§ 47.31 Health; Medication Administration.
RCNY § 47.31
(a)Medication policy required. Each permittee shall establish a policy as to whether the permittee will or will not administer medication, and incorporate such policy in the program's health care plan component of the written safety plan required by 24 RCNY Health Code § 47.11. Notwithstanding any program's general policy not to administer medication, such policy shall indicate that the program may be required to administer medication to a child with a disability, pursuant to the Americans with Disabilities Act.
(b)Exempt staff. A program that employs staff who are also currently State licensed physicians, physician assistants, registered nurses, nurse practitioners, licensed practical nurses, or emergency medical technicians may administer medications without such staff obtaining additional qualifications or certification.
(c)Health care consultant and duties. All permittees that choose to administer medications to children shall designate a health care consultant of record, who shall be a health care provider as defined in this Article. The permittee shall confer with the health care consultant and shall obtain approval of the consultant for the portion of the health care plan regarding policies and procedures related to the administration of medications. The consultant shall review documentation of all staff authorized to administer medications and determine if staff have required professional licenses or certificates of completion of required training. A health care plan shall be valid for two years and shall be updated when designated staff has changed. The health care consultant shall visit the program at least once every two years and shall review the permittee's health care policies, procedures, documentation, practice and compliance with its health care plan for administering medications. If the consultant determines that the approved health care plan is not being reasonably followed by the permittee, the consultant may revoke his or her approval of the plan. If the consultant revokes his or her approval of the health care plan, the health care consultant shall immediately provide written notification to the permittee and the Department, upon which notification the program shall immediate cease administering medication, and immediately notify all parents and guardians of children in the program of such cessation, until such time as a new health care plan is approved. All relevant documentation shall be kept on site and made available to the Department upon request.
(d)Staff members certified to administer medications. Only a trained, designated staff person may administer medications to children, except where the only administration of medications will be over-the-counter ("OTC") topical ointments, including sunscreen lotion and topically applied insect repellant; and of asthma inhalers, nebulizers, and epinephrine auto-injectors to children whose parent or guardian has provided written consent, medical authorization, and training. The staff person administering medications to children shall be at least 18 years of age, possess current certifications in first aid, CPR, and medication administration training (MAT) in a course approved or administered by the Department or the State Office of Children and Family Services. MAT certificates shall be made available for inspection by the Department on request. MAT certifications shall be effective for a period of three years from the date of issuance. Recertification training shall extend certification for additional three-year periods. If a designated staff person ceases to work in a program for a continuous period of one year, certification shall automatically lapse. Where certification lapses, the person may be recertified after repeating initial MAT or recertification training, as required by the Department. Where a permittee has failed to comply with requirements for the administration of medications set forth in this section, the Department may require retraining or may prohibit the permittee from administering medications.
(e)Medication administration procedures. Except as provided in 24 RCNY Health Code § 47.29(c), permittees and designated staff may administer prescription and OTC medications for eyes or ears, oral medications, topical ointments and medications, and inhaled medications in accordance with the provisions of this section.
(1)A copy of the permittee's written policies regarding the administration of medications shall be reviewed, explained, and provided to parents at the time of enrollment.
(2)The permittee shall obtain from a child's parent and health care provider a statement in writing that indicates medicine to be administered and schedule of administration.
(3)A parent, or other adult authorized in writing by the parent, may administer medications to a child while the child is attending a program at any time.
(4)The permittee shall maintain a medication administration log, to be kept on site and made available to the Department upon request, to document the name of the child to whom medication was administered, the date and time of administration, the type and quantity of medication administered, and name of the staff member, parent, or other parentally authorized adult who administered the medication.
(5)Permittees and designated staff may not administer medications by injection, vaginally or rectally, except as follows: (A) For a child with special health care needs where the parent, program and the child's health care provider have agreed on a plan, pursuant to which the permittee or designated staff may administer medications by injection, vaginally or rectally; or (B) Where the permittee or designated staff hold a valid New York State license as a physician, physician's assistant, registered nurse, nurse practitioner, licensed practical nurse, or advanced emergency medical technician.
