Bill Text: CA SB253 | 2015-2016 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Juveniles: psychotropic medication.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Vetoed) 2016-11-30 - Last day to consider Governor's veto pursuant to Joint Rule 58.5. [SB253 Detail]

Download: California-2015-SB253-Amended.html

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BILL NUMBER: SB 253	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 31, 2015
	AMENDED IN ASSEMBLY  JULY 8, 2015
	AMENDED IN ASSEMBLY  JULY 1, 2015
	AMENDED IN SENATE  JUNE 2, 2015
	AMENDED IN SENATE  MAY 5, 2015
	AMENDED IN SENATE  APRIL 22, 2015
	AMENDED IN SENATE  MARCH 23, 2015

INTRODUCED BY   Senator Monning
   (Principal coauthor: Assembly Member Chiu)
   (Coauthors: Senators Beall and Leno)
   (Coauthor: Assembly Member Gatto)

                        FEBRUARY 18, 2015

   An act to amend Section 4064.5 of the Business and Professions
Code, and to amend, repeal, and add  Section  
Sections  369.5  and 739.5  of, and to add Section
369.4 to, the Welfare and Institutions Code, relating to juveniles.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 253, as amended, Monning.  Dependent children:
  Juveniles:  psychotropic medication.
   Existing law establishes the jurisdiction of the juvenile court,
which may adjudge children to be dependents  or wards  of
the court under certain  circumstances, including when the
child suffered or there is a substantial risk that the child will
suffer serious physical harm, or a parent fails to provide the child
with adequate food, clothing, shelter, or medical treatment.
  circumstances.  Existing law authorizes only a
juvenile court judicial officer to make orders regarding the
administration of psychotropic medications for a dependent  or
delinquent  child who has been removed from the physical custody
of his or her parent. Existing law requires the 
 that  court authorization for the administration of
psychotropic medication to a child be based on a request from a
physician, indicating the reasons for the request, a description of
the child's diagnosis and behavior, the expected results of the
medication, and a description of any side effects of the medication.
   This bill, commencing July 1, 2016, would require that an order
authorizing the administration of psychotropic medications to a
dependent child  or a delinquent child in foster care  be
granted only upon the court's determination that  there is
clear and convincing evidence that   the 
administration of the medication is in the best interest of the child
and that specified requirements have been met, including a
requirement that the prescribing physician confirms that he or she
has conducted a comprehensive evaluation of the child, as specified.
The bill would prohibit the court from authorizing the administration
of psychotropic medications to a child under other specified
circumstances, unless a 2nd  independent  medical
opinion is obtained from  a child psychiatrist or a
behavioral pediatrician.   an appropriately qualified
health care professional.  The bill would prohibit the court
from authorizing the administration of a psychotropic medication
unless the court is provided documentation that appropriate
laboratory screenings and tests for the child have been completed no
more than 45 days prior to submission of the request to the court.
The bill would impose additional requirements on the court to
implement these provisions and to conduct review hearings, as
specified. The bill would require the child's social worker to submit
a report to the court prior to the review hearing, to include
information from the child, the child's caregiver, the public health
nurse, and the court appointed special advocate. By increasing the
duties of county social workers, this bill would create a
state-mandated local program. The bill would authorize psychotropic
medication to be administered in an emergency without court
authorization. The bill would require court authorization to be
sought as soon as practical, but in no case more than 2 court days
after emergency administration of the psychotropic medication. The
bill would require the Judicial Council to adopt rules to implement
these provisions.
   This bill would require the State Department of Health Care
Services, in collaboration with the Judicial Council, to identify
resources to assist courts in securing  2nd review and
 2nd opinions  in those counties in which there are
fewer than 10 practicing child and adolescent psychiatrists  in
order to avoid undue delays in the authorization of psychotropic
medications.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 4064.5 of the Business and Professions Code is
amended to read:
   4064.5.  (a) A pharmacist may dispense not more than a 90-day
supply of a dangerous drug other than a controlled substance pursuant
to a valid prescription that specifies an initial quantity of less
than a 90-day supply followed by periodic refills of that amount if
all of the following requirements are satisfied:
   (1) The patient has completed an initial 30-day supply of the
dangerous drug.
