|(a) Purpose. The purpose of this section is to provide
the qualifications, conduct, and practice activities of a medication
aide employed in a correctional facility or employed by a medical
services contractor for a correctional facility.
(b) Supervision and applicable law and rules. A medication
aide must function under the direct supervision of a licensed nurse
on duty or on call by the correctional facility using the medication
aide. A medication aide must:
(1) function in accordance with applicable law and
rules relating to administration of medication and operation of a
correctional facility; and
(2) comply with TDCJ rules applicable to personnel
used in a correctional institution.
(c) Allowable and prohibited practices of a medication
(1) A medication aide may:
(A) observe and report to the correctional facility's
charge nurse reactions and side effects to medication shown by an
(B) take and record vital signs before the administration
of medication which could affect or change the vital signs;
(C) administer regularly prescribed medication to an
inmate if the medication aide:
(i) is trained to administer the medication;
(ii) personally prepares the medication or sets up
the medication to be administered; and
(iii) documents the administration of the medication
in the inmate's clinical record;
(D) administer oxygen per nasal cannula or a non-sealing
mask only in an emergency, after which the medication aide must verbally
notify the licensed nurse on duty or on call and appropriately document
the action and notification;
(E) apply specifically ordered ophthalmic, otic, nasal,
vaginal, and rectal medication;
(F) administer previously ordered PRN medication. A
medication aide must document in the inmate's records, symptoms indicating
the need for the medication, and the time the symptoms occurred;
(G) administer the initial dose of a medication;
(H) order an inmate's medications from the correctional
(I) measure a prescribed amount of a liquid medication
to be administered;
(J) break a tablet for administration to an inmate
(i) the licensed nurse on duty or on call has calculated
the dosage; and
(ii) the inmate's medication card or its equivalent
accurately documents how the tablet must be altered before administration;
(K) crush medication if:
(i) authorization is obtained from the licensed nurse
on duty or on call; and
(ii) the authorization is documented on the inmate's
medication card or its equivalent.
(2) A medication aide may not:
(A) administer medication by the injection route including:
(iv) intradermal; and
(B) administer medication used for intermittent positive
pressure breathing treatments or any form of medication inhalation
(C) calculate an inmate's medication dose for administration;
(D) crush medication, except in accordance with paragraph
(1)(K) of this subsection;
(E) administer medications or feedings by way of a
tube inserted in a cavity of the body;
(F) receive or assume responsibility for reducing to
writing a verbal or telephone order from a physician, dentist, or
(G) apply topical medications that involve the treatment
of skin that is broken or blistered or when a specified aseptic technique
is ordered by the attending licensed practitioner;
(H) steal, divert, or otherwise misuse medications;
(I) violate any provision of Texas Human Resources
Code §161.083, or this chapter;
(J) fraudulently procure or attempt to procure a permit;
(K) neglect to administer appropriate medications,
as prescribed, in a responsible manner; or
(L) administer medications if the person is unable
to do so with reasonable skill and safety to residents by reason of
drunkenness or excessive use of drugs, narcotics, chemicals, or any
other type of material.
(d) Background and education requirements. Before applying
for a corrections medication aide permit under Texas Human Resources
Code §161.083, an applicant must be:
(1) able to read, write, speak, and understand English;
(2) at least 18 years of age;
(3) free of communicable diseases and in suitable physical
and emotional health to safely administer medications;
(4) a graduate of a high school or successfully passed
a general educational development test; and
(5) employed in a correctional facility or by a medical
service contractor for a correctional facility on the first day of
an applicant's medication aide training program.
(e) Application. An applicant for a corrections medication
aide permit under Texas Human Resources Code §161.083 must submit
an official Corrections Medication Aide application form to HHSC.
(1) An applicant must submit the general statement
enrollment form that contains:
(A) specific information regarding personal data, certain
misdemeanor and felony convictions, work experience, education, and
(B) a statement that all the requirements in subsection
(d) of this section were met before the start of the program;
(C) a statement that the applicant understands that
application fees submitted in the permit process are nonrefundable;
(D) a statement that the applicant understands material
submitted in the application process are nonreturnable;
(E) a statement that the applicant understands that
it is a misdemeanor to falsify any information submitted to HHSC;
(F) the applicant's dated and notarized signature.
