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COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN
RECIPIENT RIGHTS – CHAPTER 7
SAFEGUARDING THE RIGHTS OF RECIPIENTS – SECTION 300
MEDICAL SERVICES AND PSYCHOTROPICS – SUBJECT 012
Page 1 of 2
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I.
PURPOSE: To establish policy and procedure for the provision of medical services with services being
limited to prescribing, dispensing, and monitoring psychoactive agents.
II.
APPLICATION: All Mental health services programs of Community Mental Health for Central Michigan and
any contracted agencies.
III.
REFERENCES:
A. Michigan Mental Health Code Act 258 of the Public Acts of 1974 as amended 330.1719.
B. Administrative Rules 330.7158.
IV.
POLICY: To provide medical services consistent with generally accepted medical practice and in
conformance with policies and guidelines promulgated by the Department of Community Health. With the
exception of first aid and/or emergency procedures, medical services directly provided by the Board will be
primarily concerned with prescribing, dispensing and monitoring psychoactive agents. Other medical and
dental service needs of consumers will be addressed by Case Managers in treatment plans and referral
made for needed services.
V.
PROCEDURE:
A.
Medication shall be administered only at the order of a physician.
B.
Medication shall not exceed United States Food and Drug Administration standards or a peer
review organizational standards, unless the required blood level cannot be otherwise maintained.
C.
Medication shall not be used as punishment, for the convenience of staff, or as a substitute for
other appropriate treatment.
D.
Telephone requests and consequent telephone orders for medication shall be executed only in
emergency situations and shall be entered immediately on the medication record form and signed
by the prescribing physician as soon as possible.
E.
Orders for medication shall be effective only for the specific number of days indicated by the
prescribing physician.
F.
The administration of psychotropic medication shall be reviewed as specified in the plan of service
and based on recipient’s clinical status.
G.
Individuals who are treated with major tranquilizers, Lithium, Tegretol, or Depakote shall receive
essential laboratory services as indicated by the Physician’s Desk Reference (PDR) and
determined by the prescribing physician.
H.
Staff administering medications shall receive training for that purpose. Consumers capable of selfmanagement shall be encouraged to manage their own medications.
I.
The provider shall ensure that written documentation of medications given will be available in the
consumer’s record.
J.
Medication errors and adverse drug reactions shall be immediately reported to the prescribing
physician or designee. If there appear to be serious medical consequences, medical attention will
be sought immediately at an emergency room or urgent care center. Staff involved will document
the situation in the case record in addition to completing an incident report.
K.
The provider shall ensure that when a recipient changes providers, an adequate supply of
medication (prescribed/authorized in writing by a physician) will be made available to the recipient,
if necessary, until he/she can become established with another provider.
L.
An annual physical examination shall be recommended when individual medical needs require it for
consumers who receive psychotropic agents from Board physicians.
M.
Any psychotropic agents stored on Board premises will be stored in a locked, secure place.
Preparations of such agents will be restricted to an identified, private area adjacent to the storage
facility. All dispensing of such agents will be recorded and the records against inventory regularly
checked. All dispensing of such agents will be recorded in the consumer’s case record at the time
the dose was given (sample medications will be handled in accordance with the Michigan Public
Health Code.)
COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN
RECIPIENT RIGHTS – CHAPTER 7
SAFEGUARDING THE RIGHTS OF RECIPIENTS – SECTION 300
MEDICAL SERVICES AND PSYCHOTROPICS – SUBJECT 012
Page 2 of 2
___________________________________________________________________________________________
N.
O.
P.
Q.
R.
S.
T.
U.
Psychotropic medication may be administered without the consent of the consumer if treatment is
ordered by the court, e.g. court-ordered alternative treatment to hospitalization. The attending
physician or nurse will provide to the consumer (and parents or guardians, if applicable) a
description of the side effects involved with the specific medications prescribed.
If a consumer who is court ordered for psychotropic medication and refuses the medication, a
consultation with the doctor for the purpose of selecting options will occur. These options may
include initiating legal action in response to enforcing the court order, which could include:
1.
Reporting non-compliance to the court.
2.
Calling the police to transport consumer to the emergency room.
Psychotropic medication will not be forced on consumers by Community Mental Health for Central
Michigan staff. Medication will be administered with informed consent. However, hospitals and
institutions may involuntarily administer medications to individuals who present a danger to
themselves or others. The programs will be subject to their internal rights, policies and procedures
as well as medical policies and procedures that govern such practices.
A consumer (and parent or guardian, if applicable) shall be informed of side effects and instructed
to report the occurrence of side effects to the physician or nurse. The attending physician or nurse
will provide to the patient (and parent or guardian, if applicable) a printed description of the side
effects, while at the same time requiring signature on a consent form documenting that the
information has been received.
If a consumer’s medication is changed, a progress note shall be entered to correspond to that
change and include the rationale for that change.
When desired clinical results are obtained and the consumer’s condition has stabilized, the
medication will be maintained at the minimum maintenance dosage needed.
The clinical plan for assessing Tardive Dyskinesia will use Sovner’s Abnormal Inventory Movement
Scale (AIMS) to monitor this disorder. This assessment shall be performed as often as medical
needs require for those on antipsychotic medication with results being reviewed by a physician if
changes have been noted.
The rationale for concomitant use of medications shall be documented in the clinical record.
Date
Approved: 10/1/01
Revised: 3/26/02
Procedural changes: 8/20/02