Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 130 - Medicaid Coverage; Home and Community-Based Waiver Services
Article 2 - Home and Community-Based Waiver Services; Nursing Facility and ICF/MR Level of Care
7 AAC 130.227 - Administration of medication and assistance with self-administration of medication
Universal Citation: 7 AK Admin Code 130.227
Current through November 28, 2024
(a) Except as provided in (i) of this section, a provider shall offer administration of medication and assistance with self-administration of medication as integral parts of the following home and community-based waiver services:
(1)
adult day services under
7
AAC 130.250;
(2) day habilitation services under
7
AAC 130.260;
(3) residential habilitation services under
7
AAC 130.265;
(4) employment services under
7
AAC 130.270;
(5) intensive active treatment services under
7
AAC 130.275;
(6) respite care services under
7
AAC 130.280.
(b) provider of the services listed in (a) of this section shall be responsible for administration of medication or assistance with self-administration of medication if
(1) a medication is
(A) time-sensitive and may not be delayed;
or
(B) required as needed by a
recipient;
(2) the
recipient or the recipient's representative requests assistance with the
recipient's self-administration of medication or requests administration of
medication by the provider;
(3) the
recipient's support plan developed in accordance with
7
AAC 130.217 and
7
AAC 130.218 specifies that the recipient needs
(A) assistance with self-administration of
medication; or
(B) administration
of medication by the provider;
(4) no individual otherwise responsible for
administration of medication or assistance with self-administration of
medication for that recipient is available at the time when the recipient
requires medication; and
(5) the
individual that provides administration of medication or assistance with
self-administration of medication has completed the training requirements of
(f) of this section.
(c) The provider may employ, or make arrangements with, a registered nurse with an active license under AS 08.68 to
(1)
administer medications to a recipient or to delegate administration of
medication in accordance with
12 AAC 44.950 -
12 AAC 44.990 and this section;
and
(2) provide the training
specified in (f) of this section.
(d) A provider listed in (a) of this section shall develop and implement written policies and procedures that address
(1) administration of medication and
assistance with self-administration of medication while a recipient is in the
care of and receiving services from the provider;
(2) training in administration of medication
and assistance with self-administration of medication under (f) of this
section;
(3) documentation under
(g) of this section;
(4)
supervision of individuals that provide assistance with administration of
medication or assistance with self-administration of medication;
(5) monitoring and evaluation of
(A) administration of medication;
or
(B) assistance with
self-administration of medication; and
(6) requirements for reporting medication
errors.
(e) Before a provider may provide administration of medication or assistance with self-administration of medication under this section, the provider must
(1) have a written delegation for
administration of medication or assistance with self-administration of
medication from the recipient or recipient's representative, or a delegation in
accordance with
12 AAC 44.965 or another
applicable statute or regulation;
(2) have written information that identifies
(A) how to store each medication;
(B) the route of administration for each
medication;
(C) potential
interaction for each medication with other medications the recipient is
taking;
(D) potential side effects
of each medication;
(E) the
individual to notify in the event of the recipient's adverse reaction to a
medication; and
(F) if the
medication is to be taken as needed,
(i) the
circumstances in which the medication is to be administered; and
(ii) whether the delegating authority must be
notified before the medication is administered or before assistance with
self-administration is provided.
(f) Each individual that provides administration of medication or assistance with self-administration of medication must have on file, with the provider, written verification of attendance and successful completion of the following training appropriate to the task:
(1) if the individual is to provide
assistance with the recipient's self-administration of medication, the
individual must successfully complete training that addresses the activities
listed in (j)(2) of this section;
(2) if the individual is to administer
medication to a recipient without the assistance of the recipient, the
individual must successfully complete training that has been approved under
12 AAC
44.965(c).
(g) An individual providing administration of medication or assistance with self-administration of medication under this section must document, in the recipient's record for all medication taken by the recipient while the recipient is in the care of the individual,
(1) the name of the medication;
(2) the dosage administered;
(3) the time of administration;
(4) the name of the individual that assisted
the recipient with the recipient's self-administration of medication or
administered medication to the recipient; and
(5) the written delegation under (e)(1) of
this section authorizing administration of medication or assistance with
self-administration of medication.
(h) A provider of the services listed in (a) of this section shall develop and implement a system to manage and report medication errors that includes
(1) a plan
for documenting and tracking medication errors;
(2) a requirement for reporting, as a
critical incident under
7
AAC 130.224, any medication error that results in
medical intervention;
(3) a
protocol for analyzing medication errors each quarter;
(4) a procedure for taking corrective action
based upon that analysis; and
(5) a
process for summarizing the quarterly analyses and corrective action conducted
under this subsection, and submitting that summary to the department with the
application to renew certification under
7
AAC 130.220 or upon request.
(i) The requirements of this section do not apply if
(1) the services are provided in a
foster home or assisted living home licensed under AS 47.32, and medications
are provided in accordance with
7
AAC 10.1070;
(2) the recipient administers the recipient's
own medication without assistance; or
(3) the recipient or the recipient's
representative gives the provider written notice designating an individual that
will be responsible for administration of medication or assistance with
self-administration of medication for the recipient, and the provider arranges
with that individual to administer the medication or assist with
self-administration at the time medication is required by the
recipient.
(j) In this section,
(1) "administration of medication"
means the direct delivery or application of an oral, nasal, ophthalmic, otic,
topical, vaginal, or rectal medication by a provider to or into the body of a
recipient that is unable to administer medication independently, and the use of
an epinephrine auto-injector for a severe allergic reaction;
(2) "assistance with self-administration of
medication" means
(A) reminding the recipient
to take medication;
(B) opening a
medication container or prepackaged medication for the recipient;
(C) reading a medication label to the
recipient;
(D) providing food or
liquids if the medication label instructs the recipient to take the medication
with food or liquids;
(E) observing
the recipient while the recipient takes medication;
(F) checking the recipient's
self-administered dosage against the label of the medication
container;
(G) reassuring the
recipient that the recipient is taking the dosage as prescribed; or
(H) directing or guiding the hand of the
recipient, at the recipient's request, while the recipient administers
medication;
(3)
"medication" means a drug or product, including an over-the-counter product,
that is intended to be taken by the recipient at a scheduled time or as needed,
and that is prescribed for a recipient by an individual
(A) with an active license under AS 08 to
practice as
(i) an advanced practice
registered nurse;
(ii) a physician,
including an osteopath;
(iii) a
physician assistant; or
(iv) a
dentist; or
(B) who is an
employee of the federal government assigned to a tribal health care program,
and who has an active license from a jurisdiction in the United States to
practice as
(i) an advanced practice
registered nurse;
(ii) a physician,
including an osteopath;
(iii) a
physician assistant; or
(iv) a
dentist;
(4)
repealed 7/1/2015;
(5) "medication
error" means
(A) a failure to document
medication administration;
(B) a
failure to provide medication administration at, or within one hour before or
one hour after, the scheduled time;
(C) the delivery of medication
(i) at a time other than when a medication
was scheduled, if the time was outside the acceptable range in (B) of this
paragraph;
(ii) other than by the
prescribed route;
(iii) other than
in the prescribed dosage;
(iv) not
intended for the recipient; or
(v)
intended for the recipient, but given to another
individual.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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