Connecticut General Statutes
Chapter 368v - Health Care Institutions
Section 19a-492e. - Delegation of medication administration by registered nurse to home health aides and hospice aides. Regulations.

(a) For purposes of this section “home health care agency” and “hospice agency” have the same meanings as provided in section 19a-490. Notwithstanding the provisions of chapter 378, a registered nurse may delegate the administration of medications that are not administered by injection to home health aides and hospice aides who have obtained certification and recertification every three years thereafter for medication administration in accordance with regulations adopted pursuant to subsection (b) of this section, unless the prescribing practitioner specifies that a medication shall only be administered by a licensed nurse. Any home health aide or hospice aide who obtained certification in the administration of medications on or before June 30, 2015, shall obtain recertification on or before July 1, 2018.

(b) (1) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the provisions of this section. Such regulations shall require each home health care agency or hospice agency that serves clients requiring assistance with medication administration to (A) adopt practices that increase and encourage client choice, dignity and independence; (B) establish policies and procedures to ensure that a registered nurse may delegate allowed tasks of nursing care, to include medication administration, to home health aides or hospice aides when the registered nurse determines that it is in the best interest of the client and the home health aide or hospice aide has been deemed competent to perform the task; (C) designate home health aides and hospice aides to obtain certification and recertification for the administration of medication; and (D) ensure that such home health aides receive such certification and recertification.
(2) The regulations shall establish certification and recertification requirements for medication administration and the criteria to be used by home health care agencies and hospice agencies that provide services for clients requiring assistance with medication administration in determining (A) which home health aides and hospice aides shall obtain such certification and recertification, and (B) education and skill training requirements, including ongoing training requirements for such certification and recertification.
(3) Education and skill training requirements for initial certification and recertification shall include, but not be limited to, initial orientation, training in client rights and identification of the types of medication that may be administered by unlicensed personnel, behavioral management, personal care, nutrition and food safety, and health and safety in general.
(c) Each home health care agency and, on or before January 1, 2022, each hospice agency shall ensure that, on or before January 1, 2013, delegation of nursing care tasks in the home care setting is allowed within such agency and that policies are adopted to employ home health aides or hospice aides for the purposes of allowing nurses to delegate such tasks.
(d) A registered nurse licensed pursuant to the provisions of chapter 378 who delegates the task of medication administration to a home health aide or hospice aide pursuant to this section shall not be subject to disciplinary action based on the performance of the home health aide or hospice aide to whom tasks are delegated, unless the home health aide or hospice aide is acting pursuant to specific instructions from the registered nurse or the registered nurse fails to leave instructions when the nurse should have done so, provided the registered nurse: (1) Documented in the patient's care plan that the medication administration could be properly and safely performed by the home health aide or hospice aide to whom it is delegated, (2) provided initial direction to the home health aide or hospice aide, and (3) provided ongoing supervision of the home health aide or hospice aide, including the periodic assessment and evaluation of the patient's health and safety related to medication administration.
(e) A registered nurse who delegates the provision of nursing care to another person pursuant to this section shall not be subject to an action for civil damages for the performance of the person to whom nursing care is delegated unless the person is acting pursuant to specific instructions from the nurse or the nurse fails to leave instructions when the nurse should have done so.
(f) No person may coerce a registered nurse into compromising patient safety by requiring the nurse to delegate the administration of medication if the nurse's assessment of the patient documents a need for a nurse to administer medication and identifies why the need cannot be safely met through utilization of assistive technology or administration of medication by certified home health aides or hospice aides. No registered nurse who has made a reasonable determination based on such assessment that delegation may compromise patient safety shall be subject to any employer reprisal or disciplinary action pursuant to chapter 378 for refusing to delegate or refusing to provide the required training for such delegation. The Department of Social Services, in consultation with the Department of Public Health, home health care agencies and hospice agencies, shall develop protocols for documentation pursuant to the requirements of this subsection. The Department of Social Services shall notify all licensed home health care agencies and hospice agencies of such protocols prior to the implementation of this section.
(g) The Commissioner of Public Health may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulations, provided notice of intent to adopt regulations is published in the Connecticut Law Journal not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.
(June 12 Sp. Sess. P.A. 12-1, S. 11; P.A. 16-66, S. 33; P.A. 17-146, S. 31; P.A. 19-97, S. 8; P.A. 21-121, S. 51.)
History: June 12 Sp. Sess. P.A. 12-1 effective July 1, 2012; P.A. 16-66 amended Subsecs. (a) and (b) to add references to recertification and further amended Subsec. (b) to designate existing provision re education and skill training requirements as Subdiv. (3); P.A. 17-146 amended Subsec. (a) by adding provision re recertification of homemaker-home health aides in administration of medications on or before July 1, 2018, effective June 30, 2017; P.A. 19-97 replaced references to homemaker-home health aides with references to home health aides, effective July 1, 2019; P.A. 21-121 added references to hospice agencies and hospice aides and made conforming changes, and amended Subsec. (c) by adding provision re delegation of nursing care tasks by hospice agencies on or before January 1, 2022, effective July 1, 2021.

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