1. (1) Psychotropic medications and medications for behavior must be:

   1. (a) Prescribed by a physician or health care provider through a written order; and
   2. (b) Monitored by the prescribing physician or health care provider, ISP team, and program provider for desired responses and adverse consequences.
2. (2) The use of PRN psychotropic medications is prohibited.
3. (3) When medication is first prescribed and annually thereafter, the program provider must obtain a signed balancing test from the prescribing health care provider using the Department-approved Balancing Test Form or by inserting the required form content into forms maintained by the program provider. A program provider must present the physician or health care provider with a full and clear description of the behavior and symptoms to be addressed, as well as any side effects observed.
4. (4) The program provider must keep signed copies of the Balancing Test Forms required in section (3) of this rule in the child's medical record for seven years.

5. (5) A mental health assessment by a qualified mental health professional or licensed medical practitioner must be completed, except as noted in subsection (a) of this section, prior to the administration of a new medication for more than one psychotropic or any antipsychotic medication to a child in the legal care or custody of Child Welfare residing in a Host Home.

   1. (a) A mental health assessment is not required in any of the following situations:

      1. (A) In a case of urgent medical need;
      2. (B) For a substitution of a current medication within the same class;
      3. (C) A medication order given prior to a medical procedure; or
      4. (D) A change in dosage of a current medication.

   2. (b) When a mental health assessment is required, the program provider:

      1. (A) Must notify the DHS-CW caseworker when a child is in legal custody of DHS-CW; or
      2. (B) Must arrange for a mental health assessment when a child is a voluntary care placement.

   3. (c) The mental health assessment:

      1. (A) Must have been completed within three months prior to the prescription; or
      2. (B) May be an update of a prior mental health assessment that focuses on a new or acute problem.
   4. (d) Whenever possible, information from the mental health assessment must be communicated to the licensed health care provider prior to the issuance of a prescription for psychotropic medication.

6. (6) Within one business day after receiving a new prescription or knowledge of a new prescription for psychotropic medication for a child under the legal care or custody of Child Welfare residing in a Host Home, a program provider must notify:

   1. (a) The CDDP services coordinator; and
   2. (b) The child's parent when the parent retains legal guardianship or the child's guardian; or
   3. (c) DHS-CW when DHS-CW is the child's guardian.

7. (7) A program provider's notification to a child's parent or guardian and the child's CDDP services coordinator must contain all of the following:

   1. (a) Name of the prescribing licensed health care provider.
   2. (b) Name of the medication.
   3. (c) Dosage, any change of dosage, suspension, or discontinuation of the current psychotropic medication.
   4. (d) Dosage administration schedule prescribed.
   5. (e) Reason the medication was prescribed.
   6. (f) The side effects of the medication.
8. (8) When DHS-CW is a child's guardian, an in-residence caregiver or program provider must get a written informed consent from DHS-CW prior to filling a prescription for any new psychotropic medication except in a case of urgent medical need.
9. (9) An in-residence caregiver and program provider must cooperate as requested when a review of psychotropic medications is indicated.

Statutory/Other Authority

ORS 409.050, 427.104, 441.715, 443.450 & 443.455

Statutes/Other Implemented

ORS 427.104, 441.705-441.720, 441.740, 443.745, 443.384, 443.392, 443.400-443.445, 443.450, 443.455, 443.880, 443.881 & 443.991

History

APD 36-2019, adopt filed 10/29/2019, effective 11/01/2019