October 1, 2013
The Departments of Public Health, Mental Health, Children and Families, and Developmental Services have developed this training policy to compile in a single document the many policies regarding the preparation of MAP trainers and direct care staff; to clarify issues concerning training and testing; to briefly describe the centralized database for trainers; and to depict the applications for DPH registration and Certification/Recertification in the DMH/DCF/DDS Medication Administration Training Program. According to the regulations, Training Programs must meet the jointly established specifications of the Departments.
Becoming a Trainer
Regulations at 105 CMR 700.003(F)(2)(a) require that a trainer be a registered nurse, nurse practitioner, physician assistant, registered pharmacist or licensed physician who meets the applicable requirements for a trainer.
The jointly established requirements for a trainer are:
- Currently licensed as a registered nurse, nurse practitioner, physician assistant, registered pharmacist, or physician in Massachusetts;
- At least two years of experience in his/her profession;
- Completion of the DPH approved ‘Train the Trainer’ Program offered through the Departments of Mental Health, Children and Families, and Developmental Services;
The "Train the Trainer" (T T T) program is offered by DPH/DMH/DCF/DDS approximately every two months at a centralized location within the state. The program is conducted jointly by a DDS MAP Coordinator and a DMH/DCF MAP Coordinator. Technical assistance is provided as needed by the DPH Clinical Reviewer. Professionals who meet the above criteria and wish to become a trainer should contact a DDS or DMH/DCF MAP Coordinator to obtain a list of scheduled trainings.
Prospective MAP Trainers must provide the Train the Trainer instructor with an updated resume and proof of licensure by the commencement of the T T T Session. TTT MAP Coordinator instructors will then forward trainers’ resumes, names, addresses, telephone numbers, and professional license numbers with the dates of expiration to the Central Office at the Department of Mental Health. This information will be data entered into the MAP Trainer’s database.
Being a Trainer
To maintain their approval status, trainers must remain current regarding all DPH approved training and testing materials, advisories, policies and other changes through scheduled meetings with a MAP Coordinator, and as determined by DPH. Trainers not attending scheduled meetings may be notified that their approval status has been revoked.
Regulation at 105 CMR 700.003(F)(2), 115 CMR 5.15(6)(a) and 104 CMR 28.06(9)(b)(6) require all training programs to meet specifications jointly established by DPH, DMH, DCF, and DDS. DPH approved MAP Training Programs must not be less than 16 hours in length, including classroom instruction, testing, and the practicum. Trainers must comply with this specification.
The Medication Administration Program’s training program is specific to DMH/DCF/DDS registered MAP programs only. MAP trainers may only train those staff who will be administering medications in DMH/DCF/DDS registered MAP programs. All trainers must use the most recent DPH approved training manual and testing materials.
Staff training and Certification is transferable between DMH, DCF, and DDS only. Because certificates are transferable between all DMH/DCF/DDS community residential programs, all required portions of the training manual must be taught. No part may be eliminated or modified due to the trainer’s or service provider’s preferences or personal beliefs or for any other reasons.
Failure to teach the entire compulsory training would lead to inconsistencies in training and qualifications. If DMH, DCF, DDS, or the Service Provider policies prohibit or discourage use of any portion of the training, (e.g., staff may not administer via a specific route) then staff should be instructed on the specific rules on site. Nevertheless, that portion of the training must be provided as part of the basic training.
Additional Training for Vital Signs
To administer medications that require the monitoring of vital signs for administration, Certified staff must be proficient in this skill. Training for vital signs is not offered in the initial MAP training; therefore additional training must be provided to those Certified staff whose responsibilities include monitoring of vital signs for medication administration. Regulation at 105 CMR 700.003(F)(1)(b) states "... that only properly trained and Certified personnel administer medication." Furthermore, regulation at 105 CMR 700.003(F)(2) states that these staff must have successfully completed a training program that meets the specifications for a training curriculum and examination process established jointly by the Department of Public Health and the Department of Mental Health, Department of Developmental Services or the Department of Children and Families.
Service Providers are responsible for (1) obtaining instructions from Health Care Providers regarding the need for monitoring of vital signs for medication administration; (2) obtaining specific, written parameters for vital signs, if appropriate; (3) training their staff to take vital signs; and (4) maintaining a current list of staff who have been trained and are competent in obtaining vital signs. Documentation should include the name, address and telephone number of the trainer(s). This list should be maintained both at the site and in the Service Provider’s main office.
Upon completion of an approved MAP Certification Training Class and attaining a successful Pretest score, staff may be eligible to be tested by the D&S Diversified Technologies. Applicants for Certification/Recertification must have their identity verified. The staff person must bring two forms of identification to the testing site. One of the IDs must be a current and clear photo ID.
Staff may not administer medications until they pass a D&S Diversified Technologies administered Certification exam and skills test. MAP Certification is effective on the date that the test results are posted on the D&S Diversified Technologies website indicating that the staff person passed the Certification exam. MAP Certification is valid for two years from the last day of the month in which the test was passed. If a staff person fails Certification three times, then that staff must complete the full MAP Initial Certification training again or complete remedial training given by the current MAP Trainer of record on the D&S database.
Once MAP Certification expires, staff have one year to recertify before they must yet again complete the full Certification training. During this period, however, the staff person may not administer medications.
Applications for Massachusetts Controlled Substance Registration
Community residential programs, day programs, and short-term respite programs that support stable individuals who are living in DMH, DCF or adult DDS licensed, funded, or operated programs with the assistance of medication administration may apply for a Massachusetts Controlled Substance Registration (MCSR). The Department of Public Health MCSR application is available on line. All new, renewal, or amended information, requires an application form. For DMH or DDS adult sites: the completed form along with a copy of the license(s), certificate(s), or front page copy of the contract with DMH or DDS must be submitted to the DPH Drug Control Program. For DMH or DCF youth sites: the completed form along with a copy of the license(s) and copy of front page of the DMH/DCF contract must be submitted to the DPH Drug Control Program. Please be advised that all incomplete forms will be returned for completion.
It is the responsibility of the Service Provider to assure that the trainer of their staff is an approved trainer. Service Providers may contact their Central Office at the Department of Mental Health to confirm a trainer’s approval.