We recommend that the Michigan Department of Health and Human Services ensure the electronic case records for children who are prescribed psychotropic medications are maintained in accordance with requirements by implementing policies specific to non-emergency situations that require the FC-PMOU to document when consent forms do not need to be obtained; implementing procedures for caseworkers and the FC-PMOU to monitor the Medicaid claim data to ensure consent forms are obtained and documented; and implementing procedures requiring caseworkers and the FC-PMOU to monitor other medications prescribed for children, including opioids, for potential medication interaction and adverse side effects.