Can a nurse delegate tasks to home care caregivers in West Virginia?

In limited cases. West Virginia's approved medication assistive personnel (AMAP) program lets trained, RN-supervised unlicensed staff give medications in covered settings, including private homes where an RN supervises the care. Covered routes include oral, inhaled, topical, drops, suppositories and gastrostomy tube; the only injections allowed are prefilled insulin or insulin pens. AMAPs can also do glucometer tests and tube feedings, and must retrain every two years.

What conditions apply?

• West Virginia's AMAP program covers private residences where health care services and health maintenance tasks are provided under RN supervision, along with ICF/IID, assisted living and behavioral health group homes
• Only licensed professionals or approved medication assistive personnel (AMAP) may administer medications. AMAPs are facility staff who are trained and retrained every two years and approved and supervised by an authorized RN
• After assessing the resident, the RN (with the resident's health care professional) recommends authorizing the staff member, who must be trained, judged competent, consult the RN regularly and be monitored by the RN; the resident must be in stable condition
• Medication administration covers oral, inhaled, gastrostomy tube, topical, eye, ear, nose drop and rectal/vaginal medications; injections are excluded except prefilled insulin or insulin pens
• Health maintenance tasks: glucometer tests, gastrostomy tube feedings, enemas and ostomy care, plus tracheostomy and ventilator care in a private residence for residents living with family or natural supports
• The employing agency must carry liability insurance covering the AMAP and supervising provider

Is there an exception for self-directed care?

Parents or guardians may administer medication and perform health maintenance tasks for their adult or minor child, even if paid for that care (W. Va. Code 16B-10-4(d)).

What is the difference between medication reminders and administration?

Reminding a client to take their medicine, or handing them a container they open themselves, is usually treated as assistance. Giving the medicine, such as placing pills in the mouth, giving an injection or crushing tablets, is administration and generally needs a license or nurse delegation. Check your state's rule and the client's care plan.