MISSISSIPPI LEGISLATURE
2024 Regular Session
To: Public Health and Human Services
By: Representative Creekmore IV
AN ACT TO BE KNOWN AS THE MEDICATION AIDE ACT; TO PROVIDE FOR THE CERTIFICATION OF MEDICATION AIDES BY THE STATE DEPARTMENT OF HEALTH; 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 HEALTH CARE PROFESSIONAL AT A PERSONAL CARE HOME/ASSISTED LIVING FACILITY; TO SPECIFY THE MINIMUM COMPETENCIES FOR A MEDICATION AIDE; TO SPECIFY THE COMPONENTS OF A MEDICATION AIDE CERTIFICATION PROGRAM, WHICH MAY BE OFFERED BY TECHNICAL OR COMMUNITY COLLEGES OR BY A LICENSED HEALTH CARE PROFESSIONAL EMPLOYED AT A PERSONAL CARE HOME/ASSISTED LIVING FACILITY; TO REQUIRE APPLICANTS TO COMPLETE MEDICATION AIDE CERTIFICATION TRAINING AND PASS AN EXAMINATION IN ORDER TO BE CERTIFIED; TO REQUIRE EACH FACILITY OPERATOR USING CERTIFIED MEDICATION AIDES TO HAVE A WRITTEN POLICY GOVERNING THE PROVISION OF MEDICATIONS BY CERTIFIED MEDICATION AIDES; TO REQUIRE PERSONAL CARE HOMES/ASSISTED LIVING FACILITIES TO DISCLOSE TO THEIR RESIDENTS AND THEIR FAMILIES THAT THE FACILITY EMPLOYS AND USES MEDICATION AIDES; TO PRESCRIBE THE CURRICULUM STANDARDS FOR THE MEDICATION AIDE CERTIFICATION PROGRAM AND THE REQUIRED INFORMATION IN THE PROGRAM INSTRUCTION; TO PROVIDE THAT THE DEPARTMENT SHALL HAVE A MEDICATION AIDE REGISTRY FOR PERSONS WHO HAVE BEEN CERTIFIED AS A MEDICATION AIDE; TO PROVIDE THAT 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 ANY PROVISION OF THIS ACT; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) This section shall be known and may be cited as the Medication Aide Act.
(2) The purpose of this 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 homes/assisted living facilities in the State of Mississippi.
(3) As used in this section, the following words shall have the meanings as defined in this subsection unless the context clearly requires otherwise:
(a) "Licensed health care professional" means an individual for whom administration of medication is included in the scope of practice.
(b) "Department" means the State 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 section and generally managed by a licensed health care professional at the personal care home/assisted living facility. 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 the department for inspection and copying for a period not to exceed six (6) months. The medication administration records shall include information and data that the department requires by rules adopted for the administration of this section, which shall be adopted within ninety (90) days after the effective date of this section.
(7) (a) The minimum competencies for a medication aide are: (i) Maintaining confidentiality;
(ii) Complying with a recipient's right to refuse to take medication;
(iii) Maintaining hygiene and current accepted standards for infection control;
(iv) Documenting accurately and completely;
(v) Providing medications appropriately by prescribed orders;
(vi) Having the ability to understand and follow instructions;
(vii) Practicing safety in application of medication procedures; and
(viii) Complying with limitations and conditions under which a medication aide may provide medications.
(b) The minimum standards for competencies listed in paragraph (a) of this subsection, methods for competency assessment of medication aides and successful completion of medication aide certification training shall be as set forth in this section. This training and competency can be achieved by the successful completion of a medication aide certification program.
(c) A medication aide certification program shall be a minimum of a fifteen (15) hour training program on the competencies listed in paragraph (a) of this subsection and the standards adopted by the department and may be offered in one of two (2) ways:
(i) By technical or community colleges; or
(ii) By a licensed health care professional employed at a personal care home/assisted living facility or through a contractual arrangement with a licensed health care professional to administer the program within the personal care home/assisted living facility.
(d) Regardless of the forum, all medication aide certification programs shall meet the program standards and curriculum standards enumerated in this section. Competency assessment shall include passing an examination, which shall be administered after completion of the program by the college or by the licensed health care professional as set forth in paragraph (c) of this subsection. 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 the department. Upon confirmation of the completion of the program and receipt of the application as required in subsection (12) of this section, the department shall award a certificate within thirty (30) days of the date of receipt of the application.
(8) The length of the medication aide certification program, including practicum experience and supervised medication passes, shall not be less than fifteen (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.
(9) To maintain certification, each certified medication aide shall be required to complete a biannual 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:
(a) An approved instructor as defined in subsection (8) of this section; or
(b) Online continuing education used by RNs, physical therapists and similar health care professionals. Such online continuing education shall have the ability to file completion certificates with the department.
(10) (a) Each facility operator using certified medication aides shall have a written policy governing the provision of medications by certified medication aides. The policy shall specify (i) activities that will be performed by certified medication aides; (ii) the process to review, monitor and oversee the work of the certified medication aides; (iii) the frequency of the activities to be performed; and (iv) by whom.
(b) Personal care homes/assisted living facilities shall disclose to their residents and their families that the facility employs and uses medication aides, and 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.
(a) The program instruction shall include general information relevant to the provision of medication. Topics shall 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.
(b) Practicum Experience. This portion of the curriculum shall use physical facilities that reasonably simulate a health care setting, or use 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 shall design exercises for skill demonstration that simulate the various aspects of safe and effective medication provision and documentation thereof.
(c) Supervised medication passes. When the 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 nonverbal prompts or manual assistance. An approved instructor may authorize an LPN who may 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.
(12) (a) To register as a medication aide, an individual must (i) have successfully completed the certification requirements in this section; (ii) be at least eighteen (18) years of age; (iii) file an application with the department.
(b) Registration as a medication aide shall be renewed every two (2) years based upon competency. The department may prescribe by rule 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 section.
(c) 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.
(d) An applicant or medication aide shall report to the department, 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 subsection (7) of this section or it reflects on the moral character of the applicant or medication aide.
(e) 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.
(f) 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.
(13) (a) 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 subsection (12) of this section.
(b) The registry shall contain the following information on each registrant:
(i) The individual's full name;
(ii) Information necessary to identify individuals qualified to provide medications in personal care homes/assisted living facilities;
(iii) Any conviction of a felony reported to the department; and
(iv) Listing of evidence of continuing education received from a personal care home/assisted living facility; and (v) Other information as the department may require by rule.
(b) 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.
(c) The notice may be given by United States certified mail, return receipt requested, to the last known address of the applicant or registrant.
(15) If an informal conference is requested, the department 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.
(16) Except as provided by subsection (15) of this section, an applicant or registrant who desires to contest an action or to further contest an affirmed or modified action shall give written notice to the department. The executive director of the department shall be the decision-maker in a contested case under this section. The hearings on a petition for judicial review of any final decision regarding an action for an alleged violation shall be set for hearing at the earliest possible date. The times for pleadings and hearings in such action shall be set by the judge of the court with the object of securing a decision at the earliest possible time.
(17) 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.
SECTION 2. This act shall take effect and be in force from and after July 1, 2024.