Florida Senate - 2018              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 1788
       
       
       
       
       
                               Ì847484JÎ847484                          
       
       576-03269-18                                                    
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to medication administration; amending
    3         s. 393.506, F.S.; revising training requirements for
    4         direct service providers to assist with the
    5         administration of or to supervise the self
    6         administration of medication under certain
    7         circumstances; providing requirements for the
    8         competency and skills of direct service providers to
    9         be validated; requiring direct service providers to
   10         complete an annual inservice training course in
   11         medication administration and medication error
   12         prevention developed by the Agency for Persons with
   13         Disabilities; providing construction; requiring the
   14         validation and revalidation of competency for certain
   15         medication administrations to be performed with an
   16         actual client; requiring the agency to adopt specified
   17         rules; providing an effective date.
   18          
   19  Be It Enacted by the Legislature of the State of Florida:
   20  
   21         Section 1. Section 393.506, Florida Statutes, is amended to
   22  read:
   23         393.506 Administration of medication.—
   24         (1) A direct service provider who is not currently licensed
   25  to administer medication may supervise the self-administration
   26  of medication or may administer oral, transdermal, ophthalmic,
   27  otic, rectal, inhaled, enteral, or topical prescription
   28  medications to a client if the provider meets the requirements
   29  of as provided in this section.
   30         (2) In order to supervise the self-administration of
   31  medication or to administer medications as provided in
   32  subsection (1), a direct service provider must satisfactorily
   33  complete an initial a training course conducted by an agency
   34  approved trainer of not less than 6 4 hours in medication
   35  administration and be found competent to supervise the self
   36  administration of medication by a client and or to administer
   37  medication to a client in a safe and sanitary manner. The
   38  competency of the direct service provider to supervise and
   39  administer otic, transdermal, and topical medication must be
   40  assessed and validated using simulation during the course, and
   41  need not be revalidated annually. If the direct service provider
   42  has already completed an initial training course of at least 4
   43  hours and has a current validation for oral or enteral routes of
   44  medication administration on or before July 1, 2018, then he or
   45  she is not required to complete the course. If for any reason
   46  the direct service provider loses his or her validation by
   47  failing to meet the annual validation requirement for oral or
   48  enteral medication administration, or the annual inservice
   49  training requirement in subsection (3), then the direct service
   50  provider must complete the initial training course and obtain
   51  all required validations before he or she may supervise the
   52  self-administration of medication by a client or administer
   53  medication to a client. If a direct service provider has
   54  completed an initial training course of at least 4 hours, but
   55  has not received validation for otic, transdermal, or topical
   56  medication administration before July 1, 2018, then that direct
   57  service provider must seek separate validation before
   58  administering otic, transdermal, and topical medication. Those
   59  validations may be performed through simulation.
   60         (3) In addition to the initial training course, a direct
   61  service provider must annually and satisfactorily complete a 2
   62  hour agency-developed inservice training course in medication
   63  administration and medication error prevention conducted by an
   64  agency-approved trainer. The inservice training course will
   65  count toward annual inservice training hours. This subsection
   66  may not be construed to require an increase in the total number
   67  of hours required for annual inservice training for direct
   68  service providers.
   69         (4) Competency must be validated initially and revalidated
   70  annually for oral, enteral, ophthalmic, rectal, and inhaled
   71  medication administration. The initial and annual validations of
   72  medication administration must be performed onsite with an
   73  actual client using the client’s actual medication and must
   74  include the validating practitioner personally observing the
   75  direct service provider satisfactorily:
   76         (a) Supervising the oral, enteral, ophthalmic, rectal, or
   77  inhaled self-administration of medication by a client; and
   78         (b) Administering medication to a client by oral, enteral,
   79  ophthalmic, rectal, or inhaled medication routes.
   80         (5) Any unlicensed direct service provider who completes
   81  the required initial training course and is validated in the
   82  oral or enteral route of medication administration is not
   83  required to retake the initial training course unless he or she
   84  fails to maintain annual validation in the oral or enteral
   85  route, in which case, the provider must complete again the
   86  initial 6-hour training course and any additional validations
   87  before he or she may supervise the self-administration of
   88  medication by a client or to administer any medication to a
   89  client.
   90         (6) Only a direct service provider who has met the training
   91  requirements of this section and who has been validated as
   92  competent may administer medication to a client. In addition, a
   93  direct service provider who is not currently licensed to
   94  administer medication may supervise the self-administration of
   95  medication by a client or may administer medication to a client
   96  only if the client, or the client’s guardian or legal
   97  representative, has given his or her informed written consent
   98  must be assessed and validated at least annually in an onsite
   99  setting and must include personally observing the direct service
  100  provider satisfactorily:
  101         (a) Supervising the self-administration of medication by a
  102  client; and
  103         (b) Administering medication to a client.
  104         (3) A direct service provider may supervise the self
  105  administration of medication by a client or may administer
  106  medication to a client only if the client, or the client’s
  107  guardian or legal representative, has given his or her informed
  108  consent to self-administering medication under the supervision
  109  of an unlicensed direct service provider or to receiving
  110  medication administered by an unlicensed direct service
  111  provider. Such informed consent must be based on a description
  112  of the medication routes and procedures that the direct service
  113  provider is authorized to supervise or administer. Only a
  114  provider who has received appropriate training and has been
  115  validated as competent may supervise the self-administration of
  116  medication by a client or may administer medication to a client.
  117         (7)(4) The training, determination of competency, and
  118  initial and annual validations validation required in this
  119  section shall be conducted by a registered nurse licensed
  120  pursuant to chapter 464 or by a practical nurse licensed under
  121  chapter 464. A physician licensed pursuant to chapter 458 or
  122  chapter 459 may validate or revalidate competency.
  123         (8)(5) The agency shall establish by rule standards and
  124  procedures that a direct service provider must follow when
  125  supervising the self-administration of medication by a client
  126  and when administering medication to a client. Such rules must,
  127  at a minimum, address qualification requirements for trainers,
  128  requirements for labeling medication, documentation and
  129  recordkeeping, the storage and disposal of medication,
  130  instructions concerning the safe administration of medication or
  131  supervision of self-administered medication, informed-consent
  132  requirements and records, and the training curriculum and
  133  validation procedures. The agency shall adopt rules to establish
  134  methods of enforcement to ensure compliance with this section.
  135         Section 2. This act shall take effect July 1, 2018.