Rule 5123-6-03 | Authorization of developmental disabilities personnel to perform health-related activities and administer prescribed medication.
(A) Purpose
This rule sets forth conditions under which developmental disabilities personnel may perform health-related activities and administer prescribed medication.
(B) Individuals for whom developmental disabilities personnel may perform health-related activities and administer prescribed medication
Developmental disabilities personnel who are not authