(1) This rule establishes criteria and procedures under which an employee or an agent of a contractor may assist and supervise an individual in taking medication. Assistance and supervision may only be given where a medication which is normally self-administered has been prescribed for an individual and where the physician who prescribed the medication also prescribed assistance or supervision in the administration of the medication.

(2) For the purposes of this rule, the following definitions apply:

(a) "Assistance" means providing any degree of support or aid to an individual who independently performs at least one component of medication-taking behavior; and

(b) "Supervision" means critically observing and directing an individual engaged in medication-taking behavior.

(3) An agent or employee of a contractor in order to assist or supervise in the administration of medication to individuals, must be certified by the department as herein provided unless the agent or employee is otherwise authorized by law to provide such assistance or supervision.

(4) To be certified, an employee or agent of a contractor must demonstrate knowledge of seizure disorders and of the use and side effects of medications by achieving a score of at least 90% on a comprehensive test administered by the department.

(5) Application for certification to provide supervision and assistance in the administration of medication is made by providing notification to the Department of Public Health and Human Services, Developmental Disabilities Program, P. O. Box 4210, Helena, MT 59604.

(6) Any contractor may receive, free of charge, an instructional and reference aid entitled Seizure Disorders and Medications, a self-paced instructional manual.

(7) The department administers the comprehensive test to a qualified applicant within 30 days of receipt of the notification of application for certification.

(8) Notice of certification or noncertification is mailed within 10 days of the date of testing. The notice designates an effective date and an expiration date for the certification. Certification is approved for a maximum of 2 years.

(9) A person may receive consecutive certification by retaking the test as provided in (4) through (7) .

(10) Every contractor shall maintain a current list of contractor employees and agents certified to supervise and assist in the administration of medication.

(11) If an individual has been receiving developmental disabilities services for 30 days and supervision and assistance is to be administered for more than 10 consecutive days, this activity must be included as an objective in the written individual plan. To address the objective, an individual program plan must be prepared which describes a program to train the individual to self-administer the medication and must specify at least:

(a) the target medication-taking behavior;

(b) the conditions under which such behavior should occur;

(c) the conditions under which such behavior will be trained;

(d) the criterion for completion of the individual program plan in accordance with (13) herein;

(e) the written strategies for training the target behavior;

(f) a data recording system which accounts for each prescribed medication dosage; and

(g) a daily data recording system which specifies progress or lack of progress toward the target behavior.

(12) Every instance of assistance or supervision provided under this rule must be recorded and must include at least the name of the person who receives medication, the name of the person who assists or supervises the taking of medication, the date and time the medication was taken, and the type of medication taken.

(13) An individual is considered to be capable of self-administering medication when it has been documented that the individual has self-administered all (100%) of prescribed medication dosages for a consecutive 30 day period.

(14) There are two conditions under which an individual program plan to teach self-administration of medication is no longer necessary. They are:

(a) the individual has met the criterion specified in (13) , or

(b) the IP team has reviewed the ongoing implementation of the individual program plan and found that the individual has reached the maximum level of independence in the self-administration of medication of which the individual is currently capable. In making this decision, the team must evaluate whether:

(i) the individual has made any progress;

(ii) the program has been consistently implemented;

(iii) a variety of teaching strategies has been employed;

(iv) the decision to discontinue the program will interfere with the individual's ability to be served in a less restrictive environment; and

(v) the program has been in place long enough to make a decision concerning its effectiveness.

(15) If the IP team decides that an individual program plan to teach self-administration of medication is no longer necessary, the requirements concerning the need for certified personnel and recording instances of assistance and supervision must be met.

(16) The feasibility of re-instituting a program to teach self-administration of medication must be examined at subsequent IP meetings by the team. If the individual's situation changes such that there is a possibility of further acquisition of the skill, a program is initiated.

(17) The department may revoke or suspend a certification.

(a) The department may revoke certification by notifying the certified person of the reason for revocation in writing at least 10 days prior to the effective date of revocation. The certified person may request, in writing, within the 10 days prior to revocation, a review by the division administrator. A decision is issued within 30 days from the date the request for review is received. When a request for a review is made, the revocation is not effective until the division administrator's decision is made.

(b) The department may suspend a certified person's right to assist or supervise in the administration of medication for a period no longer than 15 days, after which the suspension must be removed or notice of revocation issued. If notice of revocation is issued, suspension may continue until the effective date of revocation or until the division administrator's decision is made.