SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Columbia, South Carolina

TO:             All Organizational

SUBJECT:  Contraceptive Drugs

I.        Purpose:

The purpose of this directive is to establish a policy and procedure concerning the use of contraceptive drugs by patients in facilities of the S. C. Department of Mental Health.  All members of the medical staff at each facility should thoroughly familiarize themselves with this directive in order to effectively assist patients concerning this matter.

II.      Policy:

It is the policy of this Department to provide assistance for all persons entrusted to its care with all health related matters.  In order to fully comply with this goal, contraceptive drugs will be provided for patients in accordance with the provisions and procedures outlined in this directive.

III.     PROCEDURES:

These procedures will be followed in prescribing contraceptive drugs in facilities of the Department of Mental Health.

1.       Newly Admitted Patients:

A. When a person is admitted to a facility with an identifiable current
     prescription for a contraceptive drug, a notation of this information
     shall be made in the patient's medical records, (Form M-310).  If the
     anticipated length of stay for the patient is short term (4 to 12 weeks)
     the case physician shall write an order continuing the contraceptive
     drug for the patient during the course of hospitalization, unless
     otherwise contraindicated.

B.  If the patient is unable to identify the contraceptive drug accurately,
     the case physician shall contact the patient's personal physician for
     proper identification of the drug.  An order for the drug shall then be
     written, unless otherwise contraindicated.

C. After it has been determined that a contraceptive drug is to be
     administered while the person is a patient in a Departmental facility, a
     consent form (SCDMH Form M-179) shall be signed by the patient
     if they are 16 years of age or older.   If a patient is under 16, or
     declared mentally incompetent, this consent must also be signed by
     the parent or legal guardian or other responsible person.  Completed
     consent forms shall be filed in the patient's medical record.  If a
     consent form cannot be obtained, the contraceptive drug shall not be
     prescribed and a notation to this effect placed in the medical record.

2.       Other Patients:

A. In cases where there is significant justification contraceptive drugs
     may also be prescribed and administered to patients who have been
     hospitalized for longer periods of time.  The decision to prescribe or
     continue contraceptive drugs shall be the responsibility of the case
     physician.

B.  The case physician shall order the drug as any other medication is
     prescribed, except that a consent form shall be signed by every
     patient who is 16 years of age or older.  If a patient is under 16, or
     declared mentally incompetent, this consent must also be signed by
     the parent or legal guardian or other responsible person.  The
     completed form shall be filed in the medical record.   If a consent
     form cannot be obtained, the contraceptive drug shall not be
     prescribed and a notation to this effect placed in the medical record.

3.       Availability of Drugs:

A. Contraceptive drugs will be available from Departmental pharmacies
     for patients when ordered by members of the medical staffs.  These
     drugs shall be provided without cost to patients.

B. Persons bringing contraceptive drugs with them to a facility at the
     time of admission shall be required to relinquish possession of them.
     If it is determined by a physician that this is the drug which has been
     prescribed by the patient's personal physician and there is no
     contamination in any way they shall be sent to the patient's ward to
     be administered by Nursing personnel.  Contaminated drugs shall be
     destroyed.

C. Patients receiving contraceptive drugs at the time of discharge shall
     be provided a twenty-eight day supply.  When a patient is
     incompetent or unable to self-administer the medication, the family
     or the person to whom the patient is discharged shall be notified that
     the patient is receiving the medication and that a private physician
     should be consulted for supervision.

D. Contraceptive drugs shall not be prescribed nor provided for
     employees of the Department of Mental Health.

IV.      CONTRACEPTIVE DEVICES:

Persons admitted to a facility who have a prescribed contraceptive device should be handled in the same manner as persons who are receiving contraceptive drugs.   The decision as to the prescribing of such a device for patients or continuing its use within a facility is the responsibility of the case physician.  When it is determined that such a device should be prescribed it shall be provided for the patient without cost.

V.      PATIENTS FROM OTHER DEPARTMENTS

When persons from other state agencies or departments are receiving treatment in a facility of the Department of Mental Health, all decisions concerning contraceptive drugs and devices shall be made in consultation with the agency who has primary responsibility for the person.  It is the responsibility of each facility to consult with the appropriate person or persons of the agency or department to obtain documentation of consent and approval for the administration of contraceptive drugs and/or use of devices.  In each instance the procedures as outlined for patients of Departmental facilities shall be followed.

VI.     RESCISSIONS

This directive rescinds all previous directives and memorandums concerning this subject.

                                                                               

May 12, 1977