Ohio Nursing Homes: Legislation to dispense meds by quick trained techs.

[liberalnurse]

This apparently is going on in 20 other states. The republican owned nursing home cartels have found another way to disinfranchise our vulerable seniors......

As an Ohio Legislative Liaison, I call out to DU members to assist with our mission to stop this abuse.


Good afternoon, all.

The medication administration technician issue has hit the proverbial fan. We need your help now more than ever. Please make it a priority to call or email your and other key legislators, listed at the bottom of this email, and urge them to OPPOSE SB 196 that has been amended. Details follow from Jan Lanier, who is with Wynne Simpkins and Lisa Rankin at the statehouse now, fighting for nurses and patients against this irresponsible measure.


!!!!!!!ACTION ALERT!!!!!!!



STAT



Medication Administration by Unlicensed Persons



In the final days of the 125th General Assembly House leadership has unilaterally decided to "gift" the long-term care (LTC) industry by enacting into law a broad provision that gives authority for unlicensed persons to administer medications in nursing homes, residential care facilities, & ICFs/MR. The proposed (but yet undrafted) language, while termed a "pilot" in reality is a two-year phase-in of statewide medication aides with few statutorily imposed direction or constraints.



This major policy change with significant implications for public safety has not had a single legislative hearing because the change will not be accomplished through a stand-alone bill. Rather, strategists have set into motion a plan to amend an existing Senate bill (SB196) currently before the House Commerce & Labor Committee, thus effectively eliminating any meaningful opportunity for public scrutiny of the amendment language. In fact, timing considerations will make it almost impossible for lawmakers to carefully review this important proposal. They will be forced to rely on what they hear from industry lobbyists and their constituents - hopefully many nurses! If nurses do not express their concerns the will of the LTC industry will prevail unchallenged. It is also essential that nursing demonstrate to legislators its determination to be an effective player at the statehouse. W must mount a visible force in response to this power play from LTC, so that our ability to achieve any of our legislative goals in the future will not be jeopardized!



WHAT TO DO NOW!!!



Please email, call, write or visit your own state representative and state senator, Speaker Larry Householder, Speaker to be Jon Husted, and the members of the House Commerce & Labor Committee. Make the following points:



· The public policy change affected by the anticipated amendment to SB196 has significant safety implications and should not be doe in haste without an opportunity to carefully assure adequate safeguards are in place.



· There is no reason to rush this language through in a lame duck session.



· While nursing has a long-standing history of opposing the use of unlicensed individuals to perform health care tasks that could cause serious harm if done incorrectly. We have repeatedly offered to meet with stakeholders to begin a dialog and hopefully reach a reasonable compromise on this issue of medication administration. These offers have been ignored and the discussions have never occurred.



· The amendment as we expect it to be drafted if very general with much of the responsibility for developing the phased-in program left to rule making. An advisory council largely made up of LTC industry representatives will have no statutory constraints to consider with respect to the kinds of drugs that can be given. The route of administration, the role of the licensed nurse, the qualifications of the medication aide, the length or content of the training covers. Such lack of direction will allow the LTC industry to control the entire process with not recourse for the general public.



· While described as a "pilot" there are no expectations set forth in statute to guide data collection, or analysis. The time frame of 18 months to two years is inadequate to allow program start up, meaningful data collection and analysis. The program will be come permanent unless the legislature acts to rescind the authorizing statute.



· Conclude with your own experiences relative to the safety of medication administration in long term care.





Legislators to Contact IMMEDIATELY:

Gov. Bob Taft Phone: [phone] Link to email: http://governor.ohio.gov/contactinfopage.asp
Speaker Larry Householder: Phone: [phone] Email: [e-mail]
Rep. Shawn Webster (or aide Stephanie): Phone: [phone] Email: [e-mail]
Rep. Tim Schaffer (or aide Jessica Mead): Phone: [phone] Email: [e-mail]
Rep. Jon Husted (or aides Chris Kershner or Dan Baker): Phone: [phone] Email: [e-mail]
Rep. Chuck Calvert (or aides Zeb or Peter): Phone: [phone] Email: [e-mail]
Senate President Doug White: Phone: [phone] Email: [e-mail]
Sen. Bill Harris: Phone: [phone] Email: [e-mail]
Sen. Lynn Wachtmann: Phone: [phone] Email: [e-mail]
Sen. Jeff Jacobson: Phone: [phone] Email: [e-mail]

