COLUMBIA — The director of the state's disabilities agency is warning providers not to allow untrained staff to administer medications to vulnerable adults in their care after officials discovered that some providers have discontinued the training.
The letter from Beverly Buscemi, director of the state Department of Disabilities and Special Needs, is on the agenda for Thursday's meeting of DDSN commissioners.
"DDSN's increased monitorship in this area discovered that several providers have discontinued training staff in one of the approved programs," Buscemi wrote. "If your agency is currently allowing unlicensed staff who have not successfully completed a DDSN approved medication technician certification program (to) administer medications, they must stop doing so immediately."
The letter, a copy of which was provided by the agency to The Greenville News, went to all DSN boards and private residential providers in the state on Aug. 31. The agency oversees the care of tens of thousands of vulnerable adults, those with intellectual disabilities, autism, traumatic brain or spinal cord injuries.
Buscemi wrote that the issue is an important one because a large percentage of vulnerable adults require prescribed medications.
She said that overall, medication errors rates in the DDSN system are lower than those in nursing homes or hospitals, a fact she attributed to training of staff in proper administering of medication.
She said while many vulnerable adults self-administer medications, something the agency wants as part of the adults' independence, staff also need to be properly trained in assessing whether individuals are prepared to self-medicate.
"Unlicensed staff having completed a DDSN approved medication certification training program can assist individuals learn to self-administer medications," she wrote. "However, assistance by unlicensed staff who have not completed approved training is not allowed."
She said the agency is developing a uniform assessment process to help verify an individual's ability to self-medicate.
The letter did not mention how many of the dozens of providers in the state have discontinued training or why.
Deborah McPherson, a former DDSN commissioner and vulnerable adult advocate, said the issue is an important one because of the risk of harm if medications are not properly administered. She said she is aware of two deaths of vulnerable adults with medication issues, one of which eloped from his group home and died without any of the medication in his system that he was supposed to be administered. In the other case, she said, a vulnerable adult died of a drug overdose, according to the coroner.
"How many individuals have been hurt by being administered medications" from unlicensed and untrained staff,? she asked.
Mary Poole, executive director of the York County Disabilities and Special Needs Board, which is a member of the South Carolina Providers Coalition, said her board is offering training to any provider whose staff is in need of medication certification.
She said all of her staff are trained in medication administration, including substitutes. She said the training is offered during orientation for new employees and staff also undergo re-certification training. In addition, she said, staff can be asked to re-take the training following medication errors.
"You have to have some kind of training because most people aren't used to giving out the kind of medications we give out," she said. "It's a little more than your typical Tylenol and Amoxicillin medication."
She said while training is important, so is accountability and follow-through, to review errors and address mistakes.
"Training is only as good as consistency and follow-through," she said. "I can train anybody to do anything. It doesn't mean they are going to do it."