(a) Subject to
12 AAC 44.965, or another
applicable statute or regulation, an entity listed in
7
AAC 10.1000(b) shall meet each
applicable requirement of this section unless the entity has an onsite
pharmacist and consequently follows a more stringent procedure for that
requirement, including a procedure required under 12 AAC 52, or by federal law,
and the department has been informed in writing of the more stringent procedure
and has approved its use for purposes of this section.
(b) If, as part of health-related services
provided in an assisted living home, the home supervises the
self-administration of medications, supervision must be performed in accordance
with AS
47.33.020.
(c) Except as provided in (d) and (g)(4) of
this section, an entity subject to this section shall
(1) ensure that each stored medication,
including each nonprescription medication, is in its original container and
properly labeled with the name of the adult or child for whom it is intended,
the name of the medication, the dosage, expiration date, and directions for
administration; except as provided in
7
AAC 10.1000(c), the requirements of
this paragraph do not apply to nonprescription medication used communally in a
foster home or foster group home;
(2) store medications in a manner that
prevents access by unauthorized persons;
(3) store controlled substances in a locked,
permanently affixed storage container; for a controlled substance that requires
refrigeration, the storage container must be locked; the entity shall establish
written procedures for maintaining a record that accurately accounts for the
receipt and each use of each controlled substance, and for periodically
reconciling the record; except as provided in
7
AAC 10.1000(c), the requirements of
this paragraph do not apply to a child care facility;
(4) store medications, including controlled
substances, in accordance with the manufacturer's recommendations;
and
(5) ensure that nonprescription
medications and health products, including nonaspirin fever reducers,
naturopathic remedies, vitamin and mineral supplements, diaper ointments and
powders, sunscreen, and insect repellent, are used only at the dose, duration,
or method of administration specified on the manufacturer's label.
(d) The provisions of (c) of this
section do not apply to a medication that a resident of an assisted living home
is allowed to keep in that resident's room.
(e) The following entities subject to this
chapter may be delegated the task of administration of medicine under
12 AAC 44.965:
(1) a foster home for an adult;
(2) a foster group home for adults;
(3) an assisted living home.
(f) An entity not listed in (e) of
this section may administer medication if
(1)
within the scope of the person's own license;
(2) under other legal authority; or
(3) under the supervision of another licensed
health care provider.
(g) An entity authorized to administer
medication may do so only under the following conditions:
(1) the entity must first obtain written
permission for the administration of prescription medication from the adult or
that adult's representative, or the parent of a child in care upon admission
into the entity, or when a new medication is prescribed; if the department is
the child's legal guardian, the entity must first obtain written permission
from the department;
(2) the entity
may administer prescription medication and special medical procedures only in
the dosage, at the intervals, or in the manner prescribed by a physician or
other person legally authorized to prescribe medication or medical
procedures;
(3) if an entity
providing care for children has not obtained written permission from the
child's parent for the administration of a commonly used nonprescription
medication or medication contained in the first aid kit required by
7
AAC 10.1075, the entity shall document telephone
permission to administer that medication; a foster home, a foster group home,
or an entity providing care for a child for whom the department is the legal
guardian is not required to obtain permission from the child's parent for the
administration of nonprescription medication, but shall administer
nonprescription medication as authorized by the department in the placement
agreement;
(4) the entity shall
have a written policy for the use of any commonly used nonprescription
medication for oral or topical use kept on hand by the entity for the communal
use of any adult or child in care for whom the medication may be indicated; the
requirements of this paragraph do not apply to an assisted living home serving
two or fewer residents;
(5)
prescription medicine must be kept in
(A) the
original container showing the date filled, the expiration date, instructions,
and the physician's or other medical professional's name; or
(B) medicine sets filled by a pharmacist, a
licensed medical professional, or a resident's representative; the prescription
date filled, the expiration date, instructions, and the physician's or other
medical professional's name must be affixed to or stored with each medicine
set;
(6) in an entity
with one or more employees, only one designated employee in each shift may
administer medication, the designated employee shall record and initial the
time each dose is administered;
(7)
unused medication must be returned to the parent of a child in care when the
medication is no longer needed, except that an entity providing care for a
child for whom the department is the legal guardian shall discard the unused
medication
(A) in a manner that prevents
access by children in care; and
(B)
in accordance with instructions from the manufacturer, if
any;
(8) an assisted
living home shall ensure that unused medication is properly discarded and shall
notify the resident or resident's representative of the disposal of the
medication.
(h) The
entity shall ensure that medication requiring refrigeration is grouped
together, stored in a manner to prevent contamination of food, and labeled as
required by this section. A residential child care facility or an assisted
living home that provides care for six or more residents shall keep medication
in a separate refrigeration unit that is not used to store food.
(i) In addition to complying with the other
requirements of this section, a residential psychiatric treatment center
(1) shall ensure that the record of the
prescription and administration of prescription and nonprescription medications
is kept in each child's files and in another master medications file arranged
to show in chronological order the prescription and administration of
medications to each child, with records sorted by each child's name, showing
each diagnosis for each child;
(2)
shall make the records described in (1) of this subsection available for
department review for the purpose of identifying and preventing abuse, or
inappropriate or unnecessary use of prescription or nonprescription
medications;
(3) may not use a
medication for the purpose of sedating or controlling the behavior of a child;
however, subject to
7
AAC 50.870, a medication may be used for chemical
restraint in a residential psychiatric treatment center; in this paragraph,
"chemical restraint" has the meaning given in
7
AAC 50.990;
(4) may not administer a psychotropic or
neuroleptic class medication to a child unless the use of the medication is
part of the child's treatment plan developed under
7
AAC 50.840 and use of the medication has been
consented to by the child's parent, Indian custodian, or guardian after both
the clinical director and the prescribing physician have given sufficient
information and counseling to the parent, Indian custodian, or guardian to
ensure that the parent, Indian custodian, or guardian can give an informed
consent to or refusal of the use of the medication; the information and
counseling must discuss the option of not using the medication, the potential
benefits and disadvantages of the medication, and alternative medications or
therapies that might reasonably be used to treat the same condition;
and
(5) may not discharge or
threaten to discharge a child because the child's parent, Indian custodian, or
guardian declines to give consent to the use of any recommended
medication.
(j) In this
section,
(1) "controlled substance" means a
drug, substance, or immediate precursor included in the schedules set out in
AS
11.71.140-11.71.190;
(2) "Indian custodian" has the meaning given
in 25 U.S.C.
1903(6).
