ICCAP and Illinois Psychiatric Society Oppose
Illinois HB 5279
February 11, 2010

Short Description: DCFS-PSYCHOTROPIC MEDS-KIDS

House Sponsors
Rep. Mary E. Flowers
http://ilga.gov/house/Rep.asp?MemberID=1372

Synopsis As Introduced
Creates the Administration of Psychotropic Medications to Children Act. Requires prior approval from an authorized agent before the administration of psychotropic medications to children for whom the Department of Children and Family Services has legal responsibility. Requires authorized agents to receive training on the list of psychotropic medications approved by the Pharmacological Review Committee, a committee created under the Act for the purpose of developing and publishing a manual that lists all Committee approved psychotropic medications, including the purpose of these medications, the acceptable range of dosages, contraindications, and time limits, if any. Contains provisions on medication approval standards; rules governing the administration of psychotropic medications to children housed in residential facilities or facilities run by the Illinois Department of Corrections; on-site inspections of residential facilities; required forms; training requirements; penalties for violators of the Act; and other matters. Effective immediately.

2/23/2010
Below: a statement about HB 5729 from

Margery Johnson,  M.D.
President, IL Council of Child and Adolescent Psychiatry
Children’s Memorial Hospital

The current system of psychotropic medication approvals by the DCFS consent unit, headed up by Michael Naylor, MD at UIC, is already providing a high level of scrutiny of psychotropic meds for wards of the state.  I’m not sure that this does anything more than add another layer of bureaucracy that may delay needed treatment for wards. 

It appears that “authorized agents” can still deny consent based on his or her own biases, even if the prescribing physician and the consulting psychiatrist feel that the medication is appropriate.

Written information is supposed to be provided in the child’s primary language.  Even at a big clinic like Children’s, we don’t have medication information sheets in any language other than English.  So how is a small clinic supposed to comply with this, especially for less common languages?  Translation services are very costly.

I find the violations section ambiguous.  It says “A person who administers psychotropic medication ……..without obtaining the authorization…..shall be liable…”  Who exactly is the person who administers psychotropic medication in the case of outpatients?  Is it the foster parent who keeps refilling and giving meds after consent has expired?  Is it the prescribing MD who agrees to refill a prescription when the foster family cancels an appointment and doesn’t return until weeks or months later?   Many of the psychotropic medications should not be stopped abruptly.   $5000/day could sure add up!

Monetary damages are noted to be either “actual damages” or $5000.  What does “actual damages” mean?

HFS is now requiring prior authorization for all young children on stimulants and atypical antipsychotics.  So there is already a double process- approvals from both HFS and DCFS- for some patients.  Adding more paperwork is going to exacerbate the difficulty which already exists for wards of the state in need of psychiatric care. 

Margery Johnson, M.D.
President of ICCAP

ICCAP addresses policy issues in collaboration with  AACAP's Assistant Director for State Advocacy, Kevin Jones (kjones@aacap.org), and with  the Illinois Psychiatric Society, district branch of the American Psychiatric Association.

Find more on advocacy at: www.aacap.org/cs/members_only