Cal. Code Regs. Tit. 15, § 3999.344 - Involuntary Medication

(a) If medication used in the treatment of mental disease, disorder or defect is administered in an emergency, as that term is defined in section 3999.210, such medication shall only be that which is required to treat the emergency condition. If a Psychiatrist determines that further administration of such medication is necessary for a period of longer than 72 hours and the patient does not consent to take the medication voluntarily, the provisions set forth in sections 3999.345 and 3999.346 shall be followed:

(b) Psychiatric medication shall not normally be involuntarily administered to a patient in his or her housing unit. A patient shall normally be transferred to the hospital, clinic, emergency room, or infirmary room at the institution prior to the administration of the medication. If a Psychiatrist determines that the prior transfer of the patient to such a setting would pose a greater risk to the patient and staff than the risk involved to the patient in receiving the medication in a non-medical setting, the medication may be involuntarily administered in the patient's cell, as follows:

(1) Nursing/Psychiatric Technician (PT) staff shall alert custody staff verbally that an order for involuntary medication is being implemented (either as an involuntary medication order that was ordered on an emergency basis by a Psychiatrist or as a Penal Code section 2602 order for involuntary medication that was previously ordered and is now being implemented). Nursing/PT staff shall alert custody staff verbally where the involuntary medication will be administered (either in the patient's cell or in a different location). In the event the patient develops side effects from the medication, Nursing/PT staff shall contact a Psychiatrist or Psychiatric Nurse Practitioner immediately. In the event that the patient develops emergent or life-threatening side effects, Nursing/PT staff shall immediately initiate the emergency response system.

(2) In all cases where it is both feasible and medically desirable, a fast-acting medication shall be utilized to facilitate the patient's rapid transfer to a medical setting.

(3) After being given involuntary psychiatric medication, and if the patient is not already housed in a medical setting such as a Correctional Treatment Center, Acute Psychiatric Program, Intermediate Care Facility, Outpatient Housing Unit, or General Acute Care Hospital, the patient shall be observed at least twice per day by mental health clinicians. If a significant adverse reaction to the medication is apparent, the patient shall be transferred from his or her cell to a licensed medical or mental health setting for the effective duration of the medication. The Psychiatrist shall note his or her observations and decision in writing. The patient shall be transferred to a licensed medical or mental health setting no later than 72 hours after the involuntary medication if the effective duration of the medication administered exceeds that time period.

(c) Each institution's Chief Psychiatrist, or in his or her absence, Chief Medical Executive or designee, shall ensure that a log is maintained in which is recorded each occasion of involuntary medication given to any patient. The log entries shall identify the patient by name and number, and shall include the reason for medication and the time and date of medication. This information shall be maintained as part of an electronic medical record system. Such logs shall be made available for review by the departmental medical and mental health executives, upon request.

(d) When deemed necessary and clinically indicated by the treating Psychiatrist, patients subject to an involuntary medication order are also subject to monitoring of his or her medication levels to ensure presence in the bloodstream. Patients who are subject to involuntary medication may also be required, when clinically indicated, to provide a blood or electrocardiogram test for side-effect monitoring. Laboratory tests may include, but are not limited to electrolytes, liver functions, white blood cell count, cholesterol, and glucose monitoring. Each institution shall maintain a local operating procedure that logs patients who are involuntarily required to provide blood for these purposes.

Notes

Cal. Code Regs. Tit. 15, § 3999.344

1. Change without regulatory effect renumbering former section 3364 to new section 3999.344, including amendment of section and NOTE, filed 4-15-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 16).

Note: Authority cited: Section 5058, Penal Code. Reference: Sections 2600, 2602 and 5054, Penal Code.

1. Change without regulatory effect renumbering former section 3364 to new section 3999.344, including amendment of section and Note, filed 4-15-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 16).