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for staff who work in day programs that are similar to those |
for staff who work in residential programs. This training |
program shall be developed in consultation with professional |
associations representing (i) physicians licensed to practice |
medicine in all its branches, (ii) registered professional |
nurses, and (iii) pharmacists. |
(b) For the purposes of this Section: |
"Authorized direct care staff" means non-licensed persons |
who have successfully completed a medication administration |
training program approved by the Department of Human Services |
and conducted by a nurse-trainer. This authorization is |
specific to an individual receiving service in a specific |
agency and does not transfer to another agency. |
"Medications" means oral, injectable, auto-injectable, and |
topical medications, insulin in an injectable form, oxygen, |
epinephrine auto-injectors, and vaginal and rectal creams and |
suppositories. "Oral" includes inhalants and medications |
administered through enteral tubes, utilizing aseptic |
technique. "Topical" includes eye, ear, and nasal medications. |
Any controlled substances must be packaged specifically for an |
identified individual. |
"Insulin in an injectable or auto-injectable form" means a |
subcutaneous injection, auto-injection, or other technology |
including, but not limited to: (i) an insulin pump; (ii) an |
insulin pod; (iii) via an insulin pen pre-filled by the |
manufacturer; and (iv) a syringe. |
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"GLP-1 receptor agonists in an injectable or |
auto-injectable form" means medication used for the treatment |
of type 1 and type 2 diabetes and obesity. Authorized direct |
care staff may administer insulin or GLP-1 receptor agonists |
via auto-injection or an insulin pen pre-filled by the |
manufacturer as delegated by the registered nurse and , as |
ordered by a physician, advanced practice registered nurse, or |
physician assistant, if: (i) the staff has successfully |
completed a Department-approved advanced training program |
specific to insulin or GLP-1 receptor agonist administration |
developed in consultation with professional associations |
listed in subsection (a) of this Section, and (ii) the staff |
consults with the registered nurse, prior to administration, |
of any insulin or GLP-1 receptor agonist dose that is |
determined based on a blood glucose test result. The |
authorized direct care staff shall not: (i) calculate the |
insulin or GLP-1 receptor agonist dosage needed when the dose |
is dependent upon a blood glucose test result, or (ii) |
administer insulin or GLP-1 receptor agonists to individuals |
who require blood glucose monitoring greater than 3 times |
daily, without consultation with and unless directed to do so |
by the registered nurse. An individual may self-administer |
insulin or GLP-1 receptor agonists in any form if the |
individual is deemed independent by the nurse-trainer through |
the use of the Department's required standardized screening |
and assessment instruments. |
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"Nurse-trainer training program" means a standardized, |
competency-based medication administration train-the-trainer |
program provided by the Department of Human Services and |
conducted by a Department of Human Services master |
nurse-trainer for the purpose of training nurse-trainers to |
train persons employed or under contract to provide direct |
care or treatment to individuals receiving services to |
administer medications and provide self-administration of |
medication training to individuals under the supervision and |
monitoring of the nurse-trainer. The program incorporates |
adult learning styles, teaching strategies, classroom |
management, and a curriculum overview, including the ethical |
and legal aspects of supervising those administering |
medications. |
"Self-administration of medications" means an individual |
administers his or her own medications or a portion of his or |
her own medications. To be considered capable to |
self-administer their own medication, individuals must, at a |
minimum, be able to identify their medication by size, shape, |
or color, know when they should take the medication, and know |
the amount of medication to be taken each time. The use of |
assistive or enabling technologies can be used to demonstrate |
a person's capability to administer his or her own |
medications. |
"Training program" means a standardized medication |
administration training program approved by the Department of |
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Human Services and conducted by a registered professional |
nurse for the purpose of training persons employed or under |
contract to provide direct care or treatment to individuals |
receiving services to administer medications and provide |
self-administration of medication training to individuals |
under the delegation and supervision of a nurse-trainer. The |
program incorporates adult learning styles, teaching |
strategies, classroom management, curriculum overview, |
including ethical-legal aspects, and standardized |
competency-based evaluations on administration of medications |
and self-administration of medication training programs. |
(c) Training and authorization of non-licensed direct care |
staff by nurse-trainers must meet the requirements of this |
subsection. |
(1) Prior to training non-licensed direct care staff |
to administer medication, the nurse-trainer shall perform |
the following for each individual to whom medication will |
be administered by non-licensed direct care staff: |
(A) An assessment of the individual's health |
history and physical and mental status. |
(B) An evaluation of the medications prescribed. |
(2) Non-licensed authorized direct care staff shall |
meet the following criteria: |
(A) Be 18 years of age or older. |
(B) Have completed high school or have a State of |
Illinois High School Diploma. |
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(C) Have demonstrated functional literacy. |
(D) Have satisfactorily completed the Health and |
Safety component of a Department of Human Services |
authorized direct care staff training program. |
(E) Have successfully completed the training |
program, pass the written portion of the comprehensive |
exam, and score 100% on the competency-based |
assessment demonstrating proficiency in the skill of |
administering medication specific to the individual |
and his or her medications. |
(F) Have received additional competency-based |
assessment or training by the nurse-trainer when the |
nurse-trainer determines additional skill development |
is needed to administer medication by the |
nurse-trainer as deemed necessary by the nurse-trainer |
whenever a change of medication occurs or a new |
individual that requires medication administration |
enters the program. |
(3) Authorized direct care staff shall be re-evaluated |
by a nurse-trainer at least annually or more frequently at |