And any or all of the House Commerce and Labor Committee:
Commerce and Labor

REPUBLICAN DEMOCRAT
Schaffer
Chair
McGregor
Vice Chair
Brinkman
Member
Cates
Member
Combs
Member
Core
Member
Kilbane
Member
Distel
Ranking Minority Member
D. Stewart
Member
DeGeeter
Member
Miller
Member

[Branjor]

1. I worked in a state mental hospital in the 1970s....

as a psychiatric attendant. Medication, including injections, was routinely given to patients by psychiatric attendants, who were not licensed nurses. This has been going on for many years with no outcry whatsoever that I am aware of. Just goes to show you how important mental patients are.

[liberalnurse]

2. There is no real tracking network in place

to hold them accountable either. It will eventually come about but not without great suffering to our ederly in the interm.

[mosin]

3. I call BS...

The republican owned nursing home cartels have found another way to disinfranchise our vulerable seniors......

Throwing the word "disenfranchise" around like this makes it meaningless. We can have a serious public policy debate on this issue--and we should--but blaming it on "republican owned nursing home cartels" is disingenuous. There are a lot of Democratic nursing home administrators--I know a few of them--who support this legislation as a reasonable cost-saving measure.

You can't complain about rising medical costs and refuse to discuss cost-savings without losing all credibility. Dispensing premeasured oral medications does not always require the skills of a nurse.

I need to see exact language, but I have no objection in principle to what you describe.

[liberalnurse]

4. You are nuts if you think

administrating medication to the elderly is like handing out candy at Halloween.

This cost savings will be at the expense of vulnerable senior citizens....They area at critical risk and harm.....needless deaths will occur.

So republican to save money by being in denial.....

[mosin]

5. Silly me

I guess anyone who disagrees with you is "Republican."

Well, working to protect your turf while trying to pass it off as selfless altruism sounds "Republican" to me.

I don't have a dog in this fight, except as a health care consumer.

[liberalnurse]

6. What, protecting the innocent

from profiteers is a selfless ....yes indeed. I'd bet you would sing a different tune if it were your family member being medicated by ignorant, uneducated robo pill pushers. Heaven forbid they suffer as you would sentence our present clientele.

As a consumer, you really need to sleep in their bed a while and realize, harm is a known threat with task oriented medical care.

Oh, that apparently is not part of the equation as it's a budget issue with you. So be it, if they are injured without accountability....no one really has to pay the financial price....so that must be good in your pocketbook.

Have you heard of Dinocrats.......you have now......

[sandnsea]

8. Visit a nursing home

My daughter works in a retirement home. I don't think the CNA's give medicine in Oregon, but I'm not sure. She can barely get her co-workers to feed and bathe the residents properly, let alone hand out medicine. And even though she's about half way through her nursing course, she certainly doesn't feel competent to hand out medicine. You say it's a good idea, until there's one RN or LPN on duty and somebody has a reaction and there's nobody available who knows what to do.

[liberalnurse]

9. Thanks for the support.

This issue is critical! I'm working with State Legislators and am getting in contact with the Ohio Board of Pharmacy. I'm going to work on the safety issue regarding drug diversion.....What ever works. I need some heavy weights.

[liberalnurse]

7. Update and clarification information

on what unlicensed; "off the street employees" will be doing to our elderly.

We now need to concentrate our efforts on members of the Health and Finance Committees in the House. To that end ONA is asking you to contact the individuals listed below and emphasize the following points:
The "pilot" is in reality a phased-in approach to permanently allowing the long-term care industry to use unlicensed persons to administer medications without any statutory constraints. The "pilot" becomes permanent automatically across the state in 18 months to two years even before the study data have been evaluated.

There are no limitations in the proposed statute regarding the kinds of drugs that can be administered by unlicensed people, and only minimal limitations on the route of administration. Conceivably, these unlicensed people could administer controlled substances, stock medications, titrated drugs, PRN (as needed) medications and even medications given via a gastric or jejunostomy tube.

