|
for staff who work in day programs that are similar to those |
for staff who work in residential programs. This training |
program shall be developed in consultation with professional
|
associations representing (i) physicians licensed to practice |
medicine in all
its branches, (ii) registered professional |
nurses, and (iii) pharmacists.
|
(b) For the purposes of this Section:
|
"Authorized direct care staff" means non-licensed persons |
who have
successfully completed a medication administration |
training program
approved by the Department of Human Services |
and conducted by a nurse-trainer.
This authorization is |
specific to an individual receiving service in
a
specific |
agency and does not transfer to another agency.
|
"Medications" means oral and topical medications, insulin |
in an injectable form, oxygen, epinephrine auto-injectors, and |
vaginal and rectal creams and suppositories. "Oral" includes |
inhalants and medications administered through enteral tubes, |
utilizing aseptic technique. "Topical" includes eye, ear, and |
nasal medications. Any controlled substances must be packaged |
specifically for an identified individual. |
"Insulin in an injectable form" means a subcutaneous |
injection via an insulin pen pre-filled by the manufacturer. |
Authorized direct care staff may administer insulin, as ordered |
by a physician, advanced practice nurse, or physician |
assistant, if: (i) the staff has successfully completed a |
Department-approved advanced training program specific to |
|
insulin administration developed in consultation with |
professional associations listed in subsection (a) of this |
Section, and (ii) the staff consults with the registered nurse, |
prior to administration, of any insulin dose that is determined |
based on a blood glucose test result. The authorized direct |
care staff shall not: (i) calculate the insulin dosage needed |
when the dose is dependent upon a blood glucose test result, or |
(ii) administer insulin to individuals who require blood |
glucose monitoring greater than 3 times daily, unless directed |
to do so by the registered nurse. |
"Nurse-trainer training program" means a standardized, |
competency-based
medication administration train-the-trainer |
program provided by the
Department of Human Services and |
conducted by a Department of Human
Services master |
nurse-trainer for the purpose of training nurse-trainers to
|
train persons employed or under contract to provide direct care |
or
treatment to individuals receiving services to administer
|
medications and provide self-administration of medication |
training to
individuals under the supervision and monitoring of |
the nurse-trainer. The
program incorporates adult learning |
styles, teaching strategies, classroom
management, and a |
curriculum overview, including the ethical and legal
aspects of |
supervising those administering medications.
|
"Self-administration of medications" means an individual |
administers
his or her own medications. To be considered |
capable to self-administer
their own medication, individuals |
|
must, at a minimum, be able to identify
their medication by |
size, shape, or color, know when they should take
the |
medication, and know the amount of medication to be taken each |
time.
|
"Training program" means a standardized medication |
administration
training program approved by the Department of |
Human Services and
conducted by a registered professional nurse |
for the purpose of training
persons employed or under contract |
to provide direct care or treatment to
individuals receiving |
services to administer medications
and provide |
self-administration of medication training to individuals |
under
the delegation and supervision of a nurse-trainer. The |
program incorporates
adult learning styles, teaching |
strategies, classroom management,
curriculum overview, |
including ethical-legal aspects, and standardized
|
competency-based evaluations on administration of medications |
and
self-administration of medication training programs.
|
(c) Training and authorization of non-licensed direct care |
staff by
nurse-trainers must meet the requirements of this |
subsection.
|
(1) Prior to training non-licensed direct care staff to |
administer
medication, the nurse-trainer shall perform the |
following for each
individual to whom medication will be |
administered by non-licensed
direct care staff:
|
(A) An assessment of the individual's health |
history and
physical and mental status.
|
|
(B) An evaluation of the medications prescribed.
|
(2) Non-licensed authorized direct care staff shall |
meet the
following criteria:
|
(A) Be 18 years of age or older.
|
(B) Have completed high school or have a high |
school equivalency certificate.
|
(C) Have demonstrated functional literacy.
|
(D) Have satisfactorily completed the Health and |
Safety
component of a Department of Human Services |
authorized
direct care staff training program.
|
(E) Have successfully completed the training |
program,
pass the written portion of the comprehensive |
exam, and score
100% on the competency-based |
assessment specific to the
individual and his or her |
medications.
