Rule 5.640.Psychotropic medications

Once a child is declared a dependent and removed from a parent, guardian or Indian custodian — or is a ward removed and placed in foster care — only a juvenile court judicial officer may order the administration of psychotropic medication. The court can hand that authority back, but only by an express order supported by the statutory findings, which must appear in the order itself.

The application runs on forms: JV-220 with the physician’s statement JV-220(A), or JV-220(B) where the same physician is asking to continue the same medication at the same maximum dose, plus proof of notice on JV-221. The physician signs their own statement. A social worker or probation officer applying must complete the whole of JV-220; a physician, medical office staff member or caregiver completes and signs page one only.

Nobody is meant to be silent. The child, the caregiver, the parents or guardians, an Indian custodian, the tribe and a CASA volunteer may all give input — on form JV-218 (the child’s own view) or JV-219, by letter, by speaking to the judge at a hearing, or through a social worker, probation officer, attorney or advocate. Parents, their lawyers, the child’s lawyer, a CAPTA guardian ad litem and the tribe may file form JV-222. Those forms are due within four court days of notice, though JV-218 and JV-219 may come in any time up to the hearing if one is set.

The court has seven court days from receiving a complete application to approve it, deny it, or set a hearing, and it rules on form JV-223. An incomplete application does not simply fail: the court orders the missing information and sets a hearing.

The notice provisions are long because they are tailored. Parents and their lawyers get a plain statement of what is proposed and the medication’s name, notice that the application is pending, the guide form JV-217-INFO, and blank JV-219 and JV-222 forms. Caregivers and the CASA get the same statement plus blank JV-218 and JV-219. The child’s attorney and any CAPTA guardian ad litem get the completed application and physician’s statement themselves — and, where three or more medications for 90 days or more could be authorized, the Medical Board release forms as well. An Indian child’s tribe gets its own list. Medical and psychological material may not be served electronically, and where the child lives in a group home or short-term residential therapeutic program, notice to the caregiver goes to the facility administrator.

An authorization is not permanent. It lasts until modified or terminated, or 180 days, whichever comes first. Every approval triggers a progress review, which happens at every status review hearing and whenever else the court wants. The agency files form JV-224 at least 10 calendar days beforehand, and everyone who could give input at the application stage may do so again.

The caregiver must actually be told. Within two court days of signature, the applicant gives or mails the caregiver a copy of the order — with the last two pages of the physician’s form and every medication information sheet attached to it, if the application was granted. The same package follows the child to a new placement.

Emergencies are the exception. Medication may be given without authorization where a physician finds it is needed to treat a psychiatric disorder, the purpose is to protect life, prevent serious harm, or treat current or imminent substantial suffering, and it is impractical to reach the court first. Authorization must then be sought as soon as practical, and never later than two court days after.