419-470-0100 Medication A residential care agency must meet all of the following requirements: (1) Policy and procedures. The residential care agency must have policies and procedures that cover all prescription and non-prescription medications that address all of the following: (a) How the medication will be administered. The policy must prohibit medication from being prepared in advance for more than one administration time or for more than one child in care . (b) By whom the medication will be administered. (c) How the staff of the residential care agency who administer medication will be trained. This training must address the following areas: (A) Ensuring the right person is receiving the medication; (B) The right medication is being administered; (C) The right dose of medication is being administered; (D) The medication is being administered in the right route; (E) The medication is given at the right time; and (F) Documentation requirements. (d) How the administration of medication will be documented. This must include what to do if there is a charting documentation error, if a medication is refused, if a medication is missed, or any other type of medication error that results in a medication not being administered as prescribed. (e) How the administration of medication will be monitored. (f) How medication is stored. (g) How unused medication will be disposed of. (h) Self-medication of a prescription and non-prescription medication by a child in care. (i) The program shall develop and implement a policy and procedure that ensures all orders for prescription drugs are reviewed by the individual’s primary physician, licensed physician’s assistant, nurse practitioner, or pharmacist at least every six months. When this review identifies a contra-indication or other concern, the individual’s primary physician shall be immediately notified. (2) Program staff may not dispense medication to a child in care in any of the following situations: (a) In excess of the prescribed amount. (b) In Excess of the allowed amount per label instructions for over-the-counter medications. (c) For disciplinary purposes. (d) For the convenience of staff. (e) As a substitute for appropriate treatment services. (3) A prescription, signed by a physician or qualified medical professional, is required before any prescription medication is administered to, or self-administered by a child in care. Medications prescribed for one child in care may not be administered to, or self-administered by another child in care or staff. (4) A written approval, signed by a physician or qualified medical professional, is required for any use of herbal supplements or remedies. (5) A written order, signed by a physician or qualified medical professional, is required for any medical treatment, special diet, physical therapy, aid to physical functioning, or limitation of activity. A written order, signed by a physician or qualified medical professional, is also required before a residential care agency imposes a restriction on diet or physical activity. (6) Before a residential care agency permits a child in care to self-administer prescription medication, self-administration must be recommended by the qualified medical professional, approved in writing by a physician or qualified medical professional, and closely monitored by the staff of the residential care agency. When applicable, the residential care agency must maintain documentation of the continuing evaluation of the ability of the child in care to self-administer a medication. (7) Medication storage. (a) Prescription medications that are unused and medications that are expired or recalled may not be maintained with current medication and must be disposed of as described in agency disposal policy. (b) The facility may maintain a stock supply of non-prescription medications. (c) All prescription and non-prescription medications stored in the facility must be kept in a manner that they are inaccessible to children in care and behind at least two locking mechanisms. This rule does not apply to the drug Naloxone. (d) Medications requiring refrigeration must be refrigerated and stored behind at least two locking mechanisms. (e) Medications must be maintained and stored in its original container, including the prescription label. (A) Medications administered outside of the facility such as during an outing or home visit, may be stored in an appropriate , food-safe, non-toxic, sealed container other than the original container. The container must be labeled with the following information: (i) The name of the child in care the medication is prescribed for; (ii) The name of the medication; (iii) The medication dosage; (iv) The time of administration; (v) Any instructions for administering the medication, if applicable; (vi) The date the medication was put into the temporary container. (B) A single container may not contain medications for more than one child in care. (C) If a child is prescribed more than one type of medication, the medications may be combined within a single container only if the medications in the container are all scheduled to be given at the same time, and all of the information described in (A) above is listed on the container for each medication in the container. (8) Medication disposal. Medications must be disposed of in a manner that ensures that they cannot be retrieved, in accordance with all applicable state and federal law. (9) A written record of all medication disposals must be maintained and must include all of the following: (a) A description of the prescribed medication and the amount disposed. (b) The child in care for whom the medication was prescribed. (c) The reason for disposal. (d) The method of disposal. (e) The name of the person disposing the medication, and the initials of an adult witness. (10) Medication records. A written record must be kept for each child in care listing all medications, both prescription and over-the-counter, that are administered. The record must include all of the following: (a) The name of the child in care. (b) A description of the medication, instructions for use, and the recommended dosage. (c) Dates and times medication is administered. (d) A record of missed dosages. (e) Medication dropped or disposed of. (f) Method of administration for each medication. (g) Identification of the person administering the medication. (h) Any possible adverse reactions to the medication. (i) Documentation of any medication taken outside the facility to be administered during a home visit or other activity. Statutory/Other Authority: ORS 409.050, ORS 418.005, ORS 418.327 & ORS 418.240 Statutes/Other Implemented: ORS 418.205 - 418.327 History: OTIS 35-2023, amend filed 04/17/2023, effective 04/18/2023 CWP 26-2022, renumbered from 413-215-0551, filed 11/28/2022, effective 12/01/2022 CWP 25-2020, minor correction filed 01/13/2020, effective 01/13/2020 CWP 22-2016, f. & cert. ef. 12-1-16 CWP 12-2016(Temp), f. & cert. ef. 7-1-16 thru 12-27-16 CWP 33-2008, f. & cert. ef. 10-17-08