Residential Care Agencies: Medication
(1)Policy and procedures. The residential care agency must have policies and procedures that cover all prescription and non-prescription medications that address all of the following:
(a)How the medication will be administered.
(b)By whom the medication will be administered.
(c)How the staff of the residential care agency who administer medication will be trained.
(d)How the administration of medication will be documented.
(e)How the administration of medication will be monitored.
(f)How unused medication will be disposed of.
(g)The process that ensures that each child in care’s prescription and non-prescription medications are reviewed, unless the medications are all provided through a single pharmacy. As used in this rule, “non prescription medication” means any medication that does not require a written prescription for purchase or dispensing and includes the use of any herbal remedies or supplements.
(h)How the foster care agency and the proctor foster home will ensure compliance with OAR 413-070-0470 (Substitute Caregiver Responsibilities) if it serves children in Department custody.
(2)Program staff may not dispense medication to a child in care in any of the following situations:
(a)In excess of the prescribed or authorized amount.
(b)For disciplinary purposes.
(c)For the convenience of staff.
(d)As a substitute for appropriate treatment services.
(3)A prescription, signed by a physician or qualified medical professional, is required before any prescription medication is administered to, or self-administered by a child in care. Medications prescribed for one child in care may not be administered to, or self-administered by another child in care or staff. As used in this rule, “self-administration of medication” refers to the act of a child in care placing a medication internally in, or externally on, his or her own body.
(4)A written approval, signed by a physician or qualified medical professional, is required for any use of herbal supplements or remedies.
(5)A written order, signed by a physician or qualified medical professional, is required for any medical treatment, special diet, physical therapy, aid to physical functioning, or limitation of activity.
(6)Before a residential care agency permits a child in care to self-administer prescription medication, self-administration must be recommended by the qualified medical professional, approved in writing by a physician or qualified medical professional, and closely monitored by the staff of the residential care agency.
(a)Prescription medications that are unused and medications that are outdated or recalled may not be maintained in the facility. “Outdated” means any medication whose designated period of potency, as indicated on the label, has expired.
(b)The facility may maintain a stock supply of non-prescription medications.
(c)All prescription and non-prescription medications stored in the facility must be kept in a manner that they are inaccessible to children in care.
(d)Medications requiring refrigeration must be refrigerated and secured.
(e)Medications must be maintained and stored in its original container, including the prescription label.
(8)Medication disposal. Medications must be disposed of in a manner that ensures that they cannot be retrieved, in accordance with all applicable state and federal law.
(9)A written record of all medication disposals must be maintained and must include all of the following:
(a)A description of the prescribed medication and the amount disposed.
(b)The child in care for whom the medication was prescribed.
(c)The reason for disposal.
(d)The method of disposal.
(e)The name of the person disposing the medication, and the initials of an adult witness.
(10)Medication records. A written record must be kept for each child in care listing all medications, both prescription and over-the-counter, that are administered. The record must include all of the following:
(a)The name of the child in care.
(b)A description of the medication, instructions for use, and the recommended dosage.
(c)Dates and times medication is administered.
(d)A record of missed dosages.
(e)Medication dropped or disposed of.
(f)Method of administration for each medication.
(g)Identification of the person administering the medication.
(h)Any possible adverse reactions to the medication.
(i)Documentation of any medication taken outside the facility to be administered during a home visit or other activity.
(11)Where applicable, the residential care agency must maintain documentation of the continuing evaluation of the ability of the child in care to self-administer a medication.
Rule 413-215-0551 — Residential Care Agencies: Medication,