MISSISSIPPI LEGISLATURE
2024 Regular Session
To: Public Health and Welfare
By: Senator(s) Bryan
AN ACT TO CREATE NEW SECTIONS 43-11-28, 43-11-29, 43-11-30 AND 43-11-31, MISSISSIPPI CODE OF 1972, TO ENACT THE MEDICATION AIDE ACT TO AUTHORIZE MEDICATION AIDES TO ASSIST IN THE ADMINISTRATION OF MEDICATIONS IN PERSONAL CARE HOME-ASSISTED LIVING IN THE STATE; TO SET CERTAIN DEFINITIONS; TO ESTABLISH PROHIBITIONS; TO PROVIDE THAT A MEDICATION AIDE MAY PARTICIPATE IN MEDICATION ADMINISTRATION WHEN CERTIFIED THROUGH A MEDICATION AIDE CERTIFICATION PROGRAM IN ACCORDANCE WITH THIS ACT AND GENERALLY MANAGED BY A LICENSED HEALTHCARE PROFESSIONAL AT THE PERSONAL CARE HOME-ASSISTED LIVING; TO SET THE ROUTES BY WHICH AN AIDE MAY ADMINISTER MEDICATIONS; TO REQUIRE CERTAIN RECORDKEEPING PROCEDURES FOR FACILITIES USING A MEDICATION AIDE; TO SET THE MINIMUM COMPETENCIES FOR A MEDICATION AIDE; TO ESTABLISH THE REQUIREMENTS OF A MEDICATION AIDE CERTIFICATION PROGRAM, INCLUDING CURRICULUM STANDARDS, CONTINUING EDUCATION, AND HOUR REQUIREMENTS; TO SET PRACTICUM EXPERIENCE REQUIREMENTS; TO REQUIRE THE DEPARTMENT OF HEALTH TO CREATE A MEDICATION AIDE REGISTRY; TO ESTABLISH CERTAIN DISCIPLINARY PROCEDURES WITHIN THE DEPARTMENT RELATING TO MEDICATION AIDES; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. The following shall be codified as Section 43-11-28, Mississippi Code of 1972:
43-11-28. (1) This act shall be known and may be cited as the Medication Aide Act.
(2) The purpose of the Medication Aide Act is to ensure the health, safety, and welfare of the public by providing for the accurate, cost-effective, efficient and safe utilization of medication aides to assist in the administration of medications in personal care home-assisted living in the State of Mississippi.
(3) As used in this section, the following words shall have
the meanings ascribed herein unless the context clearly requires
otherwise:
(a) "Licensed healthcare professional" means an individual for whom administration of medication is included in the scope of practice.
(b) "MDOH" means the Mississippi Department of Health.
(c) "PRN" means an administration scheme in which a medication is not routine, is taken as needed and requires assessment for need and effectiveness.
(4) A medication aide may participate in medication administration when certified through a Medication Aide Certification program in accordance with this act and generally managed by a licensed healthcare professional at the personal care home-assisted living. In each case, the individual responsible for providing such management and monitoring shall be identified in writing in the administration records.
(5) A medication aide may provide routine or PRN medications by the following routes: (a) oral; (b) inhalation; (c) topical; (d) instillation into the eyes, ears, and nasal sprays; and (e) injections of insulin and injections of prescribed anaphylactic treatments. Routine medications by allowed routes shall not include other injectable medications, vaginal medications and/or rectal medications.
(6) A facility using a medication aide shall keep and maintain accurate medication administration records. The medication administration records shall be available to MDOH for inspection and copying for a period not to exceed six (6) months. The medication administration records shall include any information and data that MDOH requires. MDOH may set these requirements by adopting rules and regulations, which shall be adopted within ninety (90) days of the effective date of this act.
