HB 0181

CS

CHAMBER ACTION

1	The Health Care Regulation Committee recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to the administration of medication;
7	amending s. 393.506, F.S.; deleting requirements for
8	unlicensed staff members of direct care service facilities
9	to administer prescribed medications to persons with
10	developmental disabilities; authorizing direct service
11	providers to administer medication to clients or to
12	supervise the self-administration of medication by
13	clients; providing requirements for direct service
14	providers to demonstrate competency regarding supervising
15	the self-administration of medication by clients or
16	administering medication to clients; requiring the Agency
17	for Persons with Disabilities to adopt rules to establish
18	standards and procedures governing the supervision of
19	self-administered medications and the administration of
20	medications by direct service providers; providing an
21	effective date.
22
23	Be It Enacted by the Legislature of the State of Florida:
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25	Section 1.  Section 393.506, Florida Statutes, is amended
26	to read:
27	393.506  Administration of medication.--
28	(1)  A Notwithstanding the provisions of part I of chapter
29	464, the Nurse Practice Act, unlicensed direct service provider
30	who is not currently licensed to administer medication care
31	services staff providing services to persons with developmental
32	disabilities may supervise the self-administration of or may
33	administer oral, transdermal, ophthalmic, otic, rectal, inhaled,
34	or topical prescription medications to a client as provided in
35	this section.
36	(2)  In order to supervise the self-administration of
37	medication or to administer medications as provided in
38	subsection (1), a direct service provider must satisfactorily
39	complete a medication administration training course of not less
40	than 4 hours in medication administration and be found competent
41	to supervise the self-administration of medication by a client
42	or to administer medication to a client in a safe and sanitary
43	manner. Competency must be assessed and validated at least
44	annually in an onsite setting and must include personally
45	observing that the direct service provider satisfactorily:
46	(a)  Supervised the self-administration of medication by a
47	client.
48	(b)  Administered medication to a client.
49	(3)  A direct service provider may supervise the self-
50	administration of medication by a client or may administer
51	medication to a client only if the client, or the client's
52	guardian or legal representative, has given his or her informed
53	consent to self-administering medication under the supervision
54	of an unlicensed direct service provider or to receiving
55	medication administered by an unlicensed direct service
56	provider. Such informed consent must be based on a description
57	of the medication routes and procedures that the direct service
58	provider is authorized to supervise or administer. Only a direct
59	service provider who has received appropriate training and has
60	been validated as competent may supervise the self-
61	administration of medication by a client or may administer
62	medication to a client.
63	(4)  The determination of competency and annual validation
64	required under this section shall be conducted by a registered
65	nurse licensed pursuant to chapter 464 or a physician licensed
66	pursuant to chapter 458 or chapter 459.
67	(5)  The agency shall establish by rule standards and
68	procedures that a direct service provider must follow when
69	supervising the self-administration of medication by a client
70	and when administering medication to a client. Such rules must,
71	at a minimum, address requirements for labeling medication,
72	documentation and recordkeeping, the storage and disposal of
73	medication, instructions concerning the safe administration of
74	medication or supervision of self-administered medication,
75	informed-consent requirements and records, and the training
76	curriculum and validation procedures.
77	(a)  For day programs, as defined in s. 393.063, the
78	director of the facility or program shall designate in writing
79	unlicensed direct care services staff who are eligible to be
80	trained to assist in the administration of or to administer
81	medication.
82	(b)  For intermediate care facilities for the
83	developmentally disabled licensed pursuant to part XI of chapter
84	400, unlicensed staff designated by the director may provide
85	medication assistance under the general supervision of a
86	registered nurse licensed pursuant to chapter 464.
87	(2)  Each facility, institution, or program must include in
88	its policies and procedures a plan for training designated staff
89	to ensure the safe handling, storage, and administration of
90	prescription medication. These policies and procedures must be
91	approved by the agency before unlicensed direct care services
92	staff assist with medication.
93	(3)  The policies and procedures must include, at a
94	minimum, the following provisions:
95	(a)  An expressed and informed consent for each client.
96	(b)  The director of the facility, program, or provider
97	must maintain a copy of the written prescription, and that
98	prescription must include the name of the medication, the dosage
99	and administration schedule, the reason for the prescription,
100	and the termination date.
101	(c)  Each prescribed medication shall be kept in its
102	original container and in a secure location.
103	(4)  The training required in this section shall be
104	conducted by a registered nurse or a physician licensed pursuant
105	to chapter 458 or chapter 459.
106	Section 2.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.