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A BILL TO BE ENTITLED
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AN ACT
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relating to the administration of medications for persons with |
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intellectual and developmental disabilities. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 301, Occupations Code, is amended to add |
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a new Subchapter O to read as follows: |
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SUBCHAPTER O. ADMINISTRATION OF MEDICATIONS FOR PERSONS WITH |
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INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. |
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Sec. 301.701. DEFINITIONS. In this subsection: |
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(1) "Assistance with self-administered medication" |
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means any needed ancillary aid provided to a client in the client's |
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self-administered medication or treatment regimen, such as |
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reminding a client to take a medication at the prescribed time, |
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opening and closing a medication container, pouring a predetermined |
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quantity of liquid to be ingested, returning a medication to the |
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proper storage area, and assisting in reordering medications from a |
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pharmacy. |
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(2) "Administration of medication" means the removal |
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of an individual/unit dose from a previously dispensed, properly |
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labeled container, verifying it with the medication order, giving |
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the correct medication and the correct dose to the proper client at |
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the proper time by the proper route; and accurately recording the |
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time and dose given. |
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(3) "Client" means a person with an intellectual and |
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developmental disability receiving services from a facility or |
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program listed in Section 301.702. |
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(4) "Unlicensed person" means an individual, not |
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licensed as health care provider: |
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(A) who is monetarily compensated to provide |
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certain health related tasks and functions in a complementary or |
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assistive role to the licensed nurse in providing direct client |
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care or carrying out common nursing functions; |
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(B) who provides those tasks and functions as a |
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volunteer but does not qualify as a friend providing gratuitous |
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care for the sick under Section 301.004(1); |
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(C) including, but not limited to, nurse aides, |
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orderlies, assistants, attendants, technicians, home health aides, |
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medication aides permitted by a state agency, and other individuals |
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providing personal care/assistance of health related services; or |
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(D) who is a professional nursing student, not |
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licensed as a nurse, providing care for monetary compensation and |
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not as part of their formal educational program shall be considered |
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to be unlicensed persons and must provide that care in conformity |
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with this chapter. |
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Sec. 301.702. APPLICABILITY. This subsection applies only |
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to administration of medications provided to certain persons with |
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intellectual and developmental disabilities who are served in: |
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(1) a facility licensed and certified under Chapter |
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252, Health and Safety Code; or |
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(2) one of the following Section 1915(c) waiver |
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programs administered by the Department of Aging and Disability |
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Services to serve persons with intellectual and developmental |
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disabilities: |
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(A) Community Living Assistance and Support |
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Services waiver; |
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(B) Home and Community Based Services waiver; or |
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(C) Texas Home Living waiver. |
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Sec. 301.703. ADMINISTRATION OF MEDICATION. (a) The board |
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by rule shall authorize the administration of medication by |
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unlicensed persons without the requirement that a registered nurse |
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delegate each administration of |
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(1) oral medication; |
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(2) topical medication; or |
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(3) metered dose inhaler. |
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(b) Medications that must be administered other than those |
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listed under subsection (a) are subject to the board's rules |
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regarding the delegation of nursing tasks to unlicensed persons in |
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independent living environments such as those listed in Section |
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301.702. |
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(c) The board by rule shall: |
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(1) require that a licensed nurse assess each client |
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with intellectual and developmental disabilities described by |
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Section 301.702 to: |
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(A) determine the appropriate level of |
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assistance the client needs with the administration of medication; |
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and |
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(B) establish criteria related to the necessary |
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skills and knowledge that must be demonstrated to permit the client |
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to have medications administered by an unlicensed person under this |
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subchapter. |
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Sec. 301.704. UNLICENSED PERSONS AUTHORIZED TO PROVIDE |
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ADMINISTRATION OF MEDICATION. (a) An unlicensed person who is a |
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member of the staff of a facility or an employee or contractor of a |
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person licensed or certified to provide Section 1915(c) waiver |
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program services as described by Section 301.702 may be authorized |
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to administer medication to a client described by Section 301.702 |
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only if the staff member, employee or contractor: |
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(1) is trained by a registered nurse or licensed |
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vocational nurse under the direction of a registered nurse |
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regarding the requirements to administer medications. |
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SECTION 2. In developing the rules required by Chapter 301, |
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Occupations Code, Subchapter O, as added by this Act, the executive |
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director of the Texas Board of Nursing shall convene a work group of |
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affected stakeholders, including public and private providers and |
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registered and licensed vocational nurses employed by the |
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facilities or providers of services described by Section 301.702, |
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Occupations Code, as added by this Act, and other persons or |
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entities the executive director of the Texas Board of Nursing |
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considers appropriate. |
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SECTION 3. Chapter 161, Human Resources Code, is amended to |
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add a new Section 161.078 to read as follows: |
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Sec. 161.078. ASSISTANCE WITH ADMINISTRATION OF |
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MEDICATIONS FOR PERSONS WITH INTELLECTUAL AND DEVELOPMENTAL |
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DISABILITIES. The department shall ensure that medications |
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administered by an unlicensed person under Chapter 301, Occupations |
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Code, Subchapter O are: |
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(1) overseen by a registered nurse or a licensed |
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vocational nurse under the supervision of a registered nurse; |
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(2) performed after receiving training to address the |
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client's identified skill and knowledge deficits until the client |
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demonstrates competence in independent medication management; and |
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(3) administered in such a way as to ensure the |
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greatest degree of independence in determining the type of |
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assistance needed, including the use of an adaptive or assistive |
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aid, device, or strategy as allowed under program rule. |
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SECTION 4. The Texas Board of Nursing and the Texas |
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Department of Aging and Disability Services shall enter into a |
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Memorandum of Understanding regarding the administration of |
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medications to persons with intellectual and developmental |
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disabilities. |
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SECTION 5. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2011. |