Title of Regulation: 18VAC90-21. Medication Administration Training and Immunization Protocol.

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: February 6, 2019.

Effective Date: February 21, 2019.

Agency Contact: Jay P. Douglas, R.N., Executive Director, Board of Nursing, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4520, FAX (804) 527-4455, or email jay.douglas@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia provides the Board of Nursing the authority to promulgate regulations to administer the regulatory system and to delegate to an agency subordinate the authority to conduct informal fact-finding proceedings.

Section 54.1-3408 of the Code of Virginia has numerous subsections authorizing unlicensed persons in certain settings to administer certain drugs, provided they have been properly trained. For example, subsection I states: "This section shall not prevent the administration of drugs by a person who has satisfactorily completed a training program for this purpose approved by the Board of Nursing…" To provide a regulatory structure for such training programs, the board promulgated 18VAC90-21. This chapter was carved out of 18VAC90-20 during the regulatory review of all regulations in 2014.

Likewise, subsection L of § 54.1-3408 provides: "A prescriber may authorize, pursuant to a protocol approved by the Board of Nursing the administration of vaccines to adults for immunization, when a practitioner with prescriptive authority is not physically present…." The protocol for such immunization is found in 18VAC90-21-50.

Purpose: The regulatory change is consistent with the principle of regulations that are clearly written and easily understandable. The current title of the regulation may be confusing to persons who think it applies to medication administration by licensed persons. It is necessary to retain the current chapter because its provisions protect the health and safety of the public, but the title is amended to be more descriptive of its content.

Rationale for Using Fast-Track Rulemaking Process: The Board of Nursing conducted a periodic review of 18VAC90-21. The amendment is technical in nature, does not change procedure, and has no impact on the public. Therefore, this action is not expected to be controversial.

Substance: The title is changed from Regulations for Medication Administration and Immunization Protocol to Regulations for Training Programs for Medication Administration by Unlicensed Persons and Immunization Protocol.

Issues: There are no advantages or disadvantages to the public; the amendment is technical and clarifying. There are no advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Nursing (Board) proposes to amend the title of 18VAC90-21.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. The current title of 18VAC90-21 is Medication Administration Training and Immunization Protocol. The Board proposes to change the title to Training Programs for Medication Administration by Unlicensed Persons and Immunization Protocol. The Board believes that the current title of the regulation may be confusing to persons who think it applies to medication administration by licensed persons. The proposed amendment is moderately beneficial in that it may reduce potential confusion amongst the public. Since it has no associated cost, the proposal would produce a net benefit.

Businesses and Entities Affected. The proposed amendment affects members of the public who may misunderstand the application of the regulation.

Localities Particularly Affected. The proposed amendment does not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendment does not affect employment.

Effects on the Use and Value of Private Property. The proposed amendment does not affect the use and value of private property.

Real Estate Development Costs. The proposed amendment does not affect real estate development costs.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposed amendment does not affect costs for small businesses.

Alternative Method that Minimizes Adverse Impact. The proposed amendment does not adversely affect small businesses.

Adverse Impacts:

Businesses. The proposed amendment does not adversely affect businesses.

Localities. The proposed amendment does not adversely affect localities.

Other Entities. The proposed amendment does not adversely affect other entities.

Agency's Response to Economic Impact Analysis: The Board of Nursing concurs with the analysis of the Department of Planning and Budget.

Summary:

The amendment modifies the chapter title to clarify that the regulations apply to medication administration by unlicensed persons.

CHAPTER 21
MEDICATION ADMINISTRATION TRAINING PROGRAMS FOR MEDICATION ADMINISTRATION BY UNLICENSED PERSONS AND IMMUNIZATION PROTOCOL