| (ii) Drug allergies or the absence of known drug allergies;
(iii) Name, strength of medication, and route of administration;
(iv) Instructions for taking the medication, the amount
taken, and the route of administration;
(v) Date and time the medication was provided;
(vi) Prescription number, or lot number for sample
drugs, and the initial amount of medication received;
(vii) Prescribing physician, advanced practice nurse
or physician assistant, and the name of the pharmacy;
(viii) Signature of the resident receiving the medication
and the staff member supervising the self-administration of medication;
(ix) The remaining amount of medication after each
dose dispensed; and
(x) Comment section for recording a variance, discrepancy,
or change.
(D) Each dose of OTC medication received by the resident
shall be documented on the OTC medication administration record and
maintained in the resident's medical file. The OTC drugs purchased
by the resident or supplied for the resident in quantities larger
than single dose packages shall be recorded on the OTC drug record.
The OTC drug record shall include:
(i) The resident's name;
(ii) The name and strength of the medication dispensed;
(iii) Drug allergies or the absence of known drug allergies;
(iv) The dosage instructions and route of administration;
(v) The initial amount received, OTC lot number, and
the expiration date;
(vi) The date and time the medication was dispensed;
(vii) The amount dispensed and the ending count after
each dose;
(viii) Comment section for recording reason for OTC
drug or other notations; and
(ix) The signature of the resident and the employee
who supervised each dose dispensed.
(E) Facility Stock OTC Drugs. Multiple OTC stock drugs
supplied in single dose packaging may be recorded on the same form.
The medication drug record for facility stock OTC drugs shall include:
(i) The resident's name;
(ii) The name, strength, and route of administration;
(iii) Drug allergies or the absence of known drug allergies;
(iv) The date, time, amount dispensed, and the lot
number on the container;
(v) Comment section to record the reason the OTC drug
was requested; and
(vi) The signature of the resident and the employee
who supervised each dose dispensed.
(10) Training for Monitoring Self-Administration of
Medications. All residential employees responsible for supervising
residents in self-administration of medication, who do not have credentials
to dispense medication, shall complete required training before performing
this task.
(A) The initial training for new employees shall be
four hours in length.
(B) Employees shall complete a minimum of two hours
of review training annually thereafter.
(C) The training shall be provided by a physician,
pharmacist, physician assistant, or registered nurse before supervising
self-administration of medications. A licensed vocational nurse or
paramedic, under supervision, may teach the course from an established
curriculum. Topics to be covered shall include:
(i) Prescription labels;
(ii) Medical abbreviations;
(iii) Routes of administration;
(iv) Use of drug reference materials;
(v) Monitoring and observing insulin preparation and
administration;
(vi) Storage, maintenance, handling, and destruction
of medication;
(vii) Transferring information from prescription labels
to the medication administration record and documentation requirements,
including sample medications; and
(viii) Procedures for medication errors, adverse reactions,
and side effects.
(11) Female Residents. If female residents are housed,
access to pregnancy management services shall be available.
(12) Mental Health. Access to mental health services
shall be available to residents.
(13) Suicide Prevention. Each facility shall have a
written suicide prevention and intervention program reviewed and approved
by a qualified medical or mental health professional. All staff with
resident supervision responsibilities shall be trained in the implementation
of the suicide prevention program.
(14) Personnel.
(A) If treatment is provided to residents by health
care personnel other than a physician, psychiatrist, dentist, psychologist,
optometrist, podiatrist, or other independent provider, such treatment
shall be performed pursuant to written standing or direct orders by
personnel authorized by law to give such orders.
(B) If the facility provides medical treatment, personnel
who provide health care services to residents shall be qualified and
appropriately licensed. Verification of current credentials and job
descriptions shall be on file in the facility. Appropriate state and
federal licensure, certification or registration requirements, and
restrictions apply.
(15) Informed Consent.
(A) If the facility provides medical treatment, the
facility shall ensure residents are provided information to make medical
decisions with informed consent. All informed consent standards in
the jurisdiction shall be observed and documented for resident care.
(B) If the facility provides medical treatment and
a resident makes an informed decision to refuse any medical procedure
or treatment, the facility shall ensure that written documentation
of the resident's refusal is maintained in the resident's medical
record.
(16) Participation in Research. Residents shall not
participate in medical, pharmaceutical, or cosmetic experiments. This
does not preclude individual treatment of a resident based on resident's
need for a specific medical procedure that is not generally available.
(17) Notification. Individuals designated by the resident
shall be notified in case of critical illness or injury.
(18) Health Records. If medical treatment is provided
by the facility:
(A) Accurate health records for residents shall be
maintained separately and confidentially;
(B) The method of recording entries in the records,
the form and format of the records, and the procedures for maintenance
and safekeeping shall be approved by the health authority; and
(C) For the residents being transferred to other facilities,
summaries or copies of the medical history record shall be forwarded
to the receiving facility prior to or at arrival.
(o) Discharge From Residential Facilities.
(1) Victim Notification. The CSCD director and facility
director shall ensure there are procedures, policies, and practices
that comply with Texas Government Code §76.016, Texas Code of
Criminal Procedure art. 42.21(a) and other applicable laws as to the
notifications made to certain crime victims of offenders who are residents
in its facilities or subject to its programs.
(2) Discharge. Discharge from residential facilities
shall be based on the following criteria:
(A) The resident has made sufficient progress towards
meeting the objectives of the supervision plan and program requirements;
(B) The resident has satisfied a sentence of confinement;
(C) The resident has satisfied a period of placement
as a condition of community supervision or satisfied the conditions
of a pre-trial agreement signed by a judge presiding over an established
drug court;
(D) The resident has demonstrated non-compliance with
program criteria or court order;
(E) The resident manifests a non-emergency medical
problem that prohibits participation in or completion of the residential
program requirements;
(F) The resident displays symptoms of a psychological
disorder that prohibits participation in or completion of the residential
program requirements; or
(G) The resident is identified as inappropriate or
ineligible for participation in the residential program as defined
by facility eligibility criteria, statute, or standard.
(3) Discharge Report. The CSCD director and facility
director shall ensure a report is prepared at the termination of program
participation that reviews the resident's performance. A copy of the
report shall be provided to the receiving CSCD community supervision
officer.
(p) Basic Services and Programs.
(1) Each facility shall, at a minimum, provide programs
in the following areas which shall include, but not be limited to:
(A) Education programs;
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