TITLE 59: MENTAL HEALTH
CHAPTER I: DEPARTMENT OF HUMAN SERVICES
PART 116 ADMINISTRATION OF MEDICATION IN COMMUNITY SETTINGS
SECTION 116.20 DEFINITIONS
Section 116.20 Definitions
The words and phrases used in this Part shall mean the following, except where a different meaning is clearly intended from the context:
"Administer" or "Administration." An act in which a single dose of medication is instilled into the body of, applied to the body of, or otherwise given to a person for immediate consumption or use, exclusive of injection or other similar methods of transmission.
"Adverse drug reaction." A person's response to medication that has an undesirable effect and may be harmful to the health of a person. The reaction may be temporary and resolve itself without lasting effects or it may require interventions to be resolved.
"Agency." Any organization that operates a residential program for persons with developmental disabilities.
"Authorized direct care staff." Non-licensed persons who have successfully completed a medication administration training program specified by the Illinois Department of Human Services (DHS) and conducted by a nurse-trainer. This authorization is specific to an individual receiving services in a specific agency and does not transfer to another agency [20 ILCS 1705/15.4(b)] or individual.
"Community residence." Any residence funded by DHS and provided by a licensed agency, or a residential setting certified or approved by DHS, or an intermediate care facility for 16 or fewer persons with developmental disabilities, licensed by the Illinois Department of Public Health (DPH) as an Intermediate Care Facility for the Developmentally Disabled (ICF/DD-16), 16 beds or fewer.
"Competency-based." Training which is tied to an identified set of skills and knowledge and requires documentation of an acceptable level of performance of a task or achievement of an outcome.
"Controlled substance." Any drug or other substance listed pursuant to a schedule in the Illinois Controlled Substances Act [720 ILCS 570].
"Days." Unless otherwise indicated, all references to days within the text of this Part refers to working days.
"DD Clinical Director." The physician serving as the clinical director of the Office of Developmental Disabilities, Division of Disability and Behavioral Health Services, Illinois Department of Human Services, or designee.
"Delegation." The transfer of responsibility for the performance of selected tasks by the registered nurse (RN) to qualified, competent assistive personnel in a selected situation, based upon the RN's plan of care. The RN retains professional accountability for the outcome of the delegated task and all the nursing care of the individual. No redelegation by assistive personnel may occur.
"Department." The Illinois Department of Human Services (DHS).
"Distribute or distribution." The act of controlling access to medications and allowing access by individuals to their medications at prescribed times.
"DPA." The Illinois Department of Public Aid.
"DPH." The Illinois Department of Public Health.
"Functional literacy." An individual's ability to read, write, speak, compute and solve problems at levels of proficiency necessary to function on the job as assessed by standardized techniques.
"Guardian." The parent of a child under the age of 18 whose parental rights have not been terminated or a person appointed by a court to be guardian of the individual.
"Individual." Any person with a developmental disability receiving services from a program.
"Intermediate care facility for the developmentally disabled (ICF/DD-16)." A residence licensed by the Illinois Department of Public Health to provide health or habilitative care on a long-term basis for 16 or fewer individuals with developmental disabilities.
"Licensed person or personnel." A physician, a registered professional nurse, an advanced practice nurse, a licensed practical nurse, a dentist, a pharmacist, a physician assistant, or a podiatrist licensed in the State of Illinois.
"Master nurse-trainer." An employee of DHS who is a registered professional nurse who has been designated by the DD Clinical Director to train/educate nurse-trainers.
"Medication." A drug prescribed for the individual by a physician, a physician assistant, an advanced practice nurse, a dentist, a podiatrist, or a certified optometrist, including drugs to be taken on a PRN basis and over-the-counter drugs.
"Medication error." The administration of medication other than as prescribed resulting in the wrong medication being taken, or medication being taken at the wrong time, or in the wrong dosage, or via the wrong route, or by the wrong person, or omitted entirely. It is meant to include a lack of documentation of medication administration or any error in that documentation. Medication errors must be reported to the DHS Bureau of Quality Enhancement or to the Illinois Department of Public Health Regional Office (if the individual is a resident of an ICF/DD-16) in accordance with written instructions from the Department's Bureau of Quality Enhancement or DPH rules (77 Ill. Adm. Code 350). All medication errors are subject to review by DHS or DPH, whichever is applicable. Medication errors that meet the reporting criteria pursuant to the Department's rules on Office of Inspector General Investigations of Alleged Abuse or Neglect or Deaths in State-Operated and Community Agency Facilities (59 Ill. Adm. Code 50) shall be reported to the Office of Inspector General.
"Medication administration record." A written record of medications prescribed for, and administered to, an individual.
"Non-licensed staff training program." A standardized competency-based medication administration training program approved by the Illinois Department of Human Services. It is conducted by a nurse-trainer for the purpose of training persons employed or under contract to provide direct care or treatment to individuals receiving services to administer medications and implement self-administration of medication training to individuals under the supervision and monitoring of the nurse-trainer. It incorporates adult learning styles, teaching strategies, classroom management, curriculum overview including ethical-legal aspects, and standardized competency-based evaluations on administration of medications and self-administration of medication training programs. [20 ILCS 1705/15.4(b)]
"Normalization." A philosophy under which persons with a developmental disability are provided or restored to patterns and conditions of everyday life which are as close as possible to norms and patterns of the mainstream of society.
"Nurse-trainer." A registered professional nurse and/or advanced practice nurse who has successfully completed the DHS nurse-trainer training program.
"Nurse-Trainer Training Program." A standardized competency-based medication administration program provided by the Illinois Department of Human Services and conducted by a DHS master nurse-trainer. Nurse-trainers shall train persons employed or under contract to provide self-administration of medication training to individuals under the supervision and monitoring of the nurse-trainer. It incorporates adult learning styles, teaching strategies, classroom management and a curriculum overview including the ethical and legal aspects of supervising those administering medication. [20 ILCS 1705/15.4(b)]
"Patent or proprietary medications." Medications and household remedies that are generally considered and accepted as harmless and nonpoisonous when used according to the directions on the label and for which there are written physician orders for their use.
"Physician." A physician licensed to practice medicine in all of its branches.
"PRN." Prescribed medications, to be taken as needed, for specific conditions.
"Registered professional nurse." A person licensed as a professional nurse as defined in the Illinois Nursing and Advanced Practice Nursing Act [225 ILCS 65].
"Self-administration." An act in which an individual administers his or her own medications. To be considered "capable of self-administering medications", individual residents must, at a minimum, be able to identify prescribed medication by size, shape, or color and know when it should be taken and in what amount it should be taken each time. [20 ILCS 1705/15.4(b)]
"Substantial compliance." Meeting the requirements set forth in this Part, except for variations from the strict and literal performance of such requirements that result in insignificant omissions and defects, given the particular circumstances and the history of those omissions and defects. Omissions that have an adverse impact on an individual's health and safety shall be considered significant and shall be considered substantial noncompliance.
"Supervision." An active process in which the Registered Professional Nurse monitors, directs, guides, and evaluates the outcomes of an activity or task. The registered nurse maintains the accountability for the tasks and responsibilities, as subcomponents of total patient care, delegated to qualified competent assistive personnel.