Section 481.67.5. Medications.

Each program shall follow its own written medication policy, which shall include the following:

         67.5(1) The program shall not prohibit a tenant from self-administering medications.

         67.5(2) A tenant shall self-administer medications unless:

            a.               The tenant or the tenant’s legal representative delegates in the occupancy agreement or signed service plan any portion of medication setup to the program.

            b.               The tenant delegates medication setup to someone other than the program.

            c.               The program assumes partial control of medication setup at the direction of the tenant. The medication plan shall not be implemented by the program unless the program’s registered nurse deems it appropriate under applicable requirements, including those in Iowa Code section 231C.16A and subrule 67.9(4). The program’s registered nurse must agree to the medication plan.

         67.5(3) A tenant shall keep medications in the tenant’s possession unless the tenant or the tenant’s legal representative, if applicable, delegates in the occupancy agreement or signed service plan partial or complete control of medications to the program. The service plan shall include the tenant’s choice related to storage.

         67.5(4) When a tenant has delegated medication administration to the program, the program shall maintain a list of the tenant’s medications. If the tenant self-administers medications, the tenant may choose to maintain a list of medications in the tenant’s apartment or to disclose a current list of medications to the program for the purpose of emergency response. If the tenant discloses a medication list to the program in case of an emergency, the tenant remains responsible for the accuracy of the list.

         67.5(5) When medication setup is delegated to the program by the tenant, staff via nurse delegation may transfer medications from the original prescription containers or unit dosing into medication reminder boxes or medication cups.

         67.5(6) When medications are administered traditionally by the program:

            a.               The administration of medications shall be provided by a registered nurse, licensed practical nurse or advanced registered nurse practitioner registered in Iowa or by certified and noncertified staff in accordance with subrule 67.9(4) or a physician assistant (PA) in accordance with 645—Chapter 327. Injectable medications shall be administered as permitted by Iowa law by a registered nurse, licensed practical nurse, advanced registered nurse practitioner, physician, pharmacist, or physician assistant (PA).

            b.               Medications shall be kept in a locked place or container that is not accessible to persons other than employees responsible for the administration or storage of such medications.

            c.               The program shall maintain a list of each tenant’s medications and document the medications administered.

            d.               Medications shall be administered as prescribed by the tenant’s physician, advanced registered nurse practitioner or physician assistant.

         67.5(7) Narcotics protocol shall be determined by the program’s registered nurse.

[ARC 8174B, IAB 9/23/09, effective 1/1/10; ARC 0961C, IAB 8/21/13, effective 9/25/13; ARC 1050C, IAB 10/2/13, effective 11/6/13; ARC 2463C, IAB 3/16/16, effective 4/20/16]