   (2) The total quantity of dosage units dispensed does not exceed
the total quantity of dosage units authorized by the prescriber on
the prescription, including refills.
   (3) The prescriber has not specified on the prescription that
dispensing the prescription in an initial amount followed by periodic
refills is medically necessary.
   (4) The pharmacist is exercising his or her professional judgment.

   (b) For purposes of this section, if the prescription continues
the same medication as previously dispensed in a 90-day supply, the
initial 30-day supply under paragraph (1) of subdivision (a) is not
required.
   (c) A pharmacist dispensing an increased supply of a dangerous
drug pursuant to this section shall notify the prescriber of the
increase in the quantity of dosage units dispensed.
   (d) In no case shall a pharmacist dispense a greater supply of a
dangerous drug pursuant to this section if the prescriber personally
indicates, either orally or in his or her own handwriting, "No change
to quantity," or words of similar meaning. Nothing in this
subdivision shall prohibit a prescriber from checking a box on a
prescription marked "No change to quantity," provided that the
prescriber personally initials the box or checkmark. To indicate that
an increased supply shall not be dispensed pursuant to this section
for an electronic data transmission prescription as defined in
subdivision (c) of Section 4040, a prescriber may indicate "No change
to quantity," or words of similar meaning, in the prescription as
transmitted by electronic data, or may check a box marked on the
prescription "No change to quantity." In either instance, it shall
not be required that the prohibition on an increased supply be
manually initialed by the prescriber.
   (e) This section does not apply to psychotropic medication or
psychotropic drugs as described in  Section  
Sections  369.5  and   739.5  of the Welfare
and Institutions Code.
   (f) Nothing in this section shall be construed to require a health
care service plan, health insurer, workers' compensation insurance
plan, pharmacy benefits manager, or any other person or entity,
including, but not limited to, a state program or state employer, to
provide coverage for a dangerous drug in a manner inconsistent with a
beneficiary's plan benefit.
  SEC. 2.  Section 369.4 is added to the Welfare and Institutions
Code, to read:
   369.4.  The State Department of Health Care Services, in
collaboration with the Judicial Council, shall identify resources,
which may include, but need not be limited to, university-based
consultation services, to assist the courts in securing 
second review and  second opinions  in those counties in
which there are fewer than 10 practicing child and adolescent
psychiatrists  in order to avoid undue delays in the
authorization of medications pursuant to  Section 
 Sections  369.5  and 739.5 of the Welfare and
Institutions Code  .
  SEC. 3.  Section 369.5 of the Welfare and Institutions Code is
amended to read:
   369.5.  (a) If a child is adjudged a dependent child of the court
under Section 300 and the child has been removed from the physical
custody of the parent under Section 361, only a juvenile court
judicial officer shall have authority to make orders regarding the
administration of psychotropic medications for that child. The
juvenile court may issue a specific order delegating this authority
to a parent upon making findings on the record that the parent poses
no danger to the child and has the capacity to authorize psychotropic
medications. Court authorization for the administration of
psychotropic medication shall be based on a request from a physician,
indicating the reasons for the request, a description of the child's
diagnosis and behavior, the expected results of the medication, and
a description of any side effects of the medication. On or before
July 1, 2000, the Judicial Council shall adopt rules of court and
develop appropriate forms for implementation of this section.
   (b) (1) In counties in which the county child welfare agency
completes the request for authorization for the administration of
psychotropic medication, the agency is encouraged to complete the
request within three business days of receipt from the physician of
the information necessary to fully complete the request.
   (2) Nothing in this subdivision is intended to change current
local practice or local court rules with respect to the preparation
and submission of requests for authorization for the administration
of psychotropic medication.
   (c) Within seven court days from receipt by the court of a
completed request, the juvenile court judicial officer shall either
approve or deny in writing a request for authorization for the
administration of psychotropic medication to the child, or shall,
upon a request by the parent, the legal guardian, or the child's
attorney, or upon its own motion, set the matter for hearing.
   (d) Psychotropic medication or psychotropic drugs are those
medications administered for the purpose of affecting the central
nervous system to treat psychiatric disorders or illnesses. These
medications include, but are not limited to, anxiolytic agents,
antidepressants, mood stabilizers, antipsychotic medications,
anti-Parkinson agents, hypnotics, medications for dementia, and
psychostimulants.
