H. B. 3021
(By Delegates Schadler, J. Miller, Andes,
Moore and Rowan)
[Introduced January 13, 2010; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new article, designated §16-5W-1, §16-5W-2,
§16-5W-3, §16-5W-4, §16-5W-5, §16-5W-6, §16-5W-7, §16-5W-8,
§16-5W-9, §16-5W-10 and §16-5W-11, all relating to permitting
medicine aides who are certified to administer certain drugs
in licensed nursing homes; setting forth the qualifications of
certified medicine aides; establishing training curricula and
competency evaluations for certified medicine aides; requiring
that a facility's records that authorizes certified medicine
aides be available for inspection; requiring facilities that
permit certified medicine aides to administer drugs to have an
administrative monitoring system; permitting the setting and
collecting of fees; and authorizing rulemaking.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new article, designated §16-5W-1, §16-5W-2, §16-5W-3, §16-5W-4, §16-5W-5, §16-5W-6, §16-5W-7, §16-5W-8,
§16-5W-9, §16-5W-10 and §16-5W-11, all to read as follows:
ARTICLE 5W. MEDICATION ADMINISTRATION BY CERTIFIED MEDICINE AIDES.
§16-5W-1. Short title.
This article may be cited as the "Medication Administration by
Certified Medicine Aides Act."
§16-5W-2. Definitions.
As used in this article, unless a different meaning appears
from the context, the following definitions apply:
(1) "Administration of medication" means:
(A) Assisting a person in the ingestion, application or
inhalation of medications, including prescription drugs, or in the
use of universal precautions or rectal or vaginal insertion of
medication, according to the legibly written or printed directions
of the attending physician or authorized practitioner, or as
written on the prescription label; and
(B) Making a written record of such assistance with regard to
each medication administered, including the time, route and amount
taken
: Provided, That for purposes of this article,
"administration" does not include judgment, evaluation,
assessments, injections of medication, monitoring of medication or
self-administration of medications, including prescription drugs
and self-injection of medication by the resident.
(2) "Authorizing agency" means the department's Office of Health Facility Licensure and Certification.
(3) "Certified Medicine Aide" means a person who has been
trained as, and has been employed as a certified nursing assistant
for the period of at least one year, has been certified by the
appropriate authorizing agency, and has completed an authorizing
agency approved course of study and training.
(4) "Department" means the Department of Health and Human
Resources.
(5)"Facility" means a nursing home that is licensed by or
approved by the department.
(6) "Health care professional" means a medical doctor or
doctor of osteopathy, a podiatrist, registered nurse, practical
nurse, registered nurse practitioner, physician's assistant,
dentist, optometrist or respiratory care professional, licensed
under chapter thirty of this code.
(7) "Medication" means a drug, as defined in section one
hundred one, article one, chapter sixty-a of this code, that has
been prescribed by a duly authorized health care professional to be
ingested through the mouth, applied to the outer skin, eye or ear,
or applied through nose drops, vaginal or rectal suppositories.
(8) "Registered professional nurse" means a person who holds
a valid license pursuant to article seven, chapter thirty of this
code.
(9) "Resident" means a resident of a facility.
(10) "Secretary" means the Secretary of the Department of
Health and Human Resources or his or her designee.
(11) "Self-administration of medication" means the act of a
resident, who is independently capable of reading and understanding
the labels of drugs ordered by a physician, in opening and
accessing prepackaged drug containers, accurately identifying and
taking the correct dosage of the drugs as ordered by the physician,
at the correct time and under the correct circumstances.
(12) "Supervision of self-administration of medication" means
a personal service that includes reminding residents to take
medications, opening medication containers for residents, reading
the medication label to residents, observing residents while they
take medication, checking the self-administered dosage against the
label on the container and reassuring residents that they have
obtained and are taking the dosage as prescribed.
§16-5W-3. Administration of medications in facilities.
(a) The secretary is authorized to establish and implement a
program for the administration of medications in facilities. The
program shall be developed and conducted in cooperation with the
appropriate agencies, advisory bodies and boards.
(b) Administration of medication pursuant to this article
shall be performed only by:
(1) Registered professional nurses;
(2) Other licensed health care professionals; or
(3) Certified medicine aides who are subject to the
supervision of and approval by a registered professional nurse.
(c) Subsequent to assessing the health status of an individual
resident, a registered professional nurse, in collaboration with
the resident's attending physician, may recommend that the facility
authorize a certified medicine aide to administer medication if the
certified medicine aide:
(1) Has been trained pursuant to the requirements of this
article;
(2) Is considered by the registered professional nurse to be
competent;
(3) Consults with the registered professional nurse or
attending physician on a regular basis; and
(4) Is monitored or supervised by the registered professional
nurse.
(d) Nothing in this article may be construed to prohibit any
certified medicine aide from administering medications or providing
any other prudent emergency assistance to aid any person who is in
acute physical distress or requires emergency assistance.
(e) Supervision of self-administration of medication by
certified medicine aide may be permitted when the substantial
purpose of the setting is other than the provision of health care.
§16-5W-4. Statutory construction.
(a) All licensed health care professionals as defined in this article remain subject to the provisions of their respective
licensing laws.
(b) Notwithstanding any other provision of law to the
contrary, the provisions of this article shall not be construed to
violate or be in conflict with any of the provisions of articles
seven or seven-a, chapter thirty of this code.
§16-5W-5. Instruction and training.
(a) The Office of Health Facility Licensure and Certification
shall establish a council of nurses to represent the facilities and
registered professional nurses affected by the provisions of this
article. The council of nurses shall prepare a procedural manual
and recommendations regarding a training course to the secretary of
the Department of Health and Human Resources. The council shall
meet every two years to review the training curricula, competency
evaluation procedures and rules implemented by the secretary, and
shall make recommendations as deemed necessary.
