Current through Vol. 42, No. 1, September 16, 2024
(a)
Scope and
applicability. Developmental Disabilities Services (DDS) provides
training for staff to regularly assess, monitor, and inform service recipients
who are at risk for tardive dyskinesia (TD). Monitoring for TD applies to all
service recipients who receive medication associated with a risk of TD.
Providers of residential services funded by Oklahoma Human Services DDS or
Oklahoma Health Care Authority have primary responsibility for implementation
of OAC 340:100-5-29. Providers of other
types of supports inform service recipients and encourage the implementation of
OAC 340:100-5-29. Providers are
required to meet standards per OAC
340:100-3-27. Service recipients:
(1) prescribed medication associated with a
risk of developing TD are regularly assessed and monitored for symptoms of TD.
The service recipient who is prescribed such medication, parent(s) of a minor
service recipient, or, if applicable, service recipient's legal guardian is
regularly informed about the risk of TD;
(2) assessed with signs or symptoms of TD are
referred to the prescribing healthcare provider for further
evaluation;
(3) diagnosed with TD
by a healthcare provider, parent(s) of a minor service recipient, or, if
applicable, legal guardian are informed of the diagnosis; and
(4) diagnosed with TD continue to receive
regular assessments and monitoring regarding the status of the
diagnosis.
(b)
Assessment and monitoring requirements. A trained rater or the
prescribing healthcare provider or designee complete assessments using a
standardized assessment scale. The Dyskinesia Identification System: Condensed
User Scale (DISCUS) is the preferred assessment scale. DDS trains staff service
providers identify to be DISCUS raters at no charge to the service provider.
Identified staff may be contract staff or employees of the service provider.
When rater training is needed, the service provider notifies DDS training
staff.
(1) Service provider staff maintains
information about service recipient exposure to medication associated with a
risk of developing TD.
(2) Copies
of assessment scales completed by provider staff, or documentation of
assessment completion by a healthcare provider or designee, are filed in the
service recipient's record per OAC
340:100-3-40.
(c)
Service recipients requiring
assessments. Service recipients:
(1)
with an unknown history of medication exposure receive an initial DISCUS
assessment. When the initial assessment :
(A)
has a total score less than five, further assessments are not needed;
or
(B) has a total score of five or
more, items in (i) and (ii) must occur.
(i) A
referral is made to the prescribing healthcare provider for additional
evaluation.
(ii) Assessments
continue to be completed every six months until a DISCUS score less than 5 is
obtained. The assessment is repeated in one month and, if the score remains
less than 5, further assessments are not needed;
(2) who are prescribed medication that may
cause TD are assessed before medication is started or within 30-calendar days
of medication initiation.
(A) Service
recipients are routinely assessed every six months while receiving medication
associated with a risk of TD.
(B)
Assessments may be done more frequently if medications are changed or side
effects are suspected or identified;
(3) who have medications discontinued which
areassociated with a risk of TD are assessed monthly as described in (A)
through (C) of this paragraph.
(A) After four
months with DISCUS scores of 5 or greater, monthly assessments are stopped, and
assessments are repeated every six months.
(B) If a DISCUS score less than 5 is
reported, assessments are completed monthly until two additional scores less
than 5 are reported.
(C) After two,
assessments with a score less than 5 are reported, assessments are
discontinued.
(4) who
have medications introduced again that may cause TD are monitored according to
OAC 340:100-5-29.
Added at 10 Ok Reg
2505, eff 5-24-93 (emergency); Added at 11 Ok Reg 2303, eff 5-26-94; Amended at
23 Ok Reg 1026, eff 5-11-06; Amended at 25 Ok Reg 986, eff
5-15-08
