§ 1438. Pharmaceutical Management.

For all juvenile facilities, the health administrator, in consultation with a pharmacist and in cooperation with the facility administrator, shall develop and implement written policy, establish procedures, and provide space and accessories for the secure storage, controlled administration, and disposal of all legally obtained drugs.

(a) Such policies, procedures, space and accessories shall include, but not be limited to, the following:

(1) securely lockable cabinets, closets, and refrigeration units;

(2) a means for the positive identification of the recipient of the prescribed medication;

(3) administration/delivery of medicines to youth as prescribed;

(4) confirmation that the recipient has ingested the medication;

(5) documenting that prescribed medications have or have not been administered, by whom, and if not, for what reason;

(6) prohibition of the delivery of medication from one youth to another;

(7) limitation to the length of time medication may be administered without further medical evaluation;

(8) the length of time allowable for a physician's signature on verbal orders, not to exceed seven (7) days;

(9) training for non-licensed personnel which includes, but is not limited to: delivery procedures and documentation; recognizing common symptoms and side-effects that should result in contacting health care staff for evaluation; procedures for consultation for confirming ingestion of medication; and, consultation with health care staff for monitoring the youth's response to medication; and,

(10) a written report shall be prepared by a pharmacist, no less than annually, on the status of pharmacy services in the institution. The pharmacist shall provide the report to the health authority and the facility administrator.

(11) transition planning.

(b) Consistent with pharmacy laws and regulations, the health administrator shall establish written protocols that limit the following functions to being performed by the identified personnel:

(1) Procurement shall be done only by a physician, dentist, pharmacist, or other persons authorized by law.

(2) Storage of medications shall assure that stock supplies of legend medications shall only be accessed by licensed health personnel. Supplies of legend medications that have been properly dispensed and supplies of over-the-counter medications may be accessed by both licensed and trained non-licensed personnel.

(3) Repackaging shall only be done by a physician, dentist, pharmacist, or other persons authorized by law.

(4) Preparation of labels can be done by a physician, dentist, pharmacist or other personnel, both licensed and trained non-licensed, provided the label is checked and affixed to the medication container by the physician, dentist, or pharmacist before administration or delivery to the youth. Labels shall be prepared in accordance with Section 4047.5 of the Business and Professions Code.

(5) Dispensing shall only be done by a physician, dentist, pharmacist, or other person authorized by law.

(6) Administration of medication shall only be done by licensed health personnel who are authorized to administer medication and acting on the order of a prescriber.

(7) Licensed health care personnel and trained non-licensed personnel may deliver medication acting on the order of a prescriber.

(8) Disposal of legend medication shall be done in accordance with pharmacy laws and regulations and requires any combination of two of the following classifications: physician, dentist, pharmacist, or registered nurse. Controlled substances shall be disposed of in accordance with Drug Enforcement Administration disposal procedures.

(c) The responsible physician shall establish policies and procedures for managing and providing over-the-counter medications to youth.

HISTORY

1. New section filed 3-6-97; operative 4-5-97 (Register 97, No. 10).

2. Amendment of subsections (a)(7) and (a)(8) and new subsection (a)(9) filed 1-11-2001; operative 2-10-2001 (Register 2001, No. 2).

3. Amendment filed 6-23-2003; operative 7-23-2003 (Register 2003, No. 26).

4. Amendment of subsection (b)(7) filed 6-18-2007; operative 7-18-2007 (Register 2007, No. 25).

5. Amendment of first paragraph and subsections (a)(3), (a)(6), (a)(8) and (a)(9), new subsection (a)(11), amendment of subsections (b)(4) and (c) and amendment of Note filed 12-2-2013; operative 4-1-2014 (Register 2013, No. 49).

Note

Note: Authority cited: Sections 210 and 885, Welfare and Institutions Code. Reference: Section 209, Welfare and Institutions Code.