Covered and Noncovered Services : Home Health Aide Services

Medication Administration

"Administer" is defined in the Pharmacy Examining Board Act, Wis. Stats. Chapter 450.01(1), as the direct application of a prescription drug or device, whether by injection, ingestion, or any other means, to the body of a patient.

Medication administration may be covered for an adult member when the member is unable to self-administer and there is no willing and able caregiver to administer the medication.

Parents typically administer medications to their minor children. However, medication administration may be reimbursed for minor children when the parents are unable to administer the medication. This includes times when parents are not allowed to leave work to administer medications and no other arrangements can be made.

General Agency Requirements Applicable to All Medication Administration by Home Health Aides

All home health agencies providing administration of a medication by a home health aide must meet the following conditions:

• The agency has policies and procedures designed to provide safe and accurate administration of medication. These policies must be followed by personnel assigned to administer medications (42 CFR s. 484.14[e]). This must include the required documentation of the name of the medication, the dose, the route of administration, the time of administration, and the identification of the person administering the medication.
• There is a written delegation of this nursing act (medication administration) by the RN as specified in Wis. Admin. Code § DHS 133.17(3).
• There is documentation that gives evidence of the educational preparation of the caregiver who administers medications as stated in Wis. Admin. Code § DHS 133.06(4)(b).
• There is immediate and accessible supervisory support available to the caregiver administering medications as directed by Wis. Admin. Code § DHS 133.18(2).
• Members must be informed, prior to delivery of service, that their medications will be administered by unlicensed personnel as stated in Wis. Admin. Code § DHS 133.08(2)(d), and 42 CFR s. 484.10(c)(1).
• Supervision and direction of the delegated nursing act meets the requirements of Wis. Admin. Code ch. N 6.03(3), which states that in the supervision and direction of delegated nursing acts, an RN shall do the following:
  • Delegate tasks commensurate with educational preparation and demonstrated abilities of the person supervised.
  • Provide direction and assistance to those supervised.
  • Observe and monitor the activities of those supervised.
  • Evaluate the effectiveness of acts performed under supervision.

Administration of Preselected Medication

A home health aide may administer medications to any member, regardless of age or functional capacity, when both of the following conditions are met:

• The medication is preselected by a nurse, pharmacist, member, or designated family member.
• All agency requirements are met.

Administration of Medication That Is Not Preselected

Administration of medication by home health aides may include selection of the medication and selection of the dose, along with direct application of the medication.

The act of administration of medication that has not been preselected may be provided by home health aides only when both of the following conditions are met and documented in the provider's records:

• When medication has not been preselected, there is documented evidence that the home health aide has been trained in the actions, uses, effects, adverse reactions, and toxic effects of all medications administered. Additionally, the home health aide must be trained relative to appropriate responses to adverse reactions to any medication administered. The delegating RN must verify the training by doing at least one return demonstration with each home health aide administering medication to a specific member as directed by Wis. Admin. Code § DHS 133.06(4)(c).
• All agency requirements are met.