(7) The minimum competencies for a medication aide include the following:
(a) Maintaining confidentiality;
(b) Complying with a recipient's right to refuse to take medication;
(c) Maintaining hygiene and current accepted standards for infection control;
(d) Documenting accurately and completely;
(e) Providing medications appropriately by prescribed orders;
(f) Having the ability to understand and follow instructions;
(g) Practicing safety in application of medication procedures; and
(h) Complying with limitations and conditions under which a medication aide may provide medications.
(8) The minimum standards for competencies listed in subsection (7) of this section, the methods for competency assessment of medication aides and successful completion of medication aid certification training shall be as set forth in this act. This training and competency can be achieved by the successful completion of a Medication Aide Certification program.
SECTION 2. The following shall be codified as Section 43-11-29, Mississippi Code of 1972:
43-11-29. (1) A Medication Aide Certification program shall be a minimum of a fifteen (15) hour training program on the competencies listed in Section 43-11-28 and the standards adopted by the MDOH and may be offered in one of two ways:
(a) By technical or community colleges; or
(b) By a licensed healthcare professional employed at a personal care home-assisted living or through a contractual arrangement with a licensed healthcare professional to administer the program within the personal care home-assisted living.
(2) Regardless of the forum, all Medication Aide Certification programs shall meet the program standards and curriculum standards enumerated herein. Competency assessment shall include passing an examination. Such examination shall be administered after completion of the program by the college or by the licensed healthcare professional as set forth above. Upon obtaining a passing grade, the attending approved instructor shall certify the passing grade and completion of the program and submit the necessary information to MDOH. Upon confirmation of the completion of the program and receipt of the application as required in Section 43-11-31, MDOH shall award a certificate within thirty (30) days of such submittal date.
(3) The length of the Medication Aide Certification program, including practicum experience and supervised medication passes, shall not be less than 15 hours. Approved instructors for Medication Aide Certification programs may include:
(a) Registered nurses (RNs);
(b) Licensed practical nurses (LPNs) who have at least two (2) years of nursing experience;
(c) Licensed pharmacists; or
(d) Licensed physicians.
(4) To maintain certification, each certified medication aide shall be required to complete a bi-annual continuing education program on the provision of medication. The continuing education program shall be no less than two (2) hours in duration. The program may be administered by (i) an approved instructor as defined herein or (ii) online continuing education used by RNs, physical therapists and similar healthcare professionals. Such online continuing education shall have the ability to file completion certificates with the MDH.
(5) Each facility operator utilizing certified medication aides shall have a written policy governing the provision of medications by certified medication aides. The policy shall specify activities that will be performed by certified medication aides; the process to review, monitor and oversee the work of the certified medication aides; the frequency of the activities to be performed; and by whom.
(6) Assisted living facilities shall (a) disclose to its residents and their families that the facility employs and uses medication aides and (b) maintain the following records:
(i) A roster of all certified medication aides employed; and
(ii) Copies of certified medication aide certificates with date of award, including evidence of renewals and continuing education attendance.
(7) Curriculum standards for the medication aid certification program shall integrate instruction that establishes a knowledge base with practicum experience that the student receives at a simulated (or real) treatment setting along with the supervised medication passes that occur.
(8) The program instruction shall include general information relevant to the provision of medication. Topics will include relevant state and federal laws and regulations, terminology, forms of medication, routes of administration, abbreviations/symbols, documentation guidelines and medication references. The program instruction shall focus on the role and scope of practice of the medication aide, as well as what is not within their scope of practice.
SECTION 3. The following shall be codified as Section 43-11-30, Mississippi Code of 1972:
43-11-30. (1) Practicum Experience. This portion of the curriculum will utilize physical facilities that reasonably simulate a health care setting, or utilize an actual health care setting, and the types of medication dispensing systems used by the personal care homes-assisted living facilities in which the applicant(s) will be employed. The approved instructor will design exercises for skill demonstration that simulate the various aspects of safe and effective medication provision and documentation thereof.
