| (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. (9) Training for Monitoring Self-Administration of Medications. All residential employees responsible for supervising residents in self-administration of medication, who are not credentialed to dispense medication, shall complete required training before performing this task. (A) The initial training for new employees shall be four (4) hours in length. (B) Employees shall complete a minimum of two (2) 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 (LVN) 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/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. (10) Female Residents. If female residents are housed, access to pregnancy management services shall be available. (11) Mental Health. Access to mental health services shall be available to residents. (12) 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. (13) 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. (14) Informed Consent. 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. (15) 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. (16) Notification. Individuals designated by the resident shall be notified in case of serious illness, injury or death. (17) Health Records. (A) If medical treatment is provided by the facility, accurate health records for residents shall be maintained separately and confidentially. (B) If medical treatment is provided by the facility, 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. (C) If medical treatment is provided by the facility for a resident being transferred to another facility, summaries or copies of the medical history record shall be forwarded to the receiving facility prior to or at arrival. (k) Discharge From CRFs. Discharge from CRFs shall be based on the following criteria: (1) The resident has made alternative housing arrangements as approved by the supervising parole officer; (2) The resident has satisfied a period of placement as a condition of parole or mandatory supervision; (3) The resident has demonstrated non-compliance with program criteria or Board order; or (4) The resident manifests an emergency medical or mental problem that requires hospitalization. (l) Mail, Telephone and Visitation. The facility director shall have written policies which govern the facility's mail, telephone and visitation privileges for residents, including mail inspection, public phone use and routine and special visits. The policies shall address compelling circumstances in which a resident's mail both incoming and outgoing may be opened, but not read, to inspect for contraband. (m) Religious Programs. (1) The facility director shall have written policies that govern religious programs for residents. The policies shall provide that residents have the opportunity to voluntarily practice the requirements of a resident's religious faith, have access to worship/religious services and the use or contact with community religious resources, when appropriate. (2) Under Texas Civil Practice & Remedies Code, Chapter 110, a CRF may not substantially burden a resident's free exercise of religion unless the application of the burden is in furtherance of a compelling governmental interest and is the least restrictive means of furthering that interest. There is a presumption that a policy or practice that applies to a resident in the custody of a CRF is in furtherance of a compelling governmental interest and is the least restrictive means of furthering that interest. The presumption may be rebutted with evidence provided by the resident. |
