Section R9-21-207. Medication

A.       Medication shall only be administered with the informed con- sent of the client or Title 36 guardian. Information relating to common risks and side effects of the medication, the proce- dures to be taken to minimize such risks, and a description of any clinical indications that might require suspension or termi- nation of the drug therapy shall be available to the client, guardian, if any, and the staff in every mental health agency. Such information shall be available to family members in accordance with A.R.S. §§ 36-504, 36-509, and 36-517.01.

B.       All clients have a right to be free from unnecessary or exces- sive medication.

C.       Medication shall not be used as punishment, for the conve- nience of the staff, or as a substitute for other behavioral health services and shall be given in the least amount medically nec- essary with particular emphasis placed on minimizing side effects which otherwise would interfere with aspects of treat- ment.

D.       Medication administered by a mental health agency shall be prescribed by a licensed physician, certified physician assis- tant, or a licensed nurse practitioner.

1.        Psychotropic medication shall be prescribed by:

a.        A psychiatrist who is a licensed physician; or

b.        A licensed nurse practitioner, certified physician assistant, or physician trained or experienced in the use of psychotropic medication, who has seen the client and is familiar with the client’s medical his- tory or, in an emergency, is at least familiar with the client’s medical history.

2.        Each client receiving psychotropic medication shall be seen monthly or as indicated in the client’s ISP by a licensed nurse practitioner, certified physician’s assistant or physician prescribing the medication, who shall note in the client’s record:

a.        The appropriateness of the current dosage,

b.        All medication being taken by the client and the appropriateness of the mixture of medications,

c.        Any signs of tardive dyskinesia or other side effects,

d.        The reason for the use of the medication, and

e.        The effectiveness of the medication.

3.        When a client on psychotropic medication  receives a yearly physical examination, the results of the examina- tion shall be reviewed by the physician prescribing the medication. The physician shall note any adverse effects of the continued use of the prescribed psychotropic medi- cation in the client’s record.

4.        Whenever a prescription  for medication is written or changed, a notation of the medication, dosage, frequency of administration, and the reason why the medication was ordered or changed shall be entered in the client’s record.

E.       Self-administration of medication by clients shall be permitted unless otherwise restricted by the responsible physician or licensed nurse practitioner. Such clients shall be trained in self-administration of medication and, if necessary, shall be monitored by trained staff.

F.       Drugs shall be stored under proper conditions of sanitation, temperature, light, moisture, ventilation, segregation and secu- rity.

G.      PRN orders for medication shall not be given for a drug used as a restraint.

Historical Note

Adopted under an exemption from A.R.S. Title 41, Chap- ter 6 pursuant to Laws 1992, Ch. 301, § 61, effective October 7, 1992; received in the Office of the Secretary of State October 14, 1992 (Supp. 92-4). Amended under an exemption from A.R.S. Title 41, Chapter 6 pursuant to Laws 1992, Ch. 301, § 61, effective September 30, 1993 (Supp. 93-3). Amended by exempt rulemaking at 9

A.A.R. 3296, effective June 30, 2003 (Supp. 03-2).