DCF 52.46(4)(a)2.k. k. Any medication administration errors and corrective or other action taken.

DCF 52.46(4)(b) (b) The center shall have a copy of a resident’s medication administration record readily available for all center authorized personnel responsible for administering medications to the resident.

DCF 52.46(5) (5) Psychotropic medications.

DCF 52.46(5)(a) (a) Definition. In this subsection, “psychotropic medication” means any drug that affects the mind and is used to manage inappropriate resident behavior or psychiatric symptoms, which may include an antipsychotic, an antidepressant, lithium carbonate or a tranquilizer.

DCF 52.46 Note Note: This definition does not include a drug that can be used to manage inappropriate symptoms when it is prescribed only for a different medical use, such as carbamazapine (Tegretol), which is usually used for control of seizures but may be used to control labile behavior, and propranolol (Inderal), which is usually used to control high blood pressure but may be used to control anxiety states or side effects from antipsychotic medication.

DCF 52.46(5)(b) (b) Rights of patients. A center shall comply with the provisions of s. 51.61 (1) (g) and (h), Stats., for all residents who are prescribed psychotropic medications.

DCF 52.46(5)(c) (c) Non-emergency procedures. A center serving a resident for whom psychotropic medications are prescribed shall ensure that all of the following requirements are met:

DCF 52.46(5)(c)1. 1. Arrangements have been made for a physician to perform an initial medical work up or conduct a medical screening of the resident for the type of psychotropic medication to be prescribed for the resident. If the prescribing physician is not a board-certified pediatrician or psychiatrist, consultation shall be obtained from a board-certified pediatrician or psychiatrist.

DCF 52.46(5)(c)2. 2. The resident, if 14 years of age or older, and the resident’s parent or guardian and legal custodian shall have signed written consent forms as required under s. DHS 94.03.

DCF 52.46(5)(c)3. 3. The center has obtained from the prescribing physician and filed in the resident’s treatment record a written report at least within the first 45 days after the resident has first received a psychotropic medication and at least every 60 days thereafter. The report shall state in detail all of the following:

DCF 52.46(5)(c)3.a. a. Reasons for the initial use of the medication.

DCF 52.46(5)(c)3.b. b. Reasons for continuing, discontinuing or changing the medication.

DCF 52.46(5)(c)3.c. c. Any recommended change in treatment goals or program.

DCF 52.46(5)(c)3.d. d. The physician’s actual observation of the resident and reaction to staff reports on the resident.

DCF 52.46(5)(c)4. 4. The method and procedures for administering or monitoring resident self-administration of a psychotropic medication shall have been approved by either the prescribing physician or a psychiatrist.

DCF 52.46(5)(d) (d) Emergency procedures. For emergency administration of a psychotropic medication to a resident, a center shall do all of the following:

DCF 52.46(5)(d)1. 1. Have authorization from a physician.

DCF 52.46(5)(d)2. 2. Whenever feasible, obtain written informed consent before using the medication from the resident’s parent or guardian and legal custodian, if any, and from the resident if 14 years of age or older.

DCF 52.46(5)(d)3. 3. Comply with the center’s emergency medical procedures under s. DCF 52.41 (1) (c) 10.

DCF 52.46(5)(d)4. 4. If written informed consent of the resident’s parent or guardian and legal custodian, if any, was not obtained before administration of the medication, notify by phone the parent or guardian and legal custodian if any, as soon as possible following emergency administration, and document the dates, times and persons notified in the resident’s treatment record.

DCF 52.46(5)(d)5. 5. Document in the resident’s treatment record the physician’s reasons for ordering emergency administration of psychotropic medication.

DCF 52.46(5)(e) (e) Revocation of consent or refusal to take.

DCF 52.46(5)(e)1. 1. A resident, if 14 years of age or older, or a resident’s parent or guardian or legal custodian, if any, may at any time revoke consent for non-emergency use of psychotropic medications, as provided under s. DHS 94.03.

DCF 52.46(5)(e)2. 2. When a consent is revoked, the center shall do all of the following:

DCF 52.46(5)(e)2.a. a. Stop administration of the medication in accordance with good medical practice for withdrawal of the specific medication.

DCF 52.46(5)(e)2.b. b. Inform the prescribing physician and the placing person or agency of consent revocation and document the revocation in the resident’s treatment record.

DCF 52.46(5)(e)3. 3. When a resident refuses to take a prescribed psychotropic medication, the center shall do all of the following:

DCF 52.46(5)(e)3.a. a. Document in the resident’s treatment record the resident’s reasons for refusal and have 2 staff members who personally witnessed the refusal sign a written statement to that effect.

DCF 52.46(5)(e)3.b. b. Notify the resident’s physician.