SECTION 1. Section 80B of chapter 112 of the General Laws, as so appearing, is hereby amended by inserting after the tenth paragraph the following 5 paragraphs: -
Registered nurses may delegate the administration of or assistance with the administration of medications in the home to a home health aide as defined under 42 CFR 484.80 or to a hospice aide as defined under 42 CFR 418.76; provided, that the home health aide has completed training on medication administration and meets requirements according to regulations promulgated by the board in conjunction with the department of public health and that the administration or assistance with administration is performed under the supervision of a registered nurse. Such delegation authority shall not apply to nurses providing services under the Continuous Skilled Nursing Agency regulations (130 CMR 438.000).
The delegation of medication administration to a home health aide permitted under this section shall exclude controlled substances pursuant to Section 31 of Chapter 94c of the General Laws. Medication administration under this section shall include methods which are oral, ophthalmic, optic, topical, internasal, transdermal, suppository, prefilled auto-injectables designed for self-administration, or products which are administered by inhalation. The delegation of administration methods including intramuscular, subcutaneous, intradermal that are not prefilled auto-injectables designed for self-administration, intraosseous or intravenous administration of medication shall not be permitted. Nothing in this paragraph shall limit the boards authority to promulgate additional regulations.
The board, in conjunction with the department of public health, shall promulgate regulations which shall include but not be limited to; training requirements for home health aides on medication administration, training requirements for nurses on the duties and appropriateness for delegating medication administration, and documentation protocols.
Said regulations shall specify that the registered nurse delegator and the home health aide are accountable for their own actions in the medication delegation process, that the nurse delegator shall take appropriate steps to verify the training and documentation requirements of the home health aide, that the delegation shall apply only to the home health aide to whom it was given and shall not be further delegated or transferred, protocols for which a nurse delegator may refuse or revoke delegation using their documented professional judgement, that no registered nurse shall be subject to disciplinary action by their employer for refusing to be a delegator or refusing to delegate if the nurse determines such delegation may compromise client safety, that no home health aide shall be subject to disciplinary action by their employer for refusing to participate in the medication delegation process, documentation protocols that delegation of administration of medication does not alter the responsibility of the home health agency or hospice to teach and the patient or family to participate in learning the self-administration of medications, whenever appropriate.
Nothing in this paragraph shall limit the boards authority to promulgate additional rules or regulations.
A nurse licensed under this chapter who delegates medication administration in accordance with the regulations shall not be subject to disciplinary action by the board for the performance of a person to whom medication administration was delegated.
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