Antipsychotic Medications: Patient Signature Requirement

According to the Department of Health Care Services (DHCS), they have heard from many physicians, mental health providers, counties and stakeholders that DHCS should seek to continue the flexibility given during the pandemic to waive the requirement for written patient signatures for anti-psychotic medications. This flexibility ended September 30, when the governor’s Executive Order ended. This requirement only applies to specialty MH facilities – any psychiatrist delivering care in the non-specialty Medi-Cal delivery system can prescribe these same medications without requiring the patient to sign an informed consent. We heard resounding support for this policy from all county and provider leaders.
This requirement has been counter-productive:

  • It only applies to patients taking anti-psychotics, not other psychiatric medications
  • It is exclusively required in specialty MH, not in managed care and fee for service network providers
  • The very patients it applies to are those with paranoia and delusions, and the pursuit of a signature is often misinterpreted by patients with suspicion
  • Providers describe using a lot of valuable patient/provider time in pursuit of this signature, instead of more important clinical needs
  • Waiving this requirement does not waive any existing patient rights related to informed consent – it only removes the requirement of a signature.

In response to stakeholder appeals, DHCS has worked on this proposed language andbackground. CSAP’s Government Affairs Committee is reviewing this proposal. If you have comments on it, please contact Paul Yoder at SYASL.

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