   (e) Nothing in this section is intended to supersede local court
rules regarding a minor's right to participate in mental health
decisions.
   (f) This section shall not apply to nonminor dependents, as
defined in subdivision (v) of Section 11400.
   (g) This section shall  remain in effect only until
  become inoperative on  July 1, 2016, and as of
January 1, 2017, is repealed, unless a later enacted statute, that is
enacted before January 1, 2017, deletes or extends that date.
  SEC. 4.  Section 369.5 is added to the Welfare and Institutions
Code, to read:
   369.5.  (a) If a child is adjudged a dependent child of the court
under Section 300 and the child has been removed from the physical
custody of the parent under Section 361, only a juvenile court
judicial officer shall have authority to make orders regarding the
administration of psychotropic medications for that child. The
juvenile court may issue a specific order delegating this authority
to a parent, upon making findings on the record that the parent poses
no danger to the child and has the capacity to authorize
psychotropic medications. Court authorization for the administration
of psychotropic medication shall be based on a request from a
physician, indicating the reasons for the request, a description of
the child's diagnosis and behavior, the expected results of the
medication, and a description of any side effects of the medication.
On or before July 1, 2016, the Judicial Council shall adopt rules of
court and develop appropriate forms for implementation of this
section.  Whenever   If  the court
authorizes the administration of a psychotropic medication, it shall
 ensure   verify  that the administration
of the psychotropic medication is only one part of a comprehensive
treatment plan for the child that shall include and specify the
psychosocial, behavioral, and alternative services, if any, the child
will receive in addition to any authorized medication.
   (b) (1) An order authorizing the administration of psychotropic
medications pursuant to this section shall be granted only upon the
court's determination that  there is clear and convincing
evidence that   the  administration of the
medication is in the best interest of the child based on a
determination that the anticipated benefits of the psychotropic
medication outweigh the short- and long-term risks associated with
the medications. An order authorizing the administration of
psychotropic medication pursuant to this section shall not be granted
if the court determines that the medication is being used as
punishment,  for the convenience of staff,   for
purposes other   than the treatment of a diagnosed mental
health condition,  as a substitute for other less invasive
treatments, or in quantities or dosages that interfere with the child'
s treatment program.
   (2) An order authorizing the administration of psychotropic
medications pursuant to this section shall be granted only if the
court determines all of the following:
   (A) The court is provided documentation confirming the child's
caregiver has been informed, and the child has been informed in an
age and developmentally appropriate manner in the primary language of
the child, about the recommended medications, the anticipated
benefits, the nature, degree, duration, and probability of side
effects and significant risks commonly known by the medical
profession, and of psychosocial treatments and interventions specific
to the identified disorder and symptoms to be considered
concurrently with or as an alternative to the medication.
   (i) The documentation shall state that the child and the child's
caregiver have been asked whether either have concerns regarding the
medication, and if so, shall describe the nature of those concerns.
   (ii) The documentation shall confirm that the child has been
informed of the right to object to the authorization of psychotropic
medication and to request a hearing pursuant to subdivision (g).
   (iii) The documentation shall include the written assent or
refusal to assent of a child who is 12 years of age or older.
   (B) The prescribing physician submitting the request for
psychotropic medication has conducted a comprehensive examination of
the child  in compliance   that complies 
with Section 2242 of the Business and Professions Code and 
consistent with the Psychiatric Evaluation and Diagnosis provisions
included in the Guidelines for the Use of Psychotropic Medication
with Children and Youth in Foster Care issued by the state, which
  that  takes into account all of the following:
   (i) The child's trauma history.
   (ii) The child's health care history, including medication
history.
   (iii)  Multiple sources of information,  
Information from multiple sources  that should include, but are
not limited to, the child, the child's parents, relatives, teacher,
caregiver or caregivers, past prescribers of psychotropic medication,
or other health care providers.
   (C) The prescribing physician also confirms all of the following:
   (i) There are no less invasive treatment options available to meet
the needs of the child.
   (ii) The dosage or dosage range requested is appropriate for the
child.
   (iii) The short- and long-term risks associated with the use of
psychotropic medications by the child does not outweigh the reported
benefits to the child.
