Chapter DOC 383

DOC 383.05 DOC 383.05 Voluntary treatment with psychotropic medication. Youth may be treated with psychotropic medications in an institution without being committed under ch. 51, Stats. Each institution shall ensure that treatment is voluntary by doing all of the following:

DOC 383.05(1) (1) The physician or APNP shall discuss the following with the youth and the parent or guardian of a youth under 18 years of age, or a legal guardian of an incompetent individual 18 years or older:

DOC 383.05(1)(a) (a) The nature of the condition.

DOC 383.05(1)(b) (b) The purposes, nature and dose of the medication.

DOC 383.05(1)(c) (c) The desired effects of the medication.

DOC 383.05(1)(d) (d) The risks and side effects of the medication.

DOC 383.05(1)(e) (e) Appropriate alternatives as available.

DOC 383.05(1)(f) (f) Prognosis without medication.

DOC 383.05 Note Note: The discussion shall be with a youth aged 18 years or older pursuant to s. DOC 383.04 (4) (a) 3.

DOC 383.05(2) (2) The physician or APNP shall ask the youth to consent to take medication, and may proceed with voluntary treatment only if:

DOC 383.05(2)(a) (a) The youth consents in writing.

DOC 383.05(2)(b) (b) Parent or guardian consent is obtained as specified in s. DOC 383.04 (4).

DOC 383.05(3) (3) The physician or APNP may not prescribe medication if the physician or APNP believes that the youth is agreeing to take medications as a result of coercion, threats, or other improper means. This does not preclude the physician or APNP, or others, from discussing with the youth the desired effects of medication, such as improvements in mental, emotional, or behavioral functioning.

DOC 383.05(4) (4) A youth 14 years or older or a parent or guardian who consented under s. DOC 383.04 (4) may withdraw or reinstate consent at any time in writing to the physician or APNP who shall make the final determination as to whether psychotropic medication is needed. A youth may not be disciplined for refusing psychotropic medication.

DOC 383.05 History History: Cr. Register, June, 2000, No. 534, eff. 7-1-00.

DOC 383.06 DOC 383.06 Involuntary treatment with psychotropic medication. A youth may be treated involuntarily with psychotropic medications only under the following circumstances:

DOC 383.06(1) (1) In an emergency, after reasonable interventions have proved unsuccessful, the attending licensed psychologist, social worker or physician or APNP shall determine whether a recommendation for an emergency transfer to a state treatment facility under s. 51.35 (3) (e), Stats., should be made to the superintendent. Pending that determination, the attending physician or APNP may order involuntary treatment with psychotropic medication. The youth may be treated involuntarily with psychotropic medications pending an emergency transfer, or for 72 hours, whichever is shorter. If an emergency transfer is initiated, the attending physician or APNP may order continued involuntary treatment with psychotropic medications pending completion of the transfer proceedings. In this subsection, “emergency” means a situation in which either of the following is true:

DOC 383.06(1)(a) (a) The youth’s perception of reality appears to be severely impaired as a result of mental illness.

DOC 383.06(1)(b) (b) The youth appears to pose an immediate danger to self or others, evidenced by a recent overt act or attempt or threat to inflict serious bodily harm.

DOC 383.06(2) (2) If a youth is committed under s. 51.20, Stats., on an outpatient basis with an order to treat involuntarily in an institution and a court has found the youth 14 years or older incompetent to refuse psychotropic medications, a physician, physician assistant, APNP, or nurse shall distribute or administer the medications. The following steps shall be followed:

DOC 383.06(2)(a) (a) A physician, physician assistant, APNP or nurse shall give the youth an opportunity to take the medication voluntarily. If it is not possible to comply with s. DOC 383.05 (1) due to the youth’s behavior, the physician, physician assistant, APNP, or nurse shall record the reasons in the youth’s clinical or medical services record.

DOC 383.06(2)(b) (b) If the youth refuses to take the medication, the physician, physician assistant, APNP, or nurse shall counsel the youth and attempt to persuade the youth to take the medication.

DOC 383.06(2)(c) (c) If the youth continues to refuse, the attending physician, physician assistant or APNP shall decide the course of action to be taken. Possible actions include:

DOC 383.06(2)(c)1. 1. Take no action for a period of time.

DOC 383.06(2)(c)2. 2. Send the youth to a special unit within the institution for treatment of mental illness.

DOC 383.06(2)(c)3. 3. When appropriate, put the youth in observation status pursuant to ch. DOC 375.

DOC 383.06(2)(c)4. 4. Recommend transfer of the youth to an appropriate health care setting.

DOC 383.06(2)(c)5. 5. If appropriate, a licensed psychologist or physician may recommend to the superintendent transfer of the youth to a state treatment facility under s. 51.35 (3) (e), Stats.

DOC 383.06(2)(c)6. 6. Direct that the youth be ordered to take the medication and that force be used to administer it, if necessary. Only the minimum amount of force required to effectively administer the medication shall be used.

DOC 383.06 History History: Cr. Register, June, 2000, No. 534, eff. 7-1-00.