Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 301 - LOCAL AUTHORITY RESPONSIBILITIES
Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS
Division 3 - STANDARDS OF CARE
Section 301.355 - Medication Services
Universal Citation: 26 TX Admin Code § 301.355
Current through Reg. 50, No. 13; March 28, 2025
(a) Prescribing of psychoactive medication. The LMHA and MCO must ensure that psychoactive medication is prescribed in accordance with Chapter 415, Subchapter A of Title 25 (relating to Prescribing of Psychoactive Medication).
(b) Medication service delivery. The LMHA, MCO, and provider must implement written procedures to ensure safe medication-related service delivery that include, but are not limited to, the following.
(1) A procedure for physician
delegation of medical acts to non-physicians. The procedure must address
delegation protocols to advanced practice nurses and/or physician assistants,
delegation of medical acts to nursing and/or unlicensed staff, and the
frequency of physician supervision over the staff member to whom a delegation
is made. The procedure must provide a method to ensure the staff members are
acting within the scope of their license and is qualified and trained to
perform the medical act.
(2) A
procedure for RNs to make assignments to LVNs or delegate to unlicensed staff
members nursing acts for the care of stable individuals with common,
well-defined health problems with predictable outcomes. The procedure must
address the types of nursing acts that may be delegated, the method to ensure
the staff member is trained and qualified to perform a delegated nursing act,
and the frequency of nursing supervision of the unlicensed staff member in
accordance with Texas Occupations Code, Chapter 301 (relating to the Nursing
Practice Act).
(3) A procedure for
medication administration by licensed medical or nursing staff that addresses
who may access and administer medications, timely administration, documentation
of administration, and monitoring of administration, and that complies with
applicable professional licensing standards and rules.
(4) A procedure for medication handling that
addresses:
(A) dispensing;
(B) labeling and record keeping of sample
medications;
(C) limiting access to
physician stock medications;
(D)
patient assistance/indigent medication program;
(E) mechanisms to ensure safe
temperature-controlled storage and transport of medication;
(F) controlled drugs;
(G) disposal/destruction of medication;
and
(H) locked areas and
maintaining security.
(5) A procedure by which a physician, a
physician's assistant, or an RN assesses and determines whether an individual
can self-administer medication and whether it can be done without
supervision.
(6) A procedure for
training and assessing the competency of staff members to perform supervision
of self-administration of medication, including:
(A) medication actions;
(B) target symptoms;
(C) understanding prescription
labels;
(D) potential
toxicity;
(E) side
effects;
(F) adverse
reactions;
(G) proper storage of
medications; and
(H) reporting and
documentation requirements.
(7) A procedure for providing appropriate
supervision of staff members who are supervising self-administration of
medication.
(8) A procedure for
medication errors that defines the most common types of medication errors and
provides for:
(A) the accurate documentation
of medication errors;
(B) the
reporting of medication errors to the physician within one hour of their
occurrence;
(C) a mechanism for
determining medication error trends;
(D) a mechanism for analyzing both individual
medication errors and trends for quality improvement; and
(E) the reporting of medication errors, as
appropriate.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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