   (iv) All appropriate laboratory screenings, measurements, or tests
for the child have been completed in accordance with accepted
medical guidelines.
   (D) A plan is in place for regular monitoring of the child's
medication and psychosocial treatment plan, the effectiveness of the
medication and psychosocial treatment, and any potential side effects
of the medication, by the physician in consultation with the
caregiver, mental health care provider, and others who have contact
with the child, as appropriate.
   (3) The person or entity submitting the request for authorization
of the administration of psychotropic medication is responsible for
providing the necessary documentation of the clinical appropriateness
of the proposed psychotropic medication and shall bear the burden of
 proof established in this section.   proof.

   (c) A court shall not issue an order authorizing the
administration of psychotropic medications for a child  described
in subdivision (a)  unless a second  independent
 medical opinion is obtained from  a child
psychiatrist or a behavioral pediatrician   an
appropriately qualified health care professional, as defined in
subdivision (b) of Section 1383.15 of the Health and Safety Code,
 if one or more of the following circumstances exist:
   (1) The request is for any class of psychotropic medication for a
child who is five years of age or younger.
   (2) The request would result in the child being administered three
or more psychotropic medications concurrently.
   (3) The request is for the concurrent administration of 
any two drugs from the same class   two antipsychotic
medications  unless the request is for medication tapering and
replacement that is limited to no more than 45 days. 
   (4) The request is for a dosage that exceeds the amount
recommended for children. 
   (d) The court shall not authorize the administration of the
psychotropic medication  for a child described in subdivision (a)
 unless the court is provided with documentation that 
all of the  appropriate laboratory screenings, measurements,
or tests for the child have been completed no more than 45 days
prior to submission of the request to the court in accordance with
accepted medical guidelines.
   (e) (1) No later than 60 days after the authorization of a new
psychotropic medication is granted or at the next review hearing
scheduled for  the child,   a child described in
subdivision (a),  if scheduled no earlier than 45 days after
the authorization of a new psychotropic medication, the court shall
conduct a review hearing to determine all of the following:
   (A) Whether the child is taking the medication or medications.
   (B) Whether psychosocial services and other aspects of the child's
treatment plan have been provided to the child.
   (C) To what extent the symptoms for which the medication or
medications were authorized have been alleviated.
   (D) Whether more time is needed to evaluate the effectiveness of
the medication or medications.
   (E) What, if any, adverse effects the child has suffered.
   (F) Any steps taken to address those effects.
   (G) The date or dates of followup visits with the prescribing
physician since the medication or medications were authorized.
   (H) Whether the appropriate followup laboratory screenings have
been performed and their findings.
   (2) Prior to the review, the child's social worker shall submit a
report to the court and to counsel for the parties, which shall
include information from the child, the child's caregiver, the public
health nurse, and the court appointed special advocate, if any.
   (3) If based upon this review, the court determines that the
proffered benefits of the medication have not been demonstrated or
that the risks of the medication outweigh the benefits, the court
shall reconsider, modify, or revoke its authorization for the
administration of medication.
   (f) (1) In counties in which the county child welfare agency
completes the request for authorization for the administration of
psychotropic medication, the agency is encouraged to complete the
request within three business days of receipt from the physician of
the information necessary to fully complete the request.
   (2) This subdivision is not intended to change current local
practice or local court rules with respect to the preparation and
submission of requests for authorization for the administration of
psychotropic medication.
   (g) Within seven court days from receipt by the court of a
completed request, the juvenile court judicial officer shall either
approve or deny in writing a request for authorization for the
administration of psychotropic medication to the child, refer the
request for a second opinion as required by subdivision (c), or
shall, upon a request by the parent, the legal guardian, or the child'
s attorney, or upon its own motion, set the matter for hearing.
   (h) If the court grants the request, or modifies and  then
 grants the request, the order for authorization is
effective until terminated or modified by court order or until 180
days following the date of the order, whichever  is 
 date occurs  earlier.
   (i) Psychotropic medication or psychotropic drugs are those
medications administered for the purpose of affecting the central
nervous system to treat psychiatric disorders or illnesses. These
medications include, but are not limited to, anxiolytic agents,
antidepressants, mood stabilizers, antipsychotic medications,
anti-Parkinson agents, hypnotics, medications for dementia, and
psychostimulants.