(b) The department shall develop and approve training
curricula and competency evaluation procedures for certified
medicine aides who administer medication pursuant to the provisions
of this article. The department shall consider the recommendations
of the council of nurses and shall consult with the West Virginia
Board of Examiners for registered nurses in developing the training
curricula and competency evaluation procedures.
(c) The program developed by the department shall require that any person who applies to act as a certified medicine aide
authorized to administer medications pursuant to the provisions of
this article shall:
(1) Hold a high school diploma or general education diploma;
(2) Be trained and certified as a certified nursing assistant;
(3) Have been employed as a certified nursing assistant for a
period of at least one year;
(4) Have been trained in cardiopulmonary resuscitation and
first aid;
(5) Participate in the initial training program developed by
the department;
(6) Pass a competency evaluation developed by the department;
and
(7) Subsequent to initial training and evaluation, participate
in a retraining program every two years.
(d) Any facility may offer the training and competency
evaluation program developed by the department to qualified
certified nursing assistants. The training and competency programs
shall be provided by the facility through a registered professional
nurse.
(e) A registered nurse who is authorized to train certified
medicine aides to administer medications in facilities shall:
(1) Possess a current active West Virginia license in good
standing to practice as a registered nurse;
(2) Have practiced as a registered professional nurse in a
position or capacity requiring knowledge of medications for the
immediate two years prior to being authorized to train certified
medicine aides; and
(3) Be familiar with the nursing care needs of residents of
facilities as described in this article.
(f) The department shall develop and approve training
curricula for a certified medicine aide training program that is
sixty hours in length and shall include:
(1) Basic training in the safe administration of medicine;
(2) Discussions of selected diseases and other medical
conditions and the drugs most commonly used in treating those
diseases or conditions;
(3) Categories of medication;
(4) Observations of the client while taking medication and
proper recording of the same;
(5) Principles of safe medication storage;
(6) Documentation required in administering medication; and
(7) A series of examinations to insure mastery of the
knowledge required in medicine administration.
§16-5W-6. Availability of records; eligibility requirements of
facility staff.
(a) Any facility that authorizes certified medicine aides to
administer medications pursuant to the provisions of this article shall make available to the authorizing agency a list of the
individual certified medicine aides authorized to administer
medications.
(b) A facility may permit a certified medicine aide to
administer medications in a single specific agency only after
compliance with all of the following:
(1) The certified medicine aide has successfully completed the
required training program and received a satisfactory competency
evaluation as required by the provisions of this article;
(2) The facility determines there is no statement on the state
administered nurse aide registry indicating that the certified
medicine aide has been the subject of finding of abuse or neglect
of a long-term care facility resident or convicted of the
misappropriation of such a resident's property;
(3) The certified medicine aide has had a criminal background
check or if applicable, a check of the State Police abuse registry,
establishing that the individual has been convicted of no crimes
against persons or drug related crimes;
(4) The medication to be administered is received and
maintained by the certified medicine aide in the original container
from which it was dispensed by a pharmacist or the prescribing
health care professional; and
(5) The certified medicine aide has complied with all other
applicable requirements of this article, the rules adopted pursuant to this article and such other criteria, including minimum
competency requirements, as are specified by the authorizing
agency.
§16-5W-7. Oversight of medication administration by certified
medicine aides.
(a) Each facility where medication is administered by
certified medicine aides shall establish in policy an
administrative monitoring system. The specific requirements of the
administrative policy shall be established by the department
through rules proposed pursuant to section eleven of this article.
(b) Monitoring of certified medicine aides authorized pursuant
to this article shall be performed by a registered professional
nurse employed or contracted by the facility.
§16-5W-8. Withdrawal of authorization.
The registered professional nurse who monitors or supervises
the certified medicine aides authorized to administer medication
pursuant to this article may withdraw authorization for a certified
medicine aide if the nurse determines that the certified medicine
aide is not performing medication administration in accordance with
the training and written instructions. The withdrawal of the
authorization shall be documented and shall be relayed to the
facility and the department in order to remove the certified
medicine aide from the list of authorized individuals.
§16-5W-9. Fees.
The department may set and collect fees necessary for the
implementation of the provisions of this article pursuant to rules
authorized by section eleven of this article.
§16-5W-10. Limitations on medication administration.
The following limitations apply to the administration of
medication by certified medicine aides:
(1) Injections or any parenteral medications may not be
administered;
(2) Irrigations or debriding agents used in the treatment of
a skin condition or minor abrasions may not be administered;
(3) No verbal medication orders may be accepted, no new
medication orders shall be transcribed and no drug dosages may be
converted and calculated; and
(4) No medications ordered by the physician or a health care
professional with legal prescriptive authority to be given "as
needed" may be administered unless the order is written with
specific parameters that preclude independent judgment.
§16-5W-11. Rules.
The department shall promulgate emergency rules pursuant
to the provisions of section fifteen, article three, chapter
twenty-nine-a of this code as may be necessary to implement the
provisions of this article. Subsequently, the department may
propose rules for legislative approval in accordance with the
provisions of article three, chapter twenty-nine-a of this code.
NOTE: The purpose of this bill is to establish a program to
permit medicine aides who are certified to administer certain drugs
in licensed nursing homes. The bill sets forth the qualifications
of certified medicine aides, establishes training curricula and
competency evaluations for certified medicine aides The bill
requires a facility's records that authorizes certified medicine
aides to be available for review. The bill also requires
facilities that permit certified medicine aides to administer drugs
to have an administrative monitoring system. The bill permits fees
to be set and collected. Additionally, the bill authorizes
rulemaking.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
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