Fla. Admin. Code Ann. R. 65C-35.011 - Medication Monitoring and Administration
(1) The monitoring of the use of psychotropic
medication provided to children will be the joint responsibility of the
prescribing physician or psychiatric nurse, the caregiver, the child protective
investigator (CPI) or case manager, and the CPI or case manager's supervisor.
Child protective investigator supervisors and case manager supervisors shall
provide ongoing review and oversight of children prescribed psychotropic
medications.
(2) The caregiver and
CPI or case manager are responsible for implementing the medication plan
developed by the prescribing physician or psychiatric nurse. The case manager
or child protective investigator shall ensure any additional medical
evaluations and laboratory tests required are completed. The CPI or case
manager shall add all information to the child's Resource Record and report the
results of evaluations and tests to Children's Legal Services, all parties, and
the prescribing physician or psychiatric nurse.
(3) Psychotropic medications will be
administrated only by the child's caregivers. Children who are age and
developmentally appropriate must be given the choice to self-administer
medication under the supervision of the caregiver or school personnel. Children
assessed as appropriate to self-administer medication must be educated by the
physician or psychiatric nurse or caregiver on the following:
(a) The method of administering the
medication;
(b) The recognized side
effects, risks and contraindications of the medication;
(c) Drug-interaction precautions;
(d) Possible side effects of stopping the
medication; and,
(e) How medication
administration will be supervised by the caregiver.
(4) The Department, community-based care
agency or its contracted service provider will develop locally approved
medication logs for documenting the administration of psychotropic medications
and any side effects or adverse reactions.
(a) The caregiver is responsible for filling
out the medication administration logs.
(b) The case manager shall obtain the
medication logs at each home visit and include the medication logs in the
child's FSFN record.
(5)
Any person with information that questions the child's health and safety,
including the signs or symptoms of side effects or adverse reactions to the
medication, shall as soon as possible bring that information to the attention
of the prescribing physician or psychiatric nurse, CPI or case manager, the CPI
or case manager's supervisor, and emergency services shall be arranged to
protect the child's safety and well-being. The child's CPI or case manager
shall provide this information to Children's Legal Services. Children's Legal
Services shall notify the court and all parties within three (3) business days
of the reported concerns.
(6) The
case manager or designee who has received training on psychotropic medications
in accordance with Rule
65C-35.014, F.A.C., shall attend
medication reviews.
(7) All details
about prescribed psychotropic medications, updates (including changes in dosage
or physician or psychiatric nurse prescribed cessation of the medication) and
all actions taken by the CPI or case manager will be entered into the Florida
Safe Families Network (FSFN) by the CPI or case manager within three (3)
business days of the action.
(8)
Whenever a child in out-of-home care is receiving psychotropic medications
pursuant to expressed and informed consent by the parent or legal guardian or
as authorized by an order of the court, the Department shall fully inform the
court of the child's medical and behavioral status at each subsequent Judicial
Review hearing and shall furnish copies of all pertinent medical records
contained in the child's Resource Record that have been generated since the
previous court hearing, including the Medical Report, incorporated by reference
in Rule 65C-35.001, F.A.C.
(9) If a child on psychotropic medication is
moved from an out-of-home placement and placed into another out-of-home
placement, the CPI or case manager must obtain the child's Resource Record and
any prescription psychotropic medication currently taken by the
child.
(10) The CPI or case manager
shall explain to the current and previous caregivers the importance of
communication regarding the child's medication monitoring and administration
and recommend that they exchange contact information.
(11) The CPI or case manager shall obtain the
medication in original labeled medication bottles, inventory the medications
provided, and transport the medications to the child's new caregiver.
(12) To ensure that the medication is
continued as directed by the prescribing physician or psychiatric nurse, the
CPI or case manager shall provide the caregiver with the following information:
(a) The full name of the child for whom the
medication is prescribed;
(b) The
condition and purpose for which the medication is prescribed for the
child;
(c) The prescribing
physician or psychiatric nurse's name and contact information;
(d) The pharmacy from which the prescription
was obtained and the contact information;
(e) The prescription number;
(f) The drug name and dosage;
(g) The times, frequency and method of
administration, and if the dosages vary at different times;
(h) Any identified side effects, risks and
contraindications (including possible side effects of stopping the
medication);
(i) Any other specific
instructions regarding the medication;
(j) The physician or psychiatric nurse's plan
to reduce and/or eliminate ongoing administration of the medication; and,
(k) The dates and time of any
follow-up appointments, including appointments for laboratory
testing.
(13) If the
child is moved from an out-of-home placement and placed in another out-of-home
placement and the medication is in an unlabeled container or prescription
information is insufficient, the CPI or case manager shall contact the
prescribing physician or psychiatric nurse, if available, and dispensing
pharmacist to ensure the proper identification and labeling of the medication
by examining the pills (if unlabeled) or to arrange for a medical evaluation in
order that treatment not be interrupted.
(14) Community-based care lead agencies shall
develop and implement protocols which ensure collaboration among those
responsible for a child's care, specifically addressing the use of psychotropic
medication and the need to share all relevant information with all parties
involved in the child's care.
Notes
Rulemaking Authority 39.407(3)(g), 39.0121 FS. Law Implemented 39.407(2), (3) FS.
New 3-17-10, Amended 4-20-17, 5-28-18, 12-3-19.
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