Psychotropic Medication for Youth in Maryland’s Out-of-Home-Care Program
Disclaimer: Nothing on the website or in the attachments is medical advice but is simply intended to inform on the Department’s actions in this realm, and any questions or concerns about medication should be directed toward a qualifying medical professional
The Maryland Department of Human Services (DHS) has issued policy outlining the procedures that local department of social services (LDSS) staff must follow to ensure that informed consent is obtained prior to the administration of a psychotropic medication to a child or youth in out-of-home care. Because DHS believes that families should be proactively involved in the behavioral health care of their child, DHS policy involves parents or guardians in this informed consent process to the maximum extent possible, except in the few instances outlined in this revised policy.
Psychotropic medications are non-routine medical care that can serve as an effective part of treatment services under medical and clinical supervision. LDSS, with oversight from Maryland’s juvenile courts, arrange services for children and youth in out-of-home care. The following procedures help Maryland ensure children and youth in out-of-home care receive the appropriate services to address their physical health, mental health, and behavioral needs so they can thrive.
The administration of psychotropic medications to youth is a medical decision made in coordination with doctors and a health care decision maker, who is generally identified by the juvenile court. Documented informed consent by the health care decision maker is required to protect the youth’s health and well-being. Psychotropic medication must not be used as a method of discipline or control for any youth.
Maryland Practice Improvements
- Training – Child welfare professionals are required to complete mandatory training within six months of its release, or within six months of their hiring. As of June 2026, the Department achieved 98% compliance with this requirement.
- Secondary Review – The Department entered into contract with a vendor in 2024 to complete a secondary (prospective) review of a youth’s prescribed psychotropic medication when the LDSS is identified as the youth’s Healthcare Decision Maker. Parents that retain Healthcare Decision Maker for their child(ren) are free to obtain their own second opinion.
- Prescriber Notification Letter – The Department issued a letter to all Maryland prescribers in February 2026 informing them of the Secondary Review process and expectations.
On the Horizon
- Electronic Health Passport – Development is currently underway to allow for the current paper health passport to transition to an electronic format, which will include real-time data feed from CRISP for youth ages 11 and younger. Portal access will be available to certain individuals and professionals, subject to access restrictions, involved with the youth. Go-Live for phase 1 is tentatively scheduled for January 2027.
- Automated Notification Letter – When an individual, outside of the LDSS, is identified by the court as a youth’s Healthcare Decision Maker, the Child, Juvenile, and Adult Management System (CJAMS) will automatically generate a letter providing guidance and best-practices for the Healthcare Decision Maker.