WEST virginia Legislature
2017 regular session
Introduced
House Bill 2497
By Delegates Ellington, Criss
and Rohrbach
[Introduced February 16,
2017; Referred
to the Committee on Health and Human Resources then the Judiciary.]
A BILL to repeal §30-7D-1, §30-7D-2, §30-7D-3, §30-7D-4, §30-7D-5, §30-7D-6, §30-7D-7, §30-7D-8, §30-7D-9, §30-7D-10, §30-7D-11, §30-7D-12 and §30-7D-13 of the Code of West Virginia, 1931, as amended; and to amend and reenact §16-5O-2 of said code, all relating to permitting medication administration by unlicensed personnel in nursing homes.
Be it enacted by the Legislature of West Virginia:
That §30-7D-1, §30-7D-2, §30-7D-3, §30-7D-4, §30-7D-5, §30-7D-6, §30-7D-7, §30-7D-8, §30-7D-9, §30-7D-10, §30-7D-11, §30-7D-12 and §30-7D-13 of the Code of West Virginia,1931, as amended, be repealed; and that §16-5O-2 of said code be amended and reenacted, all to read as follows:
ARTICLE 5O. MEDICATION ADMINISTRATION BY UNLICENSED PERSONNEL.
§16-5O-2. Definitions.
As used in this article the following definitions apply:
(a) (1) "Administration of medication"
means:
(1) (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 the health care professional in accordance with subdivision
sixty-one, section four, article five, chapter thirty of this code, or as written
on the prescription label; and
(2) (B) Making a written record of such assistance
with regard to each medication administered, including the time, route and
amount taken. However, for purposes of this article, "administration"
does not include judgment, evaluation, assessments, injections of medication
(except for prefilled insulin or insulin pens), or monitoring of medication or
self-administration of medications, such as prescription drugs and
self-injection of medication by the resident.
(b) (2) "Approved medication assistive
personnel (AMAP)" means unlicensed facility staff member, who meets
eligibility requirements, has successfully completed the required training and
competency testing, and is considered competent by the authorized registered
professional nurse to administer medications or perform health maintenance
tasks, or both, to residents of the facility in accordance with this article.
(c) (3) “Authorized practitioner" means a
physician licensed under the provisions of article three, chapter thirty of
this code or article fourteen, chapter thirty of this code.
(d) (4) “Authorized registered professional nurse”
means a person who holds an unencumbered license pursuant to article seven,
chapter thirty, and meets the requirements to train and supervise approved
medication assistive personnel pursuant to this article, and has completed and
passed the facility trainer/instructor course developed by the authorizing
agency.
(e) (5) “Authorizing agency” means the Office of
Health Facility Licensure and Certification.
(f) (6) “Delegation” means transferring to a
competent individual, as determined by the authorized registered professional
nurse, the authority to perform a selected task in a selected situation.
(g) (7) “Delegation decision model” means the
process the authorized registered professional nurse must follow to determine
whether or not to delegate a nursing task to an approved medication assistive
personnel. The delegation decision model is approved by the West Virginia Board
of Examiners for Registered Professional Nurses.
(h) (8) “Department” means the Department of
Health and Human Resources.
(i) (9) “Facility” means an intermediate care
facility for individuals with an intellectual disability, assisted living, nursing
home, behavioral health group home, private residence in which health care
services and health maintenance tasks are provided under the supervision of a
registered professional nurse as defined in article seven, chapter thirty of
this code.
(j) (10) “Facility staff member” means an
individual employed by a facility but does not include a health care
professional acting within his or her scope of practice.
(k) (11) “Family” means biological parents,
adoptive parents, foster parents, or other immediate family members living
within the same household.
(l) (12) “Health care professional” means a
medical doctor or doctor of osteopathy, a podiatrist, registered professional
nurse, practical nurse, advanced practice registered nurse, physician's
assistant, dentist, optometrist or respiratory care professional licensed under
chapter thirty of this code.
(m) (13) “Health maintenance tasks” means
performing the following tasks according to the legibly written or printed
directions of a health care professional or as written on the prescription
label, and making a written record of that assistance with regard to each
health maintenance task administered, including the time, route and amount
taken:
(1) (A) Administering glucometer tests;
(2) (B) Administering gastrostomy tube feedings;
(3) (C) Administering enemas;
(4) (D) Performing ostomy care which includes skin
care and changing appliances; and
(5) (E) Performing tracheostomy and ventilator
care for residents in a private residence who are living with family and/or
natural supports.
“Health maintenance tasks” do not include judgment, evaluation, assessments, injections of medication, except for prefilled insulin or insulin pens, or monitoring of medication or self-administration of medications, such as prescription drugs and self-injection of medication by the resident.
(n) (14) “Immediate family” means mother,
stepmother, father, stepfather, sister, stepsister, brother, stepbrother,
spouse, child grandparent and grandchildren.
(o) (15) “Location of medication administration or
location where health maintenance tasks are performed” means a facility or
location where the resident requires administration of medication or assistance
in taking medications or the performance of health maintenance tasks.
(p) (16) “Medication” means a drug, as defined in
section one hundred one, article one, chapter sixty-a of this code, which has
been prescribed by a health care professional to be ingested through the mouth,
inhaled through the nose or mouth, administered through a gastrostomy tube,
applied to the outer skin, eye or ear, or applied through nose drops, vaginal
or rectal suppositories.
(q) (17) “Natural supports” means family, friends,
neighbors or anyone who provides assistance and support to a resident but is
not reimbursed.
(18) "Nursing home" means an institution, residence or place, or any part or unit thereof, which is advertised, offered, maintained or operated, for the accommodations and care, for a period of more than twenty-four hours, for four or more persons who are ill or otherwise incapacitated and in need of extensive, ongoing nursing care due to physical or mental impairment or which provides services for the rehabilitation of persons who are convalescing from illness or incapacitation.
(r) (19) “Registered professional nurse” means a
person who holds a valid license pursuant to article seven, chapter thirty of
this code.
(s) (20) “Resident” means a resident of a facility
who for purposes of this article, is in a stable condition.
(t) (21) “Secretary” means the Secretary of the
department or his or her designee.
(u) (22) "Self-administration of medication"
means the act of a resident, who is independently capable of reading and
understanding the labels of drugs ordered by an authorized practitioner, in opening
and accessing prepackaged drug containers, accurately identifying and taking
the correct dosage of the drugs as ordered by the health care professional, at
the correct time and under the correct circumstances.
(v) (23) “Self-administration of medication with
assistance” means assisting residents who are otherwise able to self-administer
their own medications except their physical disabilities prevent them from
completing one or more steps in the process.
(w) (24) “Stable” means the individual's health condition
is predictable and consistent as determined by the registered professional
nurse.
(x) (25) “Supervision of self-administration of
medication” means a personal service which 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.
NOTE: The purpose of this bill is to permit medication administration by unlicensed personnel in nursing homes.
Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.