No language requires nurse delegation although other states utilizing unlicensed individuals do require that level of nurse oversight. The amendment language avoids this important issue by merely requiring a nurse to be in the building at all times. It is not clear what the nurse's responsibility or liability will be whereas with delegation the role of the nurse is clearly established. Delegation provides important checks and balances to assure patient safety.

There is no requirement that the unlicensed person first complete the basic nurse aide training course before administering medications. (This 75-hour course is required before an aide can even bathe a nursing home patient; yet amazingly, upon completion of an unspecified amount of training, an unlicensed person would be authorized to administer potentially fatal medications to a vulnerable population in Ohio). In the 11 other states that allow medication administration by unlicensed individuals in nursing homes, completion of the basic nurse aide training is a prerequisite to training in medication administration. Further, without requiring the individual to be recognized as a state tested nurse aide, the individual would not necessarily be required to be a high school graduate, nor is there an express requirement for a BCII criminal records check.

The statute provides no guidance regarding the length of the training course or the course curriculum contents.
Nurses are concerned that this important change to Ohio's standard of care for its elderly and disabled citizens is being rushed through, without adequate discussion, during the waning days of the 125th General Assembly. Please allow time for ALL interested parties to work together to develop a genuine pilot program that assures the safety of those participating in the study and provides legitimate data that can be used to validly and reliably determine whether using unlicensed individuals to administer medications to residents in nursing homes, residential care facilities and ICFs/MR is indeed a safe practice.

[happyvibes]

10. OBN?

I'm an LPN. What has the Ohio Board of Nursing got to say about this? I thought they were supposed to be protecting us from unskilled personnel.

[liberalnurse]

11. We had a successful Hearing at the Ohio Statehouse

on Wednesday. They, the Ohio Senate, repugs, decided not to introduce the "attatchment" to SB 196 or SB 222. We let them know we were out in force....We being, Ohio Nurses Association and other stakeholders....I brought in, networked the Ohio Board of Pharmacy and several LPN school instructors...who were there at the Hearing.


ONA is the leader here on at least getting open discussion about the issue. We don't want med techs at all but it may be a difficult battle to hold off. Many other states are getting hammered with the med tech pilot program legislation.

Here is the press release:

Nurses Win Victory for Elderly, Disabled Patients

COLUMBUS-The Ohio Nurses Association (ONA) applauds the grassroots lobbying efforts from its membership and the general nursing and patient communities to stop a proposed amendment to Senate Bill 196, sponsored by Sen. Lynn Wachtmann (R, Napoleon). The amendment, said to give authority for unlicensed persons to administer medication to patients in nursing homes and residential care facilities, was scheduled to be introduced this morning in the House Commerce and Labor Committee. It was not.

ONA, the Licensed Practical Nurses Association of Ohio (LPNAO) and other stakeholders fought vigorously this past week to alert members of the Ohio General Assembly of the grave risks to patient safety, especially for the elderly and disabled, the amendment implied. While termed a "pilot program" by its supporters in the long-term care industry, in reality the proposed language allowed for a two-year phase-in of statewide medication aides with few statutorily imposed directions or constraints.

"We applaud the Ohio General Assembly for refusing to rush through such a complex issue," said Jan Lanier, director of health policy for ONA. "Unlicensed persons administering medication affects all of us. We need systems in place, directed by a legislative body, to ensure that patient safety and quality of care is not compromised."

ONA was committed to an open dialogue with representatives from the long-term care industry earlier this year. According to ONA, points for discussion include the training, education and regulation of unlicensed persons passing drugs. Because of the complexity of the issue, ONA has requested continuously for a stand-alone bill as a vehicle of discussion.

"We're grateful to the nurses and patients who stood with us in our effort to oppose this last-minute amendment," said Lanier. "This is their victory. While ONA understands this issue needs discussion in the future, we're convinced that it must be open to public debate. Parties interested in this issue need to come together with members of the Ohio General Assembly in an effort of compromise and open dialogue."

ONA is the recognized advocate for nurses and nursing issues in the state, representing the over 140,000 registered nurses in Ohio. As the 4th largest state association of its kind in the country, ONA's mission is to advance the nursing profession in the service of quality healthcare to Ohioans.
#ONA#