   (j) (1) Psychotropic medications may be administered without court
authorization  to a child described in subdivision (a)  in
an emergency. An emergency exists if all of the following conditions
are met:
   (A) A physician finds that the child requires psychotropic
medication to treat a psychiatric disorder or illness.
   (B) The medication is immediately necessary for the preservation
of life or the prevention of serious bodily harm to the child or
others. It is not necessary for the harm to take place or become
unavoidable prior to treatment.
   (C) It is impractical to obtain authorization from the court
before administering the psychotropic medication to the child.
   (2) Court authorization shall be sought as soon as practical, but
in no case more than two court days after the emergency
administration of psychotropic medication.
   (k) This section is not intended to supersede local court rules
regarding a minor's right to participate in mental health decisions.
   (l)  Nothing in this section grants   This
section does not grant  any person the authority to administer
psychotropic medication to a child who  orally refused or
otherwise  indicates a refusal of treatment with the
authorized medication.  A child's objection to or
noncompliance with, the authorized psychotropic medication is a
treatment issue to be resolved by the physician prescribing the
medication. No   A  person shall  not 
threaten, coerce, withhold privileges, or otherwise penalize a child
for refusing to take a psychotropic medication. A child 
cannot be forced to take   described in subdivision (a)
shall not be involuntarily administered a  psychotropic
medication unless otherwise specifically permitted by statute.
   (m) This section shall not apply to nonminor dependents, as
defined in subdivision (v) of Section 11400.
   (n) This section shall become operative on July 1, 2016.
   SEC. 5.    Section 739.5 of the   Welfare
and Institutions Code   is amended to read: 
   739.5.  (a) If a minor who has been adjudged a ward of the court
under Section 601 or 602 is removed from the physical custody of the
parent under Section 726 and placed into foster care, as defined in
Section 727.4, only a juvenile court judicial officer shall have
authority to make orders regarding the administration of psychotropic
medications for that minor. The juvenile court may issue a specific
order delegating this authority to a parent upon making findings on
the record that the parent poses no danger to the minor and has the
capacity to authorize psychotropic medications. Court authorization
for the administration of psychotropic medication shall be based on a
request from a physician, indicating the reasons for the request, a
description of the minor's diagnosis and behavior, the expected
results of the medication, and a description of any side effects of
the medication. On or before July 1, 2008, the Judicial Council shall
adopt rules of court and develop appropriate forms for
implementation of this section.
   (b) (1) The agency that completes the request for authorization
for the administration of psychotropic medication is encouraged to
complete the request within three business days of receipt from the
physician of the information necessary to fully complete the request.

   (2) Nothing in this subdivision is intended to change current
local practice or local court rules with respect to the preparation
and submission of requests for authorization for the administration
of psychotropic medication.
   (c) Within seven court days from receipt by the court of a
completed request, the juvenile court judicial officer shall either
approve or deny in writing a request for authorization for the
administration of psychotropic medication to the minor, or shall,
upon a request by the parent, the legal guardian, or the minor's
attorney, or upon its own motion, set the matter for hearing.
   (d) Psychotropic medication or psychotropic drugs are those
medications administered for the purpose of affecting the central
nervous system to treat psychiatric disorders or illnesses. These
medications include, but are not limited to, anxiolytic agents,
antidepressants, mood stabilizers, antipsychotic medications,
anti-Parkinson agents, hypnotics, medications for dementia, and
psychostimulants.
   (e) Nothing in this section is intended to supersede local court
rules regarding a minor's right to participate in mental health
decisions. 
   (f) This section shall become inoperative on July 1, 2016, and as
of January 1, 2017, is repealed, unless a later enacted statute, that
is enacted before January 1, 2017, deletes or extends that date.

