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The Oregon Administrative Rules contain OARs filed through June 15, 2014
 
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OREGON YOUTH AUTHORITY

 

DIVISION 340

MEDICATION MANAGEMENT

416-340-0000

Purpose

This rule provides for consistent practice in the storage, control and administration of medication to offenders in OYA custody in close custody facilities or community substitute care placements.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05

416-340-0010

Definitions

(1) Controlled medication: DEA-controlled substances including medications that come under the jurisdiction of the Federal Controlled Substances Act (e.g. narcotics, amphetamines, and certain pain and sleeping medications). These medications have a high risk for abuse or dependence.

(2) Informed consent: The agreement by a patient (over age 14 for mental health treatment, and over age 15 for medical treatment) to treatment, examination, or procedure after the patient receives facts regarding the nature, consequences, and risks of the proposed treatment, examination or procedure. Informed consent requires that the person giving the consent understands the facts, implications, and potential consequences of an action. Written documentation of consent by an offender or his/her guardian is required for invasive procedures in which there is some risk.

(3) Medication Administration Record (MAR): The written record used to document the administration of all medication to offenders.

(4) Pro re nata (PRN): Administered as needed.

(5) Psychotropic Medication: Medication prescribed to alter brain function for purposes of treating problems with thought processes, mood, or behavior. Psychotropic medications include stimulants, antipsychotics, mood stabilizers, anxiolytics, and sedatives.

(6) Substitute care: Residential placements in the community that provide 24-hour-a-day care and supervision, excluding a relative’s home. Such placements include, but are not limited to:

(a) Foster care; and

(b) Proctor care; and

(c) Contracted residential treatment providers.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05; OYA 2-2009, f. 4-14-09, cert. ef. 4-17-09

416-340-0020

General Standards

(1) The use of medication will be solely for the health and welfare of the individual offender.

(a) Whether medication is to be used or not used and under what conditions is the sole responsibility of the attending licensed prescriber.

(b) Prescription orders will be authorized by persons who are licensed by the State of Oregon to prescribe medication.

(c) Prescription medications will be administered according to the prescriber's order and given only to the offender to whom the medication is prescribed.

(2) Consent:

(a) Pursuant to ORS 109.675 offenders 14 years of age or older may obtain, without parental knowledge or consent, outpatient diagnosis or treatment of a mental or emotional disorder, or a chemical dependency excluding methadone maintenance, by a physician, licensed psychologist, nurse practitioner or licensed clinical social worker.

(b) Pursuant to ORS 109.640, offenders 15 years of age or older may obtain, without parental consent, medical treatment, including immunizations.

(c) Pursuant to ORS 433.267, offenders 15 years of age or older may sign, on their own behalf, exemption from immunizations forms available through the Department of Public Health, if the signature would otherwise be required of the offender’s parent or legal guardian.

(d) If an offender is otherwise incapable of giving consent, no psychotropic stimulant or tranquilizing drugs will be administered to the offender without his/her informed consent, unless withholding of the drug would seriously endanger the offender's health.

(3) Pharmacy packaging and dispensing of medications administered in close custody facilities will follow Oregon administrative rule governing pharmacy practice for correctional facilities and the Nurse Practice Act.

(a) All medications will be properly labeled, including labels on prescription medications that match the prescriber's written order. All nontopical prescribed medications administered in close custody facilities will be unit dosed.

(b) Prescriptions that are not administered will be returned to the dispensing pharmacy or properly disposed.

(4) Any medical information received from a medical practitioner will be placed in the offender's permanent medical record.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05; OYA 2-2009, f. 4-14-09, cert. ef. 4-17-09; OYA 4-2009, f. 10-27-09, cert. ef. 10-28-09

416-340-0030

Medication Administration

Medications, including those issued over-the-counter, will be kept in a secured, locked container in a location designated as a limited access area.

(1) Medication will be stored as prescribed (medication requiring refrigeration will be kept under refrigeration in a locked box).

(2) Controlled medications will be stored under two locks.

(3) Oral and injectable medications will be stored separately from topical medications.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05; OYA 2-2009, f. 4-14-09, cert. ef. 4-17-09

416-340-0040

Medication Records

(1) All medications administered to offenders in close custody will be tracked on a Medication Administration Record (MAR).

(2) All medications administered to offenders in substitute care placement must be tracked by substitute care providers.

(3) Any unusual, uncommon, or severe side effects related to medications (both prescription and over-the-counter) will be documented, and an offender will receive appropriate treatment as necessary.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05; OYA 2-2009, f. 4-14-09, cert. ef. 4-17-09

416-340-0050

Intra-muscular (IM) Injections

(1) IM injections may be administered only by a physician, nurse practitioner, Registered Nurse (RN), or Licensed Practical Nurse (LPN).

(2) Except in an emergency as determined by a qualified physician, prescribed medication will not be administered IM, unless given in a clinical facility equipped to deal with possible adverse effects.

(3) No offender will receive an IM injection of major tranquilizing drugs unless a physician authorizes its use prior to each injection. Exception: When a physician finds a series of IM injections are necessary for treatment, a new prescription will not be required for each injection, provided that:

(a) If a series of shots are given within any 24-hour period, the offender, at the end of that period, will be evaluated by the physician to determine whether a transfer to a psychiatric facility would be in his/her best interests.

(b) A new prescription will be written for any additional series of injections at the end of each 24-hour period.

(4) Routine injections may be authorized by a physician and are not subject to requirements of this section.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05

416-340-0060

Psychotropic Medications

(1) Psychotropic medications will be prescribed by a physician or nurse practitioner through a written order.

(2) The use of medication to alter behavior, thought processes or mood will be based solely on a physician's determination that the medication is in the best medical interests of the offender.

(3) Psychotropic medications will be reviewed no less than every 90 days:

(a) By the prescribing physician or nurse practitioner for desired responses and adverse consequences; and

(b) To determine the continued need and/or lowest effective dosage in a carefully monitored program.

(4) Oral administration of psychotropic drugs is the preferred method.

(5) Psychotropic medication may have PRN status only when the prescriber has ordered PRN status, and a nurse has documented written parameters specific to an offender's care, per Board of Nursing administrative rules.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05; OYA 2-2009, f. 4-14-09, cert. ef. 4-17-09

416-340-0070

Medication Management in Substitute Care

(1) A substitute care provider will comply with all rules in this Division unless specifically noted.

(2) A substitute care provider will keep a record of the offender's medical history. These records will be kept current and organized in a manner that clearly shows the medical needs of the offender. These records must be forwarded to the Oregon Youth Authority upon an offender’s placement change, or placement termination.

(3) A substitute care provider will notify the offender's Juvenile Parole/Probation Officer (JPPO) within one working day of any new prescription for psychotropic medication.

(4) A substitute care provider will notify the offender's JPPO within one working day if an offender 14 years of age or older becomes known to be diagnosed or treated for any mental or emotional disorder or chemical dependency.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 418.517, 420A.010, 420A.014 & 420.054
Hist.: OYA 2-1995, f. 12-19-95, cert. ef. 1-2-96; OYA 6-2005, f. & cert. ef. 3-25-05; OYA 2-2009, f. 4-14-09, cert. ef. 4-17-09

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