Ill. Admin. Code tit. 89 § 240.741

Current through Register Vol. 48, No. 44, November 1, 2024

Section 240.741 - Prerequisites for Automated Medication Dispenser Service

a) Authorization for the AMD service is determined based on a participant's need for the service, including the participant's medication, medical, cognitive and physical needs that indicate the potential to benefit from the AMD service.

b) To be authorized for the service, the participant must:

1) meet all of the following criteria:

A) eligibility for CCP services;

B) take one or more medications that necessitate the medications be taken at a set schedule to avoid complications;

C) have the potential to benefit from the service, understand the need to take medications, respond to alerts to take medication and is physically able to take medication independently from the AMD unit;

D) designate an assisting party to assist with the AMD unit and medications; and

E) commit to using the AMD unit appropriately; and

2) exhibit at least one of the following issues or diagnoses:

A) a history of non-adherence to treatment, medication or therapy regimens;

B) resides alone or lacks assistance from others to assist with regular medication administration;

C) impaired motor function that causes difficulty in handling medication receptacles and small pills;

D) attempts at using less costly alternatives (e.g., pill reminders, medication organizers with alarms and telephone reminders/prompts) have failed;

E) recent transition from a more restrictive care setting, such as a hospital or nursing facility;

F) has a diagnosis of cognitive impairment;

G) has a diagnosis of diabetes;

H) has a diagnosis of congestive heart failure;

I) has a diagnosis of hypertension;

J) has a diagnosis of depression/mental illness; or

K) has a diagnosis of cancer.

c) Other criteria may be developed by the Department to assist in determining what is the most appropriate AMD system to meet the participant's needs.

d) The participant/authorized representative and/or the assisting party shall complete documentation acknowledging that the AMD was installed. Whenever possible, the assisting party should be present during the AMD installation.

e) The assisting party must complete documentation requested by the Department agreeing that they will be responsible for:

1) administration and oversight of the participant's medications;

2) manually filling or arranging for another person, who could be the participant, to fill the AMD unit in accordance with prescribing instructions;

3) working with the AMD provider to program the dispenser for the initial medication schedule and subsequent changes;

4) using best efforts to ensure no illegal substances are placed in the AMD unit;

5) serving as a point of contact for the AMD provider and taking reasonable and necessary actions based on any notifications of missed medication doses and other system issues;

6) receiving and understanding the instructions and demonstration given by the AMD provider for the AMD equipment;

7) understanding how to access reports about the unit and medication regimen and contacting the AMD provider when medication schedules are changed; and

8) providing reasonable advance notice to the AMD provider, CCU, and participant/authorized representative if unable to continue acting as the assisting party.

f) A participant/authorized representative will be responsible for damages to or loss of the AMD equipment unless a law enforcement report of theft has been filed.

1) The provider will document the damages/loss of equipment.

2) One documented occurrence of damages/loss of equipment may be cause for a MOU or termination, in accordance with the Participant Agreement and Section 240.350.

g) Whenever an assisting party can no longer meet the obligations set out in subsection (e), it is the responsibility of the participant/authorized representative to identify a new assisting party and cooperate with arrangements for that individual to be trained by the AMD provider. Notification of the change shall be communicated to the AMD provider and the CCU before the change is made.

h) An assisting party cannot be an individual or entity providing other services under CCP, such as an in-home service provider.

i) Failure to have a current assisting party designation may result in the participant's termination from the AMD service.

Ill. Admin. Code tit. 89, § 240.741

Added at 38 Ill. Reg. 14230, effective 6/25/2014

Amended at 42 Ill. Reg. 20653, effective 1/1/2019

Amended at 44 Ill. Reg. 2780, effective 1/29/2020

Amended at 48 Ill. Reg. 11053, effective 7/16/2024