FAQs

IDCFS is the legal guardian of all youth in care of the state of Illinois. The IDCFS Guardian’s Office is responsible for providing consent for all medical, surgical, and psychiatric treatments. Even if they are related to the child, foster parents cannot grant permission for surgical or medical procedures or for the use of psychotropic medication. Nor can the biological parents consent for the youth in care, even if they are living in their home.

Consents are good for a maximum of 180 days, or the duration specified on the consent for each medication, regardless of the number of refills or if there is a change in placement or physician. Each medication that has approved or modified consent will indicate the approved number of days of consent and the expiration date for consent.

A new consent is needed for any newly prescribed psychotropic medication or any medication whose consent has expired.

Yes, IDCFS gives consent for a youth in their care, for a specific medication up to a certain dose (dose range) and for a specific duration (up to 180 days.) The consent follows the child, and not the prescriber or facility.

Medications should NOT be stopped abruptly if a consent is not immediately available. A new placement can continue the regimen for a few days while promptly seeking a consent. This avoids interruption in treatment and withdrawal symptoms, which can be a set back for the youth. If the youth is on the medication without consent, submit a request explaining the situation and the need to continue the regimen, while your new patient is assessed. Specify the number of days needed before you will resubmit a request with a more permanent plan.

No, PRN (pro re nata – meaning “as needed”) medications are prohibited by state law because there is a lack of direct, real-time oversight by a board-certified physician in their administration. PRNs leave a gap in the Illinois Guardian’s capacity to monitor the youth in care’s psychotropic medication regimens, trials, and medical histories.

However, IDCFS recognizes that emergency medications are sometimes necessary.  As stated in IDCFS Rule 325, psychotropic medications cannot be administered to children for whom IDCFS is responsible without consent of the Department, except in an emergency. An emergency is defined as a circumstance in which a child poses a threat of imminent serious harm to self or others. When an emergency medication is given to a child, the treating facility must report it to the IDCFS Centralized Consent Unit the next business day on Form CFS 431-A, as an Emergency Medication. The form should include the date and time it was administered, as well as the formulation of the medication administered and what symptoms prompted the use of the medication.

If an OTC supplement or medication is utilized, for any type of sleep symptoms, anxiety, side effects of psychotropic medications or behaviors, a consent is needed. If a foster parent starts something purchased over the counter, and the prescriber agrees that it is effective, the prescriber is responsible for getting a consent as soon as they become aware of the situation. If the prescriber does not agree with it’s administration, they should instruct the foster parent to stop utilizing a supplement or medication that does not have IDCFS consent. Common OTC medications that require consent are melatonin and benadryl/diphenhydramine.

Is a new consent needed ?

• Yes, if a dose is going to exceed the approved maximum dose range, a new consent is needed to increase the dose.
• It depends. No new consent is needed , if an XR and/or IR form of a medication with the same active ingredient is being prescribed and has current consent, as long as the combined dose does not exceed the approved maximum dose range.
  • Except, a new consent is needed for both Guanfacine XR and Guanfacine IR to be used simultaneously.
• Yes, a new consent is needed if the route of administration is changed from oral to spray, patch, intramuscular or long acting intramuscular.

Under Illinois DCFS Rule 325 and DCFS guardianship procedures, the IDCFS guardian is responsible for determining whether psychotropic medications are safe, necessary, and appropriate for a youth in care. If a foster parent has concerns about a medication — such as side effects, safety, dosage, or observed behavioral changes — they should promptly communicate those concerns to the child’s prescribing clinician, the IDCFS caseworker / Child Welfare Specialist, and other involved clinical professionals as appropriate. A foster parent should NOT unilaterally stop, withhold, or refuse administration of a medication that has authorized consent unless there is an immediate medical emergency requiring urgent medical direction.

Foster parents are important partners in observing, reporting, and advocating for children’s well-being, but final authority to consent to psychotropic medication for youth under IDCFS guardianship rests with the IDCFS guardian. Caregivers should raise concerns through the clinical and casework team, rather than independently declining administration.

Prescribers should complete all clinical information and track when consents are needed, per Rule 325. Caseworkers should always be available to assist with this process. If the clinician is not available to fill out the form personally, always consult with the prescriber to provide the most up to date and accurate information. Incomplete, inaccurate information will slow down the consent process.

The Clinical Services in Psychopharmacology (CSP) program performs the clinical review of psychotropic medication regimens and makes a recommendation to the IDCFS guardian about whether the regimen is safe, necessary, and appropriate for a youth in care. A CSP research staff reviews the CFS 431-A Psychotropic Medication request form and will contact a prescriber when additional clinical information is needed.

Note: CSP team members are part of the clinical team authorized by the DCFS guardian and do not need a release of information (ROI) in order to discuss the clinical care of a youth in IDCFS custody.

Once the CSP research staff has adequate information, a CSP Nurse evaluates if the clinical information provided is sufficient for full consultation. A CSP consultant, a board-certified Child and Adolescent Psychiatrist, then reviews the case and provides a recommendation to IDCFS. For more detail see our IDCFS Consent Procedure Diagram.

Step 1, UIC Clinical Services in Psychopharmacology:

• The request for a psychotropic medication is submitted to IDCFS through the online consent portal.
• The CSP research team reviews the CFS 431-A request and makes a clinical recommendation to IDCFS.

Step 2, The IDCFS Consent Unit:

• The Authorized Agent reviews the recommendation and creates a consent.
• The Authorized Agent emails or faxes the CFS 431-B (Consent) to the prescriber, caseworker and person submitting the request. ‘

This process should take less then 48 hours provided that all of the needed clinicial information and accurate contact information is provided on the form. If more information is needed, the processing timeline may be affected.

