provisions by July 1, 2010.
2.Requires DSS, after consultation with the Department of
Mental Health, to report to the Legislature before July
1, 2013, regarding the findings of the pilot project.
The report shall include input fro stakeholders about
reportable outcomes. Each pilot county and the courts in
the county may develop outcome measures based on the
available data and data that is feasible to measure given
the information system used by the county and its courts.
The data shall be collected to the extend possible using
existing resources or private funding sources.
Background
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Currently, dependent children receive psychotropic
medications through a structured process: doctors submit a
medication authorization request to the court; foster
children, parents, and their attorneys receive notice and
can request a hearing; and, the court decides whether to
authorize the medication.
In three pilot counties, doctors will be required to
consider the child's medical history and conduct a thorough
examination of the child before they submit the
authorization request (in compliance with general laws
requiring an appropriate examination before prescribing any
medication). Doctors will also be required to indicate on
the authorization request form all other kinds of therapy
that the child should receive along with the medication.
Juvenile court judges, before approving medications, must
ensure that the child and caregiver have been informed
about the medication and about their right to a hearing;
that the child is present at any hearing about the
medication request; and, that a plan is in place to monitor
the medication after approval.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11
2011-12 Fund
DSS workload (report and $32 $56 $32
General
Pilot implementation) $18 $24 $18
Federal
Local assistance Unknown, potentially significant
General
New Judicial Council forms Minor and
absorbable General*
*Trial Courts Trust Fund
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SUPPORT : (Verified 9/3/09)
Children's Law Center of Los Angeles (source)
California Medical Association
California Mental Health Directors Association
California Public Defenders Association
California Youth Connection
County Welfare Directors Association
County Welfare Directors Association
Disability Rights California
Family Law Section, State Bar of California
Judicial Council of California
Junior Leagues of California State Public Affairs Committee
Juvenile Court Judges of California
Professional Fiduciary Association of California
Sacramento Child Advocates
Western Center on Law and Poverty
Youth Law Center
ARGUMENTS IN SUPPORT : According to the author's office,
there is little aggregated data on the scope of the use of
psychotropic medication for youth in the foster care
system. While some studies and articles document experts'
concerns about inappropriate and over-medication of
children in foster care, others raise concerns about the
potential for under-medicating youth who might benefit from
psychotropic medications. In general, the author states,
there is no consensus about the efficacy or appropriate
level of usage of psychotropic medications for children in
the population at large or for children in foster care.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Tom
Berryhill, Blakeslee, Blumenfield, Brownley, Buchanan,
Caballero, Charles Calderon, Carter, Chesbro, Conway,
Cook, Coto, Davis, De La Torre, De Leon, DeVore, Duvall,
Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,
Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,
Hagman, Hall, Harkey, Hayashi, Hernandez, Hill, Huber,
Huffman, Jeffries, Jones, Knight, Krekorian, Lieu, Logue,
Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,
Nestande, Niello, Nielsen, John A. Perez, V. Manuel
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Perez, Portantino, Price, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: Bill Berryhill, Block
CTW:DLW:nl 9/3/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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