Community Services Programs

Mental Health Agency Licensing Standards; Clinical Management -
Treatmnet and Care Processes Medications

MED.1
Where medications are available, administered, or supervised by staff in the agency, the agency shall retain and securely store medications.

  • MED.1.A.
    Medications are kept in original containers in a locked storage cabinet.
  • MED.1.B.
    The storage cabinet shall be equipped with separate cubicles, plainly labeled, and locked when not in use.
  • MED.1.C.
    Medications marked "for external use only" shall be stored separate from other medications.
  • MED.1.D.
    Refrigerated medications shall be kept separate from food by placing them in special trays or containers.

MED.2
Where clients self-administer medications, the agency shall provide to clients the capacity for secure storage.

  • MED.2.A.
    Clients that self-administer medications shall be allowed to keep such medications in a locked storage container in their private living areas.
  • MED.2.B.
    No client shall maintain a private drug supply for which there are no physician's orders or prescription label with the client's name.

MED.3
Agencies retain a professionally qualified individual to provide education and supervision when agency clients self-administer medications and agency staff monitor compliance and observe for side effects.

  • MED.3.A.
    Unlicensed personnel shall be trained to observe for side effects and drug reactions to psychotropics and frequently used medications (such as antibiotics) by a registered nurse consultant, and/or physician, and/or pharmacist.
  • MED.3.B.
    There shall be documentation of the activities of the professionally qualified individual including staff training and review of client records/logs.

MED.4
Where medications are available, administered or supervised by staff in the agency, the agency shall have a procedure for prescribing.

  • MED.4.A.
    Written orders to administer/discontinue medications are generated by a physician, dentist, or physician extender.
  • MED.4.B.
    Physicians review medications at least every 30 days in inpatient settings, every 90 days in outpatient settings and, in residential settings, psychotropic medications will be renewed every 90 days and all other medications no less frequently than one year.
  • MED.4.C.
    Telephone orders are accepted by a registered nurse or pharmacist, and only when necessary because of emergency circumstances.
  • MED.4.D
    Written dated orders taken by agency staff must be signed by the physician within 24 hours.

MED.5
Where medications are available, administered, or supervised by staff in the agency, there is a policy regarding their administration.

  • MED.5.A.
    The agency has policies regarding medication administration that take into account the client's right to privacy and dignity.

MED.6
No medication is prescribed and administered without the written informed consent of the client or legally responsible party.

  • MED.6.A.
    There is a process by which the prescribing physician informs the client and/or legally responsible party, and when appropriate, the community support worker, of the potential effects and side effects of medications they prescribe, e.g., information sheets.

MED.7
Where medications are available, administered, or supervised by staff in the agency, there is a policy regarding inventory of medications and paraphernalia.

  • MED.7.A.
    There is documentation that controlled drugs are counted by the incoming and outgoing medication personnel at the change of each shift.

MED.8
Where medications are available, administered, or supervised by staff in the agency, there is a policy regarding reporting and disposing of outdated medications.

  • MED.8.A.
    There is documented monitoring for outdated medications at least quarterly.
  • MED.8.A.1
    This monitoring shall include documentation of where the outdated drugs are sent and whether they were disposed of according to applicable federal, state and local laws.

MED.9
Where medication is prescribed, administered, or supervised by staff in the agency, a medication record and a record of each occasion of medication administration shall be maintained.

  • MED.9.A.
    A medication record shall be maintained which minimally includes:
    MED.9.A.1 the prescribing physician;
    MED.9.A.2 personnel administering the medication;
    MED.9.A.3 type and frequency of monitoring for effects of the medication.
  • MED.9.B. A
    medication administration record shall be maintained which minimally includes:
    MED.9.B.1 the type of medication;
    MED.9.B.2 the dosage; and
    MED.9.B.3 the frequency of use.

MED.10
In instances of medication errors, side effects, adverse reactions, client or staff concerns regarding medication, staff inform the prescribing physician and document the problem in an occurrence report.

MED.11
When the agency prescribes, administers, or supervises medications, there is a process for monitoring the effectiveness of medications.

  • MED.11.A.
    Staff members with a minimum of a medication technician certification approved by Maine's Department of Human Services, regularly review and document client response to medication.
  • MED.11.B.
    Side effects, adverse reactions and client concerns are documented, treated in a timely fashion, and corrected.

MED.12
When medications are prescribed by agency staff or consultants prescribing as part of the agency program, the prescribing professional is available to discuss medication issues and concerns between appointments.

  • MED.12.A.
    Documented concerns regarding medications are quickly followed by documented consultation with the prescribing physician.
  • MED.12.B.
    There are no substantiated complaints regarding the availability or accessibility of the prescribing physician. All substantiated complaints will be assessed for the seriousness of the violation and actions taken to achieve compliance.

MED.13
The agency complies with all federal, state and local laws concerning medication administration.

  • MED.13.A.
    There are no substantiated violations of any federal, state or local laws concerning medication administration.