Q.

Can we legally extend a client's prescription for two days prior to receipt of the court order - per proposed procedure below: 

"In the event that an existing court order for psychotropic medications for a minor has expired or is over one year old and the physician identifies that the abrupt interruption of psychotropic medications will result in an acute decompensation resulting in the inability to maintain that child in the community, the psychiatrist/ARNP will request an extension/renewal of the court order and will grant a prescription/psychotropic medications not to exceed two days, in order to all for the court order to be processed."

A lot of court orders do not have an expiration date but we do have our own policy indicating that the consents need to be obtained annually. When we receive court orders with blanket statements as to the child taking any medications we resubmit these to the court requesting that the specific medications are placed in the order.
 

A.

After further discussion with you and review of court documents you sent me, I understand that your question relates to instances in which the Court has permanently committed a child to the Department of Children and Families.

The order you sent authorizes the Department of Children and Families to act as a guardian with full authority to consent to any medical care including mental health treatment.  Therefore, I suggest that your first priority should be to request the Department to authorize further medication. If for some reason you anticipate that you will not be able to timely obtain consent from the Department your next priority should be to request authority from Court.

If you cannot obtain timely consent from either the Department or the Court I believe that you would have authority to continue the medication for a short period of time under emergency circumstances where the physician believes that the child would be an imminent danger to himself or others without the medication.

You are prudent to obtain consent for specific medication and to have a policy that consent should be renewed.