Medication Services

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Idaho has passed legislation that permits psychologists to prescribe psychotropic medication if they have certain training. Does NCCHC have a position on whether it is appropriate to have a psychologist in a correctional setting prescribing, if properly licensed?

NCCHC has no position on that specific issue, except to the extent that the facility is complying with the laws applicable in the jurisdiction.

For example, in the 2018 Standards for Health Services, standard C-01 Credentials states that “The facility’s qualified health care professionals are legally eligible to perform their clinical duties.” Compliance indicator #4 requires that qualified health care professionals not perform tasks beyond those permitted by their credentials. In standard D-02 Medication Services, compliance indicator #2 states that “Prescription medications are given only by the order of a physician, dentist, or other legally authorized individual.”

Therefore, if the psychologist is appropriately licensed and has documented proof of required training to prescribe medications per state law, this would be in compliance with the NCCHC standards.

— From CorrectCare Volume 32, Issue 2, Spring 2019

 
 

I have been given the task of developing a statewide policy for our prison system on providing prescribed medications to inmates who are not available to take them due to court trips, appointments outside the facility, transfers to other institutions, administrative leaves such as funerals, etc. Can you help?

The guidance you need is based on one principle: If the medication is clinically necessary, provisions must be made to supply that medication.

When it is the judgment of the treating physician, psychiatrist or other primary care provider that the medication needs to be continued when the inmate is temporarily out of the facility, provision must be made either for the inmate to self-medicate or for transporting agents or health staff at the “temporary” facility to provide the medications.

On the other hand, the physician may determine that a one-day “drug holiday” or other length of time without the medication will not interfere with treatment. Skipping a dose may not make a difference in the case of some medications. However, some medications need to be taken daily and on time so that the therapeutic levels remain within the proper range. This is especially true of psychotropic medications, including those for depression, antiseizure medications, HIV medications, and others as determined by the physician.

Your policy should include consulting with the designated health services staff in the situation at hand and then making appropriate arrangements. Policy should include such issues as whether the medication is to be sent with the inmate to cover him or her for the duration of the absence, or whether a prescription is sufficient. This is important when the medication may not be readily available at the receiving institution.

As well, there should be provision for steps to take when an inmate on medication is moved out without notification of the medical staff. Training for transporting staff who may need to give the medication must be addressed. When the physician determines that the medication is not needed during the temporary absence, be sure the policy includes informing the inmate of this so the inmate does not worry when the medication is not available.
— From CorrectCare Volume 18, Issue 2, Spring 2004

 
 

I am a psychologist practicing in New Mexico and have qualified for prescribing medication privileges under the new state law. Can I prescribe in the prison setting and be in compliance with NCCHC standards?

Yes. In the 2008 prison Standards, P-D-02 Medication Services states the following: "Prescription medications are administered or delivered to the patient only on the order of a physician, dentist, or other legally authorized individual" (Compliance Indicator 1).
— From CorrectCare Volume 16, Issue 4, Fall 2002; updated February 2010