   SEC. 6.    Section 739.5 is added to the  
Welfare and Institutions Code   , to read:  
   739.5.  (a) If a minor who has been adjudged a ward of the court
under Section 601 or 602 is removed from the physical custody of the
parent under Section 726 and placed into foster care, as defined in
Section 727.4, only a juvenile court judicial officer shall have
authority to make orders regarding the administration of psychotropic
medications for that minor. The juvenile court may issue a specific
order delegating this authority to a parent, upon making findings on
the record that the parent poses no danger to the minor and has the
capacity to authorize psychotropic medications. Court authorization
for the administration of psychotropic medication shall be based on a
request from a physician, indicating the reasons for the request, a
description of the minor's diagnosis and behavior, the expected
results of the medication, and a description of any side effects of
the medication. On or before July 1, 2016, the Judicial Council shall
adopt rules of court and develop appropriate forms for
implementation of this section. If the court authorizes the
administration of a psychotropic medication, it shall verify that the
administration of the psychotropic medication is only one part of a
comprehensive treatment plan for the minor that shall include and
specify the psychosocial, behavioral, and alternative services, if
any, the minor will receive in addition to any authorized medication.

   (b) (1) An order authorizing the administration of psychotropic
medications pursuant to this section shall be granted only upon the
court's determination that the administration of the medication is in
the best interest of the minor based on a determination that the
anticipated benefits of the psychotropic medication outweigh the
short- and long-term risks associated with the medications. An order
authorizing the administration of psychotropic medication pursuant to
this section shall not be granted if the court determines that the
medication is being used as punishment, for purposes other than the
treatment of a diagnosed mental health condition, as a substitute for
other less invasive treatments, or in quantities or dosages that
interfere with the minor's treatment program.
   (2) An order authorizing the administration of psychotropic
medications pursuant to this section shall be granted only if the
court determines all of the following:
   (A) The court is provided documentation confirming the minor's
caregiver has been informed, and the minor has been informed in an
age and developmentally appropriate manner in the primary language of
the minor, about the recommended medications, the anticipated
benefits, the nature, degree, duration, and probability of side
effects and significant risks commonly known by the medical
profession, and of psychosocial treatments and interventions specific
to the identified disorder and symptoms to be considered
concurrently with, or as an alternative to, the medication.
   (i) The documentation shall state that the minor and the minor's
caregiver have been asked whether either have concerns regarding the
medication, and if so, shall describe the nature of those concerns.
   (ii) The documentation shall confirm that the minor has been
informed of the right to object to the authorization of psychotropic
medication and to request a hearing pursuant to subdivision (g).
   (iii) The documentation shall include the written assent or
refusal to assent of a minor who is 12 years of age or older.
   (B) The prescribing physician submitting the request for
psychotropic medication has conducted a comprehensive examination of
the minor that complies with Section 2242 of the Business and
Professions Code and that takes into account all of the following:
   (i) The minor's trauma history.
   (ii) The minor's health care history, including medication
history.
   (iii) Information from multiple sources that should include, but
are not limited to, the minor, the minor's parents, relatives,
teacher, caregiver or caregivers, past prescribers of psychotropic
medication, or other health care providers.
   (C) The prescribing physician also confirms all of the following:
   (i) There are no less invasive treatment options available to meet
the needs of the minor.
   (ii) The dosage or dosage range requested is appropriate for the
minor.

(iii) The short- and long-term risks associated with the use of
psychotropic medications by the minor does not outweigh the reported
benefits to the minor.
   (iv) All appropriate laboratory screenings, measurements, or tests
for the minor have been completed in accordance with accepted
medical guidelines.
   (D) A plan is in place for regular monitoring of the minor's
medication and psychosocial treatment plan, the effectiveness of the
medication and psychosocial treatment, and any potential side effects
of the medication by the physician in consultation with the
caregiver, mental health care provider, and others who have contact
with the minor, as appropriate.
   (3) The person or entity submitting the request for authorization
of the administration of psychotropic medication is responsible for
providing the necessary documentation of the clinical appropriateness
of the proposed psychotropic medication and shall bear the burden of
proof.
   (c) A court shall not issue an order authorizing the
administration of psychotropic medications for a minor described in
subdivision (a) unless a second medical opinion is obtained from an
appropriately qualified health care professional, as defined in
subdivision (b) of Section 1383.15 of the Health and Safety Code, if
one or more of the following circumstances exist:
   (1) The request is for any class of psychotropic medication for a
minor who is five years of age or younger.
   (2) The request would result in the minor being administered three
or more psychotropic medications concurrently.
   (3) The request is for the concurrent administration of two
antipsychotic medications unless the request is for medication
tapering and replacement that is limited to no more than 45 days.