|
(F) Have received additional competency-based |
assessment
by the nurse-trainer as deemed necessary by |
the nurse-trainer
whenever a change of medication |
occurs or a new individual
that requires medication |
administration enters the program.
|
(3) Authorized direct care staff shall be re-evaluated |
by a
nurse-trainer at least annually or more frequently at |
the discretion of
the registered professional nurse. Any |
necessary retraining shall be
to the extent that is |
necessary to ensure competency of the authorized
direct |
care staff to administer medication.
|
|
(4) Authorization of direct care staff to administer |
medication
shall be revoked if, in the opinion of the |
registered professional nurse,
the authorized direct care |
staff is no longer competent to administer
medication.
|
(5) The registered professional nurse shall assess an
|
individual's health status at least annually or more |
frequently at the
discretion of the registered |
professional nurse.
|
(d) Medication self-administration shall meet the |
following
requirements:
|
(1) As part of the normalization process, in order for |
each
individual to attain the highest possible level of |
independent
functioning, all individuals shall be |
permitted to participate in their
total health care |
program. This program shall include, but not be
limited to, |
individual training in preventive health and |
self-medication
procedures.
|
(A) Every program shall adopt written policies and
|
procedures for assisting individuals in obtaining |
preventative
health and self-medication skills in |
consultation with a
registered professional nurse, |
advanced practice nurse,
physician assistant, or |
physician licensed to practice medicine
in all its |
branches.
|
(B) Individuals shall be evaluated to determine |
their
ability to self-medicate by the nurse-trainer |
|
through the use of
the Department's required, |
standardized screening and assessment
instruments.
|
(C) When the results of the screening and |
assessment
indicate an individual not to be capable to |
self-administer his or her
own medications, programs |
shall be developed in consultation
with the Community |
Support Team or Interdisciplinary
Team to provide |
individuals with self-medication
administration.
|
(2) Each individual shall be presumed to be competent |
to self-administer
medications if:
|
(A) authorized by an order of a physician licensed |
to
practice medicine in all its branches, an advanced |
practice nurse, or a physician assistant; and
|
(B) approved to self-administer medication by the
|
individual's Community Support Team or
|
Interdisciplinary Team, which includes a registered
|
professional nurse or an advanced practice nurse.
|
(e) Quality Assurance.
|
(1) A registered professional nurse, advanced practice |
nurse,
licensed practical nurse, physician licensed to |
practice medicine in all
its branches, physician |
assistant, or pharmacist shall review the
following for all |
individuals:
|
(A) Medication orders.
|
(B) Medication labels, including medications |
listed on
the medication administration record for |
|
persons who are not
self-medicating to ensure the |
labels match the orders issued by
the physician |
licensed to practice medicine in all its branches,
|
advanced practice nurse, or physician assistant.
|
(C) Medication administration records for persons |
who
are not self-medicating to ensure that the records |
are completed
appropriately for:
|
(i) medication administered as prescribed;
|
(ii) refusal by the individual; and
|
(iii) full signatures provided for all |
initials used.
|
(2) Reviews shall occur at least quarterly, but may be |
done
more frequently at the discretion of the registered |
professional nurse
or advanced practice nurse.
|
(3) A quality assurance review of medication errors and |
data
collection for the purpose of monitoring and |
recommending
corrective action shall be conducted within 7 |
days and included in the
required annual review.
|
(f) Programs using authorized direct care
staff to |
administer medications are responsible for documenting and |
maintaining
records
on the training that is completed.
|
(g) The absence of this training program constitutes a |
threat to the
public interest,
safety, and welfare and |
necessitates emergency rulemaking by
the Departments of Human |
Services and
Public Health
under Section 5-45
of
the
Illinois |
Administrative Procedure Act.
|
|
(h) Direct care staff who fail to qualify for delegated |
authority to
administer medications pursuant to the provisions |
of this Section shall be
given
additional education and testing |
to meet criteria for
delegation authority to administer |
medications.
