How to Complete a Psychotropic Medication Request
Instructions for completing a psychotropic medication request, CFS 431-A
What do I need to do to get a consent for different types of medication orders?
Depending on a youth’s treatment needs, prescribers can make several types of medication orders for youth in inpatient, residential, or outpatient care. Descriptions of DCFS policy related to different types of medication orders are provided. Please note that there are some medication orders which are prohibited by state law. You can use the descriptions below to best decide which medication request type to select, when submitting a CFS 431-A.
Standing Medication Requests
Standing medication orders include those medications that physicians prescribe for patients to take on a daily, weekly, or monthly schedule. Patients are to take the listed medication at the dose and schedule prescribed by the physician, without deviation.
Some medication formulations, such as a long-acting injection, require that a patient is administered the medication every month. Other medication formulations, such as immediate release tablets, have half-lives that necessitate a medication to be administered once or more daily for effective therapeutic use.
For instructions on how to complete a Standing Medication Request please visit the ‘Submission Instructions for Standing Medications‘ page. A video tutorial can be found here in both places.
One-time Emergency/STAT Medication request VS PRN Medications
Prescribers are required to notify the Department’s Division of Guardian and Advocacy, in writing, of the administration of an emergency psychotropic medication or a one-time non-emergency medication using the online consent portal or faxing DCFS form CFS 431-A.to the Consent Unit (312-814-7015).
- A quick note regarding verbiage. Some clinical staff may refer to STAT/one-time emergency medications as PRNs. There is a reason our office does not use this term and is rigid on the nomenclature. DCFS rule 325 is for the Administration of psychotropic medications to children for whom the department of children and family services is legally responsible. DCFS Rule 325, Section 325.3, under general provisions, subsection B prohibits the use of PRN medications.
What is Rule 325?
Illinois Statute 20 ILCS 535: the Administration of Psychotropic Medications to Children Act, establishes guidelines for the administration of psychotropic medications to children in foster care and delineates the responsibilities of the Department of Children and Family Services in ensuring compliance with the act. An emphasis on the importance of careful and appropriate use of psychotropic medications anchors this statute. To implement the law, DCFS was charged with the responsibility of proposing rules. These rules, TITLE 89: CHAPTER III, SUBCHAPTER B, PART 325: ADMINISTRATION OF PSYCHOTROPIC MEDICATIONS TO CHILDREN AND ADOLESCENTS FOR WHOM THE DEPARTMENT OF CHILDREN AND FAMILY SERVICES IS LEGALLY RESPONSIBLE, often referred to as DCFS Rule 325, were reviewed and approved by the Illinois Joint Commission on Administrative Rules. In Rule 325, PRN medications are defined as: “medication orders to administer a psychotropic medication for the emergency management of aggression, psychotic agitation, insomnia and other troublesome symptoms without a physician assessment or specific approval according to parameters set by the licensed prescriber.” To simplify, PRN medications are standing physician orders that give clinical staff or nurses the decision power to determine when to implement a patient’s treatment. Rule 325 prohibits the use of PRN medications. As detailed in Rule 325. “PRN medications for the purpose of behavioral management, inducing sleep, or treating other emotional, behavioral or psychiatric illnesses are prohibited…”
Although this Illinois Statute prohibits the administration of PRN medications, the Rule allows for the use of one-time emergency medications to aid in the management of behaviors that pose an immediate threat of serious harm to self or others and one-time non-emergency medications to manage symptoms of insomnia or other non-emergent symptoms that may adversely affect a youth’s sense of well-being. Administration of an emergency medication or a one-time, non-emergency medication is time sensitive. Consequently, for one-time emergency medications and one-time non-emergency medication administrations, prescribers are required to notify the Department’s Division of Guardian and Advocacy, in writing, of the administration of an emergency psychotropic medication or a one-time non-emergency medication using the online consent portal or faxing DCFS form CFS 431-A.to the Consent Unit (312-814-7015).
For instructions on how to complete One-time Emergency/STAT Medication request please visit the ‘Submission Instructions for Emergency/STAT Medications‘ page. A video tutorial can be found here in both places.
One-Time, Non-Emergency Medications
One time administration of psychiatric medications are permitted for an anticipated event that may cause agitation or safety issues. For example, medical procedures, dental appointments or transportation by airplane. To administer a one-time, non-emergency medication for a future event, a psychotropic medication request should be submitted prior to administration of the medication.
For instructions on how to complete Non-Emergency One-Time Order Medications request please visit the ‘Submission Instructions for Non-Emergency One-Time Order Medications‘ page. A video tutorial can be found here in both places.