(6)Nothing in this section shall be deemed to require any permittee to administer any medication, treatment, or other remedy except to the extent that such medication, treatment or remedy is required under the provisions of the Americans with Disabilities Act.
(7)Permittees who agree to administer medications shall do so, unless they observe circumstances specified by a child's health care provider, if any, under which medication shall not be administered. In such instances, the permittee shall contact the parent immediately.
(8)Medication may only be administered with written consent of the parent in accordance with written instructions from the child's health care provider including, but not limited to circumstances, if any, under which the medication or prescription shall not be administered. Medication shall be returned to the parent when no longer required by the child.
(9)When the permittee has written parental consent and written instructions from a health care provider authorizing administration of a specified medication if the permittee observes a specific condition or change of condition in the child while the child is in the program, the permittee may administer the medication without obtaining additional authorization from the child's parent or health care provider.
(10)To the extent that such information is not included on the medication label, written instructions by the health care provider shall include: (A) child's name; (B) health care provider's name, telephone number, and signature; (C) date authorized; (D) name of medication and dosage; (E) frequency the medication is to be administered; (F) method of administration; (G) date the medication shall be discontinued or length of time, in days, the medication is to be given; (H) reason for medication (unless this information shall remain confidential, pursuant to law); (I) most common side effects or reactions; and (J) special instructions or considerations, including but not limited to possible interactions with other medications the child is receiving or concerns regarding the use of the medication as it relates to a child's age, allergies, or any pre-existing conditions.
(11)Medications shall be kept in the original labeled bottle or container. Over-the-counter medication shall be kept in the originally labeled container and shall be labeled with the child's first and last name. Prescription medications shall contain the original pharmacy label.
(12)If medication is to be given on an ongoing, long-term basis, the parent's consent and health care provider's written instructions shall be renewed in writing at least once every six months. Any changes in the original medication shall require a permittee to obtain new written instructions from the health care provider.
(13)A permittee may administer over-the-counter topical ointments, including sunscreen lotion and topically applied insect repellant, upon the written instructions of the parent. Such administration shall be consistent with any directions for use noted on the original container, including but not limited to precautions related to age and special health conditions, and no additional certifications to administer medications are required by the permittee or designated staff. If the only administration of medication offered by the program will be the administration of over-the-counter topical ointment, including sunscreen lotion and topically applied insect repellant, a designated health care consultant is not required. The permittee or designated staff shall record in the medication log applications of such topically applied ointments, sunscreen lotions and topically applied insect repellants, with the name of the child, date and time administered, and staff signature.
(14)For all children for whom the permittee administers over-the-counter medications, pursuant to this paragraph, copies of parental written consent and instructions shall be maintained in the child's medical record file.
(15)Medications shall be kept in a clean area that is inaccessible to children. If refrigeration is required, medications shall be stored in either a separate refrigerator or a leak-proof container in a designated area of a food storage refrigerator, separated from food and inaccessible to children. Permittees shall comply with all applicable law for secure storage of all medications.
(16)Staff shall document dosages and times that medications are given, observable side effects, reasons for not giving medication and medication administration errors, and shall report to the parent and to the child's health care provider, in accordance with the provider's written instructions; medication errors shall be immediately reported to the Department.
(17)No children shall independently self-administer medications or assist in the administration of their own medications except under direct supervision of designated staff.
(18)Nothing in this section shall prevent a parent, guardian or other legally authorized individual in relation to a child from administering medication to a child while such child is in a program. In these circumstances, the permittee shall document the dosages and time that the medications were administered to the child by such individual. If the only administration of medication in such program is done by such individual, no certifications to administer medication are required by the permittee or staff.
(f)[Repealed.] (Amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018)
