H&S Code Section 1569.69 RCFE Medication Regulations

1569.69.  (a) Each residential care facility for the
elderly
licensed under this chapter shall ensure that each employee of the
facility who assists residents with the self-administration of
medications meets the following training requirements:
   (1) In facilities licensed to provide care for 16 or more
persons,
the employee shall complete 16 hours of initial training. This
training shall consist of eight hours of hands-on shadowing training,
which shall be completed prior to assisting with the
self-administration of medications, and eight hours of other training
or instruction, as described in subdivision (f), which shall be
completed within the first two weeks of employment.
   (2) In facilities licensed to provide care for 15 or fewer
persons, the employee shall complete six hours of initial training.
This training shall consist of two hours of hands-on shadowing
training, which shall be completed prior to assisting with the
self-administration of medications, and four hours of other training
or instruction, as described in subdivision (f), which shall be
completed within the first two weeks of employment.
   (3) An employee shall be required to complete the training
requirements for hands-on shadowing training described in this
subdivision prior to assisting any resident in the
self-administration of medications. The training and instruction
described in this subdivision shall be completed, in their entirety,
within the first two weeks of employment.
   (4) The training shall cover all of the following areas:
   (A) The role, responsibilities, and limitations of staff
who
assist residents with the self-administration of medication,
including tasks limited to licensed medical professionals.
   (B) An explanation of the terminology specific to
medication
assistance.
   (C) An explanation of the different types of medication
orders:
prescription, over-the-counter, controlled, and other medications.
   (D) An explanation of the basic rules and precautions of
medication assistance.
   (E) Information on medication forms and routes for
medication
taken by residents.
   (F) A description of procedures for providing assistance
with the
self-administration of medications in and out of the facility, and
information on the medication documentation system used in the
facility.
   (G) An explanation of guidelines for the proper storage,
security,
and documentation of centrally stored medications.
   (H) A description of the processes used for medication
ordering,
refills and the receipt of medications from the pharmacy.
   (I) An explanation of medication side effects, adverse
reactions,
and errors.
   (5) To complete the training requirements set forth in this
subdivision, each employee shall pass an examination that tests the
employee's comprehension of, and competency in, the subjects listed
in paragraph (3).
   (6) Residential care facilities for the elderly shall
encourage
pharmacists and licensed medical professionals to use plain English
when preparing labels on medications supplied to residents. As used
in this section, "plain English" means that no abbreviations,
symbols, or Latin medical terms shall be used in the instructions for
the self-administration of medication.
   (7) The training requirements of this section are not
intended to
replace or supplant those required of all staff members who assist
residents with personal activities of daily living as set forth in
Section 1569.625.
   (8) The training requirements of this section shall be
repeated if
either of the following occur:
   (A) An employee returns to work for the same licensee after
a
break of service of more than 180 consecutive calendar days.
   (B) An employee goes to work for another licensee in a
facility in
which he or she assists residents with the self-administration of
medication.
   (b) Each employee who received training and passed the exam
required in paragraph (5) of subdivision (a), and who continues to
assist with the self-administration of medicines, shall also complete
four hours of in-service training on medication-related issues in
each succeeding 12-month period.
   (c) The requirements set forth in subdivisions (a) and (b)
do not
apply to persons who are licensed medical professionals.
   (d) Each residential care facility for the elderly that
provides
employee training under this section shall use the training material
and the accompanying examination that are developed by, or in
consultation with, a licensed nurse, pharmacist, or physician. The
licensed residential care facility for the elderly shall maintain the
following documentation for each medical consultant used to develop
the training:
   (1) The name, address, and telephone number of the
consultant.
   (2) The date when consultation was provided.
   (3) The consultant's organization affiliation, if any, and
any
educational and professional qualifications specific to medication
management.
   (4) The training topics for which consultation was
provided.
   (e) Each person who provides employee training under this
section
shall meet the following education and experience requirements:
   (1) A minimum of five hours of initial, or certified
continuing,
education or three semester units, or the equivalent, from an
accredited educational institution, on topics relevant to medication
management.
   (2) The person shall meet any of the following practical
experience or licensure requirements:
   (A) Two years full-time experience, within the last four
years, as
a consultant with expertise in medication management in areas
covered by the training described is subdivision (a).
   (B) Two years full-time experience, or the equivalent,
within the
last four years, as an administrator for a residential care facility
for the elderly, during which time the individual has acted in
substantial compliance with applicable regulations.
   (C) Two years full-time experience, or the equivalent,
within the
last four years, as a direct care provider assisting with the
self-administration of medications for a residential care facility
for the elderly, during which time the individual has acted in
substantial compliance with applicable regulations.
   (D) Possession of a license as a medical professional.
   (3) The licensed residential care facility for the elderly
shall
maintain the following documentation on each person who provides
employee training under this section:
   (A) The person's name, address, and telephone number.
   (B) Information on the topics or subject matter covered in
the
training.
   (C) The time, dates, and hours of training provided.
   (f) Other training or instruction, as required in paragraphs
(1)
and (2) of subdivision (a), may be provided off site, and may use
various methods of instruction, including, but not limited to, all of
the following:
   (1) Lectures by presenters who are knowledgeable about
medication
management.
   (2) Video instruction tapes, interactive material, online
training, and books.
   (3) Other written or visual materials approved by
organizations or
individuals with expertise in medication management.
   (g) Residential care facilities for the elderly licensed to
provide care for 16 or more persons shall maintain documentation that
demonstrates that a consultant pharmacist or nurse has reviewed the
facility's medication management program and procedures at least
twice a year.
   (h) Nothing in this section authorizes unlicensed personnel
to
directly administer medications.
   (i) This section shall become operative on January 1, 2008.