(2) Supervised Medication Passes. When instruction and practicum experiences have been successfully completed, each student will be required to demonstrate their competency by successfully completing three (3) medication passes supervised by an approved instructor, including medication setup, delivery and documentation. The student must complete the medication passes independently without verbal and non-verbal prompts or manual assistance. An approved instructor may authorize an LPN who does not satisfy the requirements of an approved instructor to oversee 1:1 supervised medication passes. The approval must be in writing and verify that the LPN is capable of supervising the medication pass.
(3) To register as a medication aide, an individual shall:
(a) Have successfully completed the certification requirements in this Medication Aide Act;
(b) Be at least eighteen (18) years of age; and
(c) File an application with MDOH.
(4) Registration as a medication aide shall be renewed every two (2) years based upon competency. The MDOH may prescribe by rule and regulation how a medication aide can show competency for purposes of renewal, including, but not limited to, showing evidence of completion of continuing educational requirements as set forth in this act.
(5) A registered nurse or licensed practical nurse whose license has been revoked, suspended or voluntarily surrendered in lieu of discipline may not register as a medication aide.
(6) An applicant or medication aide shall report to MDOH, in writing, any conviction for a felony. A conviction is not a disqualification for registration or renewal unless it relates to the competencies identified in Section 43-11-28 or it reflects on the moral character of the applicant or medication aide.
(7) An applicant or medication aide may report any pardon or setting aside of a conviction to the department. If a pardon or setting aside has been obtained, the conviction for which it was obtained shall not be maintained on the Medication Aide Registry.
(8) If a person registered as a medication aide on the Medication Aide Registry becomes licensed as a registered nurse or licensed practical nurse, his or her registration as a medication aide becomes null and void as of the date of licensure.
(9) The department shall list each medication aide registration in the Medication Aide Registry. A listing in the registry shall be valid for the term of the registration and upon renewal unless such aide is refused renewal or is removed as provided in Section 43-11-31.
(10) The registry shall contain the following information on each registrant:
(a) The individual's full name;
(b) Information necessary to identify individuals qualified to provide medications in personal care homes-assisted living;
(c) Any conviction of a felony reported to the department;
(d) Listing of evidence of continuing education received from a personal care home-assisted living; and
(e) Any other information as the department may require by rule and regulation.
(11) The department may deny registration or refuse renewal of or remove a registration from the Medication Aide Registry for failure to meet the standards and competencies or for violation of the Medication Aide Act.
SECTION 4. The following shall be codified as Section 43-11-31, Mississippi Code of 1972:
43-11-31. (1) If the department proposes to deny, refuse renewal of, or remove a registration, it shall send the applicant or registrant a notice setting forth the action to be taken and the reasons for the determination. The denial, refusal to renew, or removal shall become final thirty (30) days after mailing the notice unless the applicant or registrant gives written notice to the department of his or her desire for an informal conference or for a formal hearing. Notice may be served by any method specified in Section 43-11-23.
(2) If an informal conference is requested, the MDOH shall assign a representative of the department to hold an informal conference with the applicant or registrant within fifteen (15) working days after receipt of a request. Within seven (7) working days after the conclusion of such conference, the representative shall affirm, modify or dismiss the action. The representative shall state in writing the specific reasons for affirming, modifying or dismissing the action and shall immediately transmit copies of the statement to the department and to the applicant or the registrant. If the representative affirms or modifies the action, it shall become final unless the applicant or registrant, within ten (10) working days after receipt of the written notice, requests in writing a formal hearing to contest the action.
(3) Except as provided by subsection (2) of this section, an applicant or registrant who desires to contest an action or to further contest an affirmed or modified action shall do so in the manner provided in Section 43-11-23.
(4) A person whose registration has been denied, refused renewal, or removed from the Medication Aide Registry may reapply for registration or for lifting of the disciplinary sanction at any time after one (1) year has elapsed since the date such registration was denied, refused renewal, or removed from the registry, in accordance with the rules and regulations promulgated by the MDOH.
SECTION 5. This act shall take effect and be in force from and after July 1, 2024, and shall stand repealed on June 30, 2024.