Other States’ Approach to Psychotropic Medications in Foster Care

For readers interested in learning more about how other States handle psychotropic medication management for youth in State care, below are links to further information. Also, a 2007 article by Dr. Micheal Naylor from the University of Illinois at Chicago and colleagues reviews issues of consent, oversight and policy implications. The article can be identified through PubMed here.


The Department of Children and Families (DCF) set up a centralized system with 24 hour turn-around for routine and 12 hour turn-around for urgent requests. Triage occurs by ARNP to one of three regional medical directors. The program uses fax/email to process review requests; identifies a formulary and suggests maximum dosages. The Psychotropic Medication Consent Process is outlined here, including prescribing guidelines, forms, monitoring protocols and educational materials.


The Department of Children and Families Services (DCFS) contracts with the Clinical Services in Psychopharmacology Program at the University of Illinois, Department of Psychiatry, to provide independent medication review of all psychotropic medication consent requests submitted on behalf of children in state custody. The program uses fax submissions to process requests and has regular and after hours consent processes. Their website offers comprehensive educational materials aimed at foster parents, case workers and physicians.


The Department of Children’s Services has established psychotropic medication utilization parameters for children in custody of the State summarized in the following document. Dr. Naylor’s article indicates that Tennessee requires prior approval for psychotropic medication requests for youths under age 5 through a psychiatrist in the Department of Children’s Services, and that consent requests for youth aged 6 to 10 years old be reviewed by a nurse practitioner before a treating clinician can start the medication.


The Department of Family and Protective Services (DFPS), along with other State Agencies, released best practices guide to ensure the proper use of psychotropic medications for children in foster care. The document was most recently updated in December 2010 and can be found here. Texas DFPS also conducts Psychotropic Medication Utilization Reviews for foster children whose medication