Any direct care staff person who fails to qualify |
as an authorized direct care
staff
after initial training and |
testing must within 3 months be given another
opportunity for |
retraining and retesting. A direct care staff person who fails
|
to
meet criteria for delegated authority to administer |
medication, including, but
not limited to, failure of the |
written test on 2 occasions shall be given
consideration for |
shift transfer or reassignment, if possible. No employee
shall |
be terminated for failure to qualify during the 3-month time |
period
following initial testing. Refusal to complete training |
and testing required
by this Section may be grounds for |
immediate dismissal.
|
(i) No authorized direct care staff person delegated to |
administer
medication shall be subject to suspension or |
discharge for errors
resulting from the staff
person's acts or |
omissions when performing the functions unless the staff
|
person's actions or omissions constitute willful and wanton |
conduct.
Nothing in this subsection is intended to supersede |
paragraph (4) of subsection
(c).
|
(j) A registered professional nurse, advanced practice |
nurse,
physician licensed to practice medicine in all its |
branches, or physician
assistant shall be on
duty or
on call at |
|
all times in any program covered by this Section.
|
(k) The employer shall be responsible for maintaining |
liability insurance
for any program covered by this Section.
|
(l) Any direct care staff person who qualifies as |
authorized direct care
staff pursuant to this Section shall be |
granted consideration for a one-time
additional
salary |
differential. The Department shall determine and provide the |
necessary
funding for
the differential in the base. This |
subsection (l) is inoperative on and after
June 30, 2000.
|
(Source: P.A. 98-718, eff. 1-1-15; 98-901, eff. 8-15-14; 99-78, |
eff. 7-20-15; 99-143, eff. 7-27-15; 99-581, eff. 1-1-17.)
|
Section 10. The MC/DD Act is amended by adding Section |
3-301.1 as follows:
|
(210 ILCS 46/3-301.1 new) |
Sec. 3-301.1. Administration of medication by direct care |
staff at day programs. For the purposes of this Act, violations |
cited against a facility as a result of actions involving |
administration of medication by direct care staff of day |
programs certified to serve persons with developmental |
disabilities by the Department of Human Services under Section |
15.4 of the Mental Health and Developmental Disabilities |
Administrative Act will not result in: |
(1) the facility being issued a "Type AA" violation as |
defined in Section 1-128.5 of this Act; |
|
(2) the facility being issued a "Type A" violation as |
defined in Section 1-129 of this Act; |
(3) the facility being issued a "Type B" violation as |
defined in Section 1-130 of this Act; |
(4) denial of the facility's license under Section |
3-117 of this Act; |
(5) the facility being placed on the Department's |
quarterly list of facilities which the Department has taken |
action against prepared under Section 3-304 of this Act; |
(6) the facility being assessed a penalty or fine under |
Section 3-305 of this Act; |
(7) the facility being issued a conditional license |
under Section 3-311 of this Act; or |
(8) the Department's suspension or revocation of a |
facility's license or refusal to renew a facility's license |
under Section 3-119 of this Act. |
The Department shall notify the Division of Developmental |
Disabilities of the Department of Human Services when it |
becomes aware of a medication error at a day program or that a |
resident is injured or is subject to alleged abuse or neglect |
at a day program.
|
Section 15. The ID/DD Community Care Act is amended by |
adding Section 3-301.1 as follows:
|
(210 ILCS 47/3-301.1 new) |
|
Sec. 3-301.1. Administration of medication by direct care |
staff at day programs. For the purposes of this Act, violations |
cited against a facility as a result of actions involving |
administration of medication by direct care staff of day |
programs certified to serve persons with developmental |
disabilities by the Department of Human Services under Section |
15.4 of the Mental Health and Developmental Disabilities |
Administrative Act will not result in: |
(1) the facility being issued a "Type AA" violation as |
defined in Section 1-128.5 of this Act; |
(2) the facility being issued a "Type A" violation as |
defined in Section 1-129 of this Act; |
(3) the facility being issued a "Type B" violation as |
defined in Section 1-130 of this Act; |
(4) denial of the facility's license under Section |
3-117 of this Act; |
(5) the facility being placed on the Department's |
quarterly list of facilities which the Department has taken |
action against prepared under Section 3-304 of this Act; |
(6) the facility being assessed a penalty or fine under |
Section 3-305 of this Act; |
(7) the facility being issued a conditional license |
under Section 3-311 of this Act; or |
(8) the Department's suspension or revocation of a |
facility's license or refusal to renew a facility's license |
under Section 3-119 of this Act. |