Requests for psychotropic medication consent can be processed during regular business hours (Monday – Friday, 8:00 AM – 4:30 PM), except for state holidays. Consent requests should be completed using this link.

Emergency, after hours consent requests that cannot wait until the next business day, due to severe behavior or placement issues, can be processed:

• Monday – Friday, 4:30 PM – 8:00 AM
• Weekends
• Holidays

Process Emergency, after hours consent requests by:

1. Contact the Child Intake and Recovery Unit (CIRU)

• Phone: 773-538-8800
• Fax: 773-538-8835

2. fax the DCFS Psychotropic Request Form: CFS 431- A to the CIRU. It is also available on the DCFS website under forms.

Efficient processing of a psychotropic medication request requires the CFS 431-A form to contain complete, thorough, and clinically specific information supporting the medical necessity of the medication. Incomplete or vague submissions may delay review and consent decisions. Essential information that needs to be included:

• current psychiatric diagnoses
• presenting symptoms/target symptoms and behaviors
• ALL current and requested psychotropic medications with medication name, dosage, route, frequency and treatment plan
• height and weight of the youth
• additional clinical rationale for the medication
• other documentation supporting complex prescribing practices.

The following link will assist you in understanding what pertinent and essential information is necessary to complete the CFS 431-A form:

• How to Complete a Psychotropic Medication Request

Court orders indicating IDCFS has the legal authority to consent for psychotropic medications are necessary to process a request and provide a consent. It is helpful if the youth is new to IDCFS care or if over 18, but requires consent, for a court order to be sent with the request. This provides the documentation that allows us to process your request promptly.

IDCFS attempts to process psychotropic medication consent requests within 24-48 hours. However, many situations will delay this process. Some common reasons for this delay include:

• Insufficient clinical information
• Incomplete and illegible forms
• The CSP Consultants could have follow-up questions on the specific rationale for the request
• “Phone tag” between the request submitter and the CSP team.

Please see the Reasons for Delays page for more information.

If it has been more than 48 hours, check to see if the CSP research staff (reachable at: 312-413-1233) has contacted you to obtain more information. Please do not re-submit your CFS 431-A form before confirming if it was received by DCFS. Prompt follow up with the CSP Research Team will facilitate faster consent turnaround. If contact with the CSP is not needed, please contact the DCFS Guardian Consent Hotline at 800-828-2179 to determine the status of your request.

Unfortunately, if a correction requires reprocessing of the request (for example, an incorrect dose or dose range), a new medication request must be submitted to generate a new confirmation number and updated medication information to process consent for the corrected regimen. When submitting the corrected request, indicate that the previous submission contained an error. The “Additional Rationale” section on the CFS 431-A form may be used to briefly describe the correction. Once reviewed and approved, an updated consent will be faxed and/or emailed to you.

When a child moves to a new placement, copies of current psychotropic medication consents (CFS 431-B) should be provided by the child’s caseworker as part of the transition process.

Requests for copies of existing consents should first be directed to the child’s caseworker or the supervisor of the caseworker. If a copy is not received from the caseworker/supervisor in a timely manner, contact the IDCFS Guardian Consent Hotline at 800-828-2179.

Foster parents do not prescribe or consent to medications. Their role is to support safe and effective treatment by:

• Reporting symptoms, behaviors, and changes in functioning ~ Observing and reporting medication effectiveness
• Identifying and reporting side effects or adverse reactions
• Supporting medication adherence as prescribed

Foster parents must not change or stop medications without direction from the prescribing clinician.

The caseworker should be promptly notified of all medication changes, including:

• New medications
• Dose changes
• Formulation changes (tablet, liquid, patch, long-acting, etc.)
• Discontinuations

This supports continuity of care and accurate documentation for the consent process

Yes. Foster parents and caseworkers should maintain a clear record of the medication name and dose, start and stop dates, and any observed changes in behavior or side effects.

Notify the prescribing clinician of any side effects as soon as possible. If side effects are severe or urgent:

1. Seek emergency medical care immediately
2. Bring a list of all current medications
3. Notify the caseworker as soon as feasible

No, NEVER double a dose as this could cause dangerous side effects and even overdose. Instead, contact the prescribing clinician for guidance, monitor the youth for any changes in behavior or symptoms, and review the medication schedule to prevent future missed doses.

If a youth refuses medication, caretakers should:

• Ask open-ended questions to understand the reason for the refusal
• Provide education about the purpose of the medication
• Help the child identify and understand any medication side effects
• Observe for “cheeking”, spitting out, or refusal patterns related to the medication
• Count the number of pills in the bottle to evaluate compliance with the medication regime
• Notify the prescribing clinician and caseworker of any medication lapses

WARNING: Medications Should Not Be Stopped Abruptly.

All medications must be stored securely and administered under supervision.

• Medications must not be freely accessible to youth
• Controlled substances must be stored in a locked container
• All medications should be administered as prescribed.

Reliable sources of information about psychotropic medication are:

• The prescribing clinician
• The dispensing pharmacist
• FDA medication information resources (e.g. Medication guides)

Psychotropic medications may be used for multiple conditions. Always consult the prescriber or pharmacist for individualized guidance on risks, benefits, and side effects.

Yes. Some youth may be prescribed more than one medication depending on their diagnoses, presenting symptoms and response to treatment. Medication regimens are individualized and monitored by the prescribing clinician.

The duration of a psychotropic medication depends on the severity of the condition and its response to treatment. Short-term conditions may require temporary medication support.

Chronic conditions may require long-term treatment to maintain stability and functioning. The prescribing clinician should be regularly assessing the continued need for psychotropic medication treatment.