The OCA Examines the Rogers Process

On this page you will find:

  • general information regarding the Rogers process
  • updates concerning the OCA’s project to examine the Rogers process
  • additional resources related to antipsychotic and other psychoactive medications for children in state custody

What is the Rogers Process?

Deciding whether a child should take antipsychotic medication, a specific class of medications to manage mental and behavioral health problems, can be a difficult decision for parents. When a child is in the custody of the Department of Children and Families (DCF), someone other than the child’s parents must make that decision. In Massachusetts, judges hold hearings to decide whether or not children in the custody of DCF should be treated with antipsychotic medication. This is known as the Rogers process. Massachusetts is one of two states in the U.S. that requires judges to approve these medication decisions for all children in DCF custody.

The Rogers process, which arose from a 1983 Massachusetts Supreme Judicial Court decision, was adopted in 1987 by the Massachusetts Department of Social Services (now DCF) to ensure that children in state custody receive appropriate medical treatment. The regulations require DCF to request approval from the court before antipsychotic medications can be given to children in DCF custody. Through this process, a Rogers Guardian ad Litem (GAL) is appointed by the judge to gather information from relevant records, the child’s medication prescriber, the child, parents and foster parents, and other key persons involved with the child’s care. The GAL then provides the court with a written report and recommendations. The court schedules a hearing that usually includes the DCF social worker, parents, DCF attorney, child’s attorney, parents’ attorney(s), and Rogers GAL, among others. After considering the evidence, the judge enters findings and may or may not authorize the administration of specific medications and dosages for the involved child.

The Rogers Research Project

In the last 23 years, the landscapes of child welfare, psychopharmacology, and children’s mental health have significantly changed. In 2009, The Child Advocate began meeting with interested professionals to discuss concerns about whether the Rogers process serves its intended purpose. These discussions evolved into the Rogers Working Group, an informal collaboration among researchers and policymakers, who have been closely involved with this project. Our examination of the Rogers process to date has been a two-phase project.

Phase 1: In the summer of 2010, an opportunity arose for the OCA to engage with Northeastern University Law School’s (NUSL) Legal Skills in Social Context (LSSC) Social Justice Program in a project to examine the Rogers process. A team of 15 NUSL LSSC students, under faculty supervision, examined the efficacy and effectiveness of the Rogers process. The two components of the project’s design included (1) an analysis of the current legal framework of the Rogers process, and (2) field interviews with key stakeholders involved with the Rogers process. On April 7, 2011, the law students submitted their final report and presented a summary of their research findings and recommendations for further consideration to the OCA and a group of interested stakeholders. Below are the link to the students’ PowerPoint presentation, final report and executive summary for your review.

Phase 2: With support from the Massachusetts Supreme Judicial Court, Court Improvement Program (CIP), the OCA commissioned a team of researchers led by Dr. Laurel Leslie of Tufts Medical Center to assist the OCA in examining the Rogers process for children in DCF custody, and to build on the research and findings of the NUSL students. The research team used the results from the students' project and conducted focus groups with key stakeholders to generate field-based recommendations regarding the current system. In August 2011, the researchers provided a report and presentation to the Rogers Working Group and OCA. The findings from this research may assist Massachusetts in its deliberations regarding the Rogers process, as well as inform the efforts of other state child welfare agencies and relevant stakeholders as they respond to federal legislation, Public Law (P.L.) 110-351, "The Fostering Connections to Success and Increasing Adoptions Act" of 2008.

The Tufts Research Team's report, Examination of the Rogers Process for Youth in the Custody of the Department of Children and Families, as well as the executive summary and appendix are available on the Tufts Medical Center Website at  

We Want Your Feedback

The OCA would like to hear about your experiences with the Rogers Process. Please email or call the OCA at 617-979-8360 to share your experiences and perspective on the current Rogers Process for children in state custody.

Additional Resources

Additional Resources Related to Antipsychotic and Other Psychoactive Medications to Manage Mental and Behavioral Health Problems for Children in State Custody

1.) Multi-State Study on Psychotropic Medication Oversight in Foster Care
Leslie LK, Mackie T, Dawson EH, Bellonci C, Schoonover D, Rodday AM, Hayek M, Hyde J. Tufts/CTSI — Tufts Clinical and Translational Science Institute, Multi-State Study on Psychotropic Medication Oversight in Foster Care, September 2010.

2.) AACAP Position Statement on Oversight of Psychotropic Medication Use for Children in State Custody: A Best Principles Guideline (2005).
AACAP website only

3.) Massachusetts Department of Mental Health - Psychoactive Medication for Children and Adolescents: Orientation for Parents, Guardians, and Others  pdf format of Psychoactive Medication for Children and Adolescents
rtf format of                             Psychoactive Medication for Children and Adolescents

4.) View from the "Other Side": Why Child Psychiatrists Hate the Rogers Decision  doc format of Why Child Psychiatrists Hate the Rogers Decision
by Virginia Merritt, M.D. Boston Juvenile Court Clinic

5.) Psychotropic Medication Management for Youth in State Care: Consent, Oversight, and Policy Considerations
Naylor, M. W., Davidson, C. V., Ortega-Piron, D. J., Bass, A., Gutierrez, A., & Hall, A. (2007). Psychotropic medication management for youth in state care: consent, oversight, and policy considerations. Child Welfare, 86, 175-192.

6.) Massachusetts Child Psychiatry Access Project - The Massachusetts Child Psychiatry Access Project (MCPAP) is a system of regional children's mental health consultation teams designed to help primary care providers (PCPs) meet the needs of children with psychiatric problems.