SENATE PUBLIC AFFAIRS COMMITTEE SUBSTITUTE FOR

SENATE BILL 583

54th legislature - STATE OF NEW MEXICO - first session, 2019

AN ACT

RELATING TO CHILDREN; ENACTING A NEW SECTION OF THE CHILDREN'S CODE TO ESTABLISH CERTAIN REQUIREMENTS, PROCEDURES AND NOTICE RELATING TO THE PRESCRIPTION AND MONITORING OF PSYCHOTROPIC MEDICATIONS FOR CHILDREN IN FOSTER CARE.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. A new section of the Children's Code is enacted to read:

     "[NEW MATERIAL] CHILDREN IN DEPARTMENT CUSTODY-- PSYCHOTROPIC MEDICATIONS--REQUIRED PROCEDURES AND REVIEW--NOTIFICATION.--

          A. The secretary of children, youth and families shall adopt and promulgate rules establishing procedures relating to the following requirements for the prescribing and use of psychotropic medications for children placed in department custody:

                (1) before a child in department custody is prescribed a psychotropic medication, a licensed health care practitioner with experience in mental health shall conduct a full evaluation, to include medical, mental health, social and trauma histories, and shall document this evaluation in the child's medical record, including:

                     (a) the medical rationale for the use of a psychotropic medication; and

                     (b) the risks and benefits of each proposed psychotropic medication;

                (2) a foster parent shall notify the department within one working day after receiving a new prescription of a psychotropic medication for a child in department custody placed with the foster parent;

                (3) if a child is under fourteen years of age, or with the consent of a child over fourteen years of age, the department shall provide to the child's parent and the parent's legal representative, if any, and the child's legal representative a notice containing the following information:

                     (a) the prescribed psychotropic medication;

                     (b) the amount of the dosage;

                     (c) the dosage recommended pursuant to a medically accepted indication;

                     (d) the reason for prescribing the psychotropic medication;

                     (e) an indication of the risks of prescribing a psychotropic medication to the child;

                     (f) the possible side effects of the psychotropic medication; and

                     (g) a list of all of the medications that the child is prescribed; and

                (4) the department and stakeholders, including medical providers, third-party health care payers and the courts, shall monitor the child's well-being while the child is taking psychotropic medication, including an annual review of medications by a licensed practitioner with training in children's mental health, who is not the prescriber of the psychotropic medication.

          B. A psychotropic medication shall not be prescribed for a child in department custody unless the prescribed use of the psychotropic medication is for a medically accepted indication that is age-appropriate and its proposed beneficial properties outweigh any risks identified in peer-reviewed medical literature relating to children's use of the psychotropic medication.

          C. Court reports for every judicial review shall include a list of prescribed psychotropic medications, dosage, reason, risks and side effects for a child under fourteen years of age or, with the child's consent, for a child over fourteen years of age.

          D. The legal representative of the child, the child's parent, the child, if over fourteen years of age, or the legal representative of the parent may file an objection to the use of or the prescribed dosage of the psychotropic medication and request a hearing. Pursuant to a hearing requested pursuant to this subsection, the court may order:

                (1) an independent evaluation of the need for or the prescribed dosage of the psychotropic medication, which evaluation may include a team treatment meeting that includes the child's prescribing licensed practitioner, the child's clinicians, consulting physicians and other supports that the court deems relevant; and

                (2) that administration of the psychotropic medication be discontinued or the prescribed dosage be modified upon a showing that either the prescribed medication or the dosage is, or both are, inappropriate.

          E. The human services department shall:

                (1) coordinate with the children, youth and families department to provide information, training, data and support to monitor psychotropic medication trends and outliers; and

                (2) direct the medical assistance division of the human services department to provide the children, youth and families department with a quarterly report of each child in protective custody, which report shall include the name, number, dosage and type of psychotropic medication that the child uses.

          F. The children, youth and families department shall analyze the report that the human services department provides pursuant to Subsection E of this section and consult with a licensed mental health professional regarding any child who:

                (1) is at least five years of age and has been prescribed four or more psychotropic medications; and

                (2) is under five years of age and has been prescribed any psychotropic medication.

          G. The human services department and the children, youth and families department shall collaborate on training prescribers on:

                (1) psychotropic medication prescribing standards;

                (2) statistics on the overuse of psychotropic medications prescribed for children who are in protective custody; and

                (3) mental health care best practices.

          H. The human services department shall direct medicaid managed care organizations to:

                (1) create a registry of all psychotropic medications administered to, or self-administered by, children in residential treatment centers, accredited residential treatment centers, group homes and treatment foster care facilities;

                (2) collaborate regularly with the behavioral health services division of the human services department and the children, youth and families department to:

                     (a) review reports and trends relating to psychotropic medications and children in protective custody; and

                     (b) review the case files of children in protective custody and address any concerns that may require immediate correction or further oversight relating to the prescription, administration or self-administration of psychotropic medications to or by children in protective custody; and

                (3) alert the children, youth and families department and the human services department when any child's psychotropic medication regime exceeds the "medically accepted indication" standard.

          I. As used in this section:

                (1) "licensed practitioner" means a licensed health care professional who has been authorized under state law to prescribe psychotropic medications;

                (2) "medically accepted indication" means any use for a covered outpatient drug that is approved pursuant to federal law or the use of which is supported by one or more citations included or approved for inclusion in any of the following compendia:

                     (a) the American hospital formulary service drug information;

                     (b) the United States pharmacopoeia drug information or any successor publication;

                     (c) the DRUGDEX information system; or

                     (d) peer-reviewed medical literature; and

                (3) "psychotropic medication" means medication, the prescribed intent of which is to affect or alter thought processes, mood or behavior, including antipsychotic, antidepressant and anxiolytic medication and behavior medications; provided that the classification of a medication depends upon its stated intended effect when prescribed, because it may have many different effects."

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