   (d) The court shall not authorize the administration of the
psychotropic medication for a minor described in subdivision (a)
unless the court is provided with documentation that appropriate
laboratory screenings, measurements, or tests for the minor have been
completed no more than 45 days prior to submission of the request to
the court in accordance with accepted medical guidelines.
   (e) (1) No later than 60 days after the authorization of a new
psychotropic medication is granted or at the next review hearing
scheduled for a minor described in subdivision (a), if scheduled no
earlier than 45 days after the authorization of a new psychotropic
medication, the court shall conduct a review hearing to determine all
of the following:
   (A) Whether the minor is taking the medication or medications.
   (B) Whether psychosocial services and other aspects of the minor's
treatment plan have been provided to the minor.
   (C) To what extent the symptoms for which the medication or
medications were authorized have been alleviated.
   (D) Whether more time is needed to evaluate the effectiveness of
the medication or medications.
   (E) What, if any, adverse effects the minor has suffered.
   (F) Any steps taken to address those effects.
   (G) The date or dates of followup visits with the prescribing
physician since the medication or medications were authorized.
   (H) Whether the appropriate followup laboratory screenings have
been performed and their findings.
   (2) Prior to the review, the minor's probation officer shall
submit a report to the court and to counsel for the parties, which
shall include information from the minor, the minor's caregiver, the
public health nurse, and the court appointed special advocate, if
any.
   (3) If based upon this review, the court determines that the
proffered benefits of the medication have not been demonstrated or
that the risks of the medication outweigh the benefits, the court
shall reconsider, modify, or revoke its authorization for the
administration of medication.
   (f) (1) The agency that completes the request for authorization
for the administration of psychotropic medication is encouraged to
complete the request within three business days of receipt from the
physician of the information necessary to fully complete the request.

   (2) Nothing in this section is intended to change current local
practice or local court rules with respect to the preparation and
submission of requests for authorization for the administration of
psychotropic medication.
   (g) Within seven court days from receipt by the court of a
completed request, the juvenile court judicial officer shall either
approve or deny in writing a request for authorization for the
administration of psychotropic medication to the minor, refer the
request for a second opinion as required by subdivision (c), or
shall, upon a request by the parent, the legal guardian, or the minor'
s attorney, or upon its own motion, set the matter for hearing.
   (h) If the court grants the request, or modifies and grants the
request, the order for authorization is effective until terminated or
modified by court order or until 180 days following the date of the
order, whichever is earlier.
   (i) Psychotropic medication or psychotropic drugs are those
medications administered for the purpose of affecting the central
nervous system to treat psychiatric disorders or illnesses. These
medications include, but are not limited to, anxiolytic agents,
antidepressants, mood stabilizers, antipsychotic medications,
anti-Parkinson agents, hypnotics, medications for dementia, and
psychostimulants.
   (j) (1) Psychotropic medications may be administered without court
authorization to a minor described in subdivision (a) in an
emergency. An emergency exists if all of the following conditions are
met:
   (A) A physician finds that the minor requires psychotropic
medication to treat a psychiatric disorder or illness.
   (B) The medication is immediately necessary for the preservation
of life or the prevention of serious bodily harm to the minor or
others. It is not necessary for the harm to take place or become
unavoidable prior to treatment.
   (C) It is impractical to obtain authorization from the court
before administering the psychotropic medication to the minor.
   (2) Court authorization shall be sought as soon as practical, but
in no case more than two court days after the emergency
administration of psychotropic medication.
   (k) This section is not intended to supersede local court rules
regarding a minor's right to participate in mental health decisions.
   (l) This section does not grant any person the authority to
administer psychotropic medication to a minor who indicates a refusal
of treatment with the authorized medication. A person shall not
threaten, coerce, withhold privileges, or otherwise penalize a minor
for refusing to take a psychotropic medication. A minor described in
subdivision (a) shall not be involuntarily administered a
psychotropic medication unless otherwise specifically permitted by
statute.
   (m) This section shall become operative on July 1, 2016. 
   SEC. 5.   SEC. 7.   If the Commission on
State Mandates determines that this act contains costs mandated by
the state, reimbursement to local agencies and school districts for
those costs shall be made pursuant to Part 7 (commencing with Section
17500) of Division 4 of Title 2 of the Government Code.