Florida Senate - 2018                        COMMITTEE AMENDMENT
       Bill No. PCS (847484) for CS for SB 1788
       
       
       
       
       
       
                                Ì677650/Î677650                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/22/2018           .                                
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       The Committee on Appropriations (Passidomo) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Section 393.506, Florida Statutes, is amended to
    6  read:
    7         393.506 Administration of medication.—
    8         (1) An unlicensed A direct service provider who is not
    9  currently licensed to administer medication may supervise the
   10  self-administration of medication or may administer oral,
   11  transdermal, ophthalmic, otic, rectal, inhaled, enteral, or
   12  topical prescription medications to a client if the unlicensed
   13  direct service provider meets the requirements of as provided in
   14  this section.
   15         (2) In order to supervise the self-administration of
   16  medication or to administer medications as provided in
   17  subsection (1), an unlicensed a direct service provider must
   18  satisfactorily complete an initial a training course conducted
   19  by an agency-approved trainer of not less than 6 4 hours in
   20  medication administration and be found competent to supervise
   21  the self-administration of medication by a client and or to
   22  administer medication to a client in a safe and sanitary manner.
   23  Competency must be assessed and validated at least annually in
   24  an onsite setting and must include personally observing the
   25  direct service provider satisfactorily:
   26         (a) The competency of the unlicensed direct service
   27  provider to supervise and administer otic, transdermal, and
   28  topical medication must be assessed and validated using
   29  simulation during the initial training course, and need not be
   30  revalidated annually. Supervising the self-administration of
   31  medication by a client; and
   32         (b) Competency must be validated initially and revalidated
   33  annually for oral, enteral, ophthalmic, rectal, and inhaled
   34  medication administration. The initial validation and annual
   35  revalidations of medication administration must be performed
   36  onsite with an actual client using the client’s actual
   37  medication and must include the validating practitioner
   38  personally observing the unlicensed direct service provider
   39  satisfactorily:
   40         1.Supervising the oral, enteral, ophthalmic, rectal, or
   41  inhaled self-administration of medication by a client; and
   42         2.Administering medication to a client by oral, enteral,
   43  ophthalmic, rectal, or inhaled medication routes.
   44         (c)1.An unlicensed direct service provider who completes
   45  the required initial training course and is validated in the
   46  oral or enteral route of medication administration is not
   47  required to retake the initial training course unless he or she
   48  fails to maintain annual validation in the oral or enteral
   49  route, in which case, the provider must complete the initial 6
   50  hour training course again and obtain all required validations
   51  before he or she may supervise the self-administration of
   52  medication by a client or administer medication to a client.
   53         2.If the unlicensed direct service provider has already
   54  completed an initial training course of at least 4 hours and has
   55  a current validation for oral or enteral routes of medication
   56  administration on or before July 1, 2018, he or she is not
   57  required to complete the initial 6-hour training course. If for
   58  any reason the unlicensed direct service provider fails to meet
   59  the annual validation requirement for oral or enteral medication
   60  administration, or the annual inservice training requirement in
   61  subsection (4), the unlicensed direct service provider must
   62  satisfactorily complete the initial training course again and
   63  obtain all required validations before he or she may supervise
   64  the self-administration of medication by a client or administer
   65  medication to a client.
   66         3.If an unlicensed direct service provider has completed
   67  an initial training course of at least 4 hours but has not
   68  obtained validation for otic, transdermal, or topical medication
   69  administration before July 1, 2018, that direct service provider
   70  must obtain validation before administering otic, transdermal,
   71  and topical medication, which may be performed through
   72  simulation.
   73         (3)An unlicensed direct service provider may administer
   74  medication to a client only if the provider has met the training
   75  requirements of this section and has been validated as
   76  competent. An unlicensed direct service provider may not
   77  supervise the self-administration of medication by a client or
   78  administer medication to a client unless the client or the
   79  client’s guardian or legal representative has given his or her
   80  informed written consent.
   81         (4)An unlicensed direct service provider must annually and
   82  satisfactorily complete a 2-hour agency-developed inservice
   83  training course in medication administration and medication
   84  error prevention conducted by an agency-approved trainer. The
   85  inservice training course shall count toward annual inservice
   86  training hours required by agency rule or by Agency for Health
   87  Care Administration rule. This subsection may not be construed
   88  to require an increase in the total number of hours required for
   89  annual inservice training for direct service providers
   90  Administering medication to a client.
   91         (3)A direct service provider may supervise the self
   92  administration of medication by a client or may administer
   93  medication to a client only if the client, or the client’s
   94  guardian or legal representative, has given his or her informed
   95  consent to self-administering medication under the supervision
   96  of an unlicensed direct service provider or to receiving
   97  medication administered by an unlicensed direct service
   98  provider. Such informed consent must be based on a description
   99  of the medication routes and procedures that the direct service
  100  provider is authorized to supervise or administer. Only a
  101  provider who has received appropriate training and has been
  102  validated as competent may supervise the self-administration of
  103  medication by a client or may administer medication to a client.
  104         (5)(4) The training, determination of competency, and
  105  initial and annual validations validation required in this
  106  section shall be conducted by a registered nurse licensed
  107  pursuant to chapter 464 or by a licensed practical nurse in
  108  accordance with the requirements of chapter 464. A physician
  109  licensed pursuant to chapter 458 or chapter 459 may validate or
  110  revalidate competency.
  111         (6)(5) The agency shall establish by rule standards and
  112  procedures that an unlicensed a direct service provider must
  113  follow when supervising the self-administration of medication by
  114  a client and when administering medication to a client. Such
  115  rules must, at a minimum, address qualification requirements for
  116  trainers, requirements for labeling medication, documentation
  117  and recordkeeping, the storage and disposal of medication,
  118  instructions concerning the safe administration of medication or
  119  supervision of self-administered medication, informed-consent
  120  requirements and records, and the training curriculum and
  121  validation procedures. The agency shall adopt rules to establish
  122  methods of enforcement to ensure compliance with this section.
  123         Section 2. This act shall take effect July 1, 2018.
  124  
  125  ================= T I T L E  A M E N D M E N T ================
  126  And the title is amended as follows:
  127         Delete everything before the enacting clause
  128  and insert:
  129                        A bill to be entitled                      
  130         An act relating to medication administration; amending
  131         s. 393.506, F.S.; revising training requirements for
  132         unlicensed direct service providers to assist with the
  133         administration of or to supervise the self
  134         administration of medication if specified requirements
  135         are met; providing validation requirements for the
  136         competency and skills of unlicensed direct service
  137         providers; providing that an unlicensed direct service
  138         provider may administer medication to a client only if
  139         he or she has met specified training requirements and
  140         has been validated as competent; prohibiting such
  141         administration and the supervision of self
  142         administration without specified informed written
  143         consent; requiring unlicensed direct service providers
  144         to complete an annual inservice training course in
  145         medication administration and medication error
  146         prevention developed by the Agency for Persons with
  147         Disabilities; providing that such training counts
  148         toward training required by agency or Agency for
  149         Health Care Administration rule; providing
  150         construction; providing that training, the
  151         determination of competency, and initial and annual
  152         validations be conducted by a registered nurse or by a
  153         licensed practical nurse; providing that certain
  154         physicians may validate or revalidate competency;
  155         requiring the Agency for Persons with Disabilities to
  156         adopt certain rules; providing an effective date.