the discretion of the registered professional nurse. Any |
necessary retraining shall be to the extent that is |
necessary to ensure competency of the authorized direct |
care staff to administer medication. |
(4) Authorization of direct care staff to administer |
medication shall be revoked if, in the opinion of the |
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registered professional nurse, the authorized direct care |
staff is no longer competent to administer medication. |
(5) The registered professional nurse shall assess an |
individual's health status at least annually or more |
frequently at the discretion of the registered |
professional nurse. |
This subsection only applies to settings where the |
registered professional nurse has jurisdiction. If direct care |
staff move to other settings, they shall consult with the |
registered professional nurse who has jurisdiction of that |
setting. |
(d) Medication self-administration shall meet the |
following requirements: |
(1) As part of the normalization process, in order for |
each individual to attain the highest possible level of |
independent functioning, all individuals shall be |
permitted to participate in their total health care |
program. This program shall include, but not be limited |
to, individual training in preventive health and |
self-administration of medication self-medication |
procedures. |
(A) Every program shall adopt written policies and |
procedures for assisting individuals who choose to |
obtain in obtaining preventative health and |
self-administration of medication self-medication |
skills in consultation with a registered professional |
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nurse, advanced practice registered nurse, physician |
assistant, or physician licensed to practice medicine |
in all its branches. |
(B) If an individual desires to gain independence |
in self-administration of medication, the individual |
Individuals shall be evaluated to determine the |
individual's their ability to self-administer |
medication self-medicate by the nurse-trainer through |
the use of the Department's required, standardized |
screening and assessment instruments. |
(C) (Blank). When the results of the screening and |
assessment indicate an individual not to be capable to |
self-administer his or her own medications, programs |
shall be developed in consultation with the Community |
Support Team or Interdisciplinary Team to provide |
individuals with self-medication administration. |
(2) Each individual shall be presumed to be competent |
to self-administer medications if: |
(A) authorized by an order of a physician licensed |
to practice medicine in all its branches, an advanced |
practice registered nurse, or a physician assistant; |
and |
(B) approved to self-administer medication by the |
individual's Community Support Team or |
Interdisciplinary Team, which includes a registered |
professional nurse or an advanced practice registered |
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nurse. |
(e) Quality Assurance. |
(1) A registered professional nurse, advanced practice |
registered nurse, licensed practical nurse, physician |
licensed to practice medicine in all its branches, |
physician assistant, or pharmacist shall review the |
following for all individuals: |
(A) Medication orders. |
(B) Medication labels, including medications |
listed on the medication administration record for |
persons who are not self-administering medication |
self-medicating to ensure the labels match the orders |
issued by the physician licensed to practice medicine |
in all its branches, advanced practice registered |
nurse, or physician assistant. |
(C) Medication administration records for persons |
who are not self-administering medication |
self-medicating to ensure that the records are |
completed appropriately for: |
(i) medication administered as prescribed; |
(ii) refusal by the individual; and |
(iii) full signatures provided for all |
initials used. |
(2) Reviews shall occur at least quarterly, but may be |
done more frequently at the discretion of the registered |
professional nurse or advanced practice registered nurse. |
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(3) A quality assurance review of medication errors |
and data collection for the purpose of monitoring and |
recommending corrective action shall be conducted within 7 |
days and included in the required annual review. |
(f) Programs using authorized direct care staff to |
administer medications are responsible for documenting and |
maintaining records on the training that is completed. |
(g) The absence of this training program constitutes a |
threat to the public interest, safety, and welfare and |
necessitates emergency rulemaking by the Departments of Human |
Services and Public Health under Section 5-45 of the Illinois |
Administrative Procedure Act. |
(h) Direct care staff who fail to qualify for delegated |
authority to administer medications pursuant to the provisions |
of this Section shall be given additional education and |
testing to meet criteria for delegation authority to |
administer medications. Any direct care staff person who fails |
to qualify as an authorized direct care staff after initial |
training and testing must within 3 months be given another |
opportunity for retraining and retesting. A direct care staff |
person who fails to meet criteria for delegated authority to |
administer medication, including, but not limited to, failure |
of the written test on 2 occasions shall be given |
consideration for shift transfer or reassignment, if possible. |
No employee shall be terminated for failure to qualify during |
the 3-month time period following initial testing. Refusal to |
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complete training and testing required by this Section may be |
grounds for immediate dismissal. |
(i) No authorized direct care staff person delegated to |
administer medication shall be subject to suspension or |
discharge for errors resulting from the staff person's acts or |
omissions when performing the functions unless the staff |
person's actions or omissions constitute willful and wanton |
conduct. Nothing in this subsection is intended to supersede |
paragraph (4) of subsection (c). |
(j) A registered professional nurse, advanced practice |
registered nurse, physician licensed to practice medicine in |
all its branches, or physician assistant shall be on duty or on |
call at all times in any program covered by this Section. |
(k) The employer shall be responsible for maintaining |
liability insurance for any program covered by this Section. |
(l) Any direct care staff person who qualifies as |
authorized direct care staff pursuant to this Section shall be |
granted consideration for a one-time additional salary |
differential. The Department shall determine and provide the |
necessary funding for the differential in the base. This |
subsection (l) is inoperative on and after June 30, 2000. |
(Source: P.A. 102-1100, eff. 1-1-23.) |