(2) An applicant must submit a certified copy or a
photocopy that has been notarized as a true and exact copy of an unaltered
original of the applicant's high school graduation diploma or transcript,
or the written results of a general educational development (GED)
(3) HHSC verifies the accreditation of the high school
that issued the diploma or transcript, or the testing service or program
that certified the GED test required by paragraph (2) of this subsection.
If HHSC is unable to verify the accreditation status of the school,
testing service, or program, and HHSC requests additional documentation
from the applicant to verify the accreditation status, the applicant
must provide the documentation to HHSC.
(4) HHSC considers a corrections medication aide permit
application as officially submitted when HHSC receives the permit
(5) HHSC sends a notice listing the additional materials
required to an applicant who does not complete the application. An
application not completed by the day of the TDCJ final exam is void.
(6) HHSC sends notice of application approval or deficiency
in accordance with §557.127 of this chapter (relating to Application
(f) Fees. An applicant must pay application and permit
renewal fees for a corrections medication aide permit by cashier's
check or money order made payable to the Health and Human Services
Commission. All fees are nonrefundable, except as provided by Texas
Government Code, Chapter 2005. The fee schedule is as follows:
(1) permit application fee--$15;
(2) renewal fee--$15;
(3) late renewal fees for permit renewals made after
the permit expires:
(A) $22.50 for an expired permit renewed from one to
90 days after expiration;
(B) $30 for an expired permit renewed from 91 days
to one year after expiration; and
(4) permit replacement fee--$5.
(g) Examination procedures. TDCJ gives a written examination
to each applicant at a site determined by TDCJ. An applicant with
a disability, including an applicant with dyslexia as defined in Texas
Education Code §51.970 (relating to Instructional Material for
Blind and Visually Impaired Students and Students with Dyslexia),
may request a reasonable accommodation for the examination under the
Americans with Disabilities Act.
(1) The applicant must meet the requirements of the
TDCJ training program described in §557.119(d) of this chapter
(relating to Training Program Requirements) before taking the written
(2) The applicant must be tested on the subjects taught
in the TDCJ training program curriculum and correctional facility
clinical experience. The examination must test an applicant's knowledge
of accurate and safe drug therapy administered to a correctional facility
(3) TDCJ administers the examination and determines
the passing grade.
(4) TDCJ must inform HHSC, on the HHSC class roster
form, of the final exam results for each applicant within 15 days
after completion of the exam.
(5) An applicant who is unable to attend the applicant's
scheduled examination due to unforeseen circumstances must contact
TDCJ to reschedule.
(6) If an applicant fails the examination, TDCJ notifies
HHSC and the applicant in writing of the failure to pass the examination.
The applicant may take one subsequent examination without having to
re-enroll in the training program described in §557.119 of this
(7) An applicant whose application for a permit is
denied under §557.113 of this chapter (relating to Determination
of Eligibility) is ineligible to take the examination.
(h) Determination of eligibility. HHSC determines eligibility
for a corrections medication aide permit applicant according to §557.113
of this chapter and subsections (d) - (g) of this section.
(i) Renewal. A permit must be renewed in accordance
with §557.115 of this chapter (relating to Permit Renewal).
(j) Changes. Medication aides must report changes in
accordance with §557.117 of this chapter (relating to Changes).
(k) Violations, complaints, and disciplinary actions.
(1) Complaints. Any person may complain to HHSC alleging
that a person or program has violated Texas Human Resources Code §161.083,
or this chapter. HHSC handles complaints in the manner set forth in
§557.123 of this chapter (relating to Violations, Complaints,
and Disciplinary Actions).
(2) Investigations of abuse and neglect complaints.
Allegations of abuse and neglect of inmates by corrections medication
aides are investigated by the TDCJ Office of Inspector General. After
an investigation, the TDCJ Office of Inspector General issues a report
to HHSC with findings of abuse or neglect against the corrections
medication aide. After reviewing the report and findings, HHSC determines
whether to initiate a formal proceeding to revoke, suspend, or refuse
to renew a corrections medication aide permit. If HHSC determines
a formal proceeding to revoke, suspend, or refuse to renew a corrections
medication aide permit should be initiated, §557.123(c) and (d)
of this chapter apply. If HHSC determines that no formal proceeding
to revoke, suspend, or refuse to renew a corrections medication aide
permit should be initiated, HHSC dismisses the complaint against the
corrections medication aide and gives written notice of the dismissal
to the corrections medication aide.
(l) Section 557.121 of this chapter (relating to Permitting
of Persons with Criminal Backgrounds) applies to corrections medication
aides under this chapter.