Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 301 - IDD-BH CONTRACTOR ADMINISTRATIVE FUNCTIONS › Subchapter G - MENTAL HEALTH COMMUNITY SERVICES STANDARDS › Division 3 - STANDARDS OF CARE › Section 301.355 - Medication Services

Current through Reg. 49, No. 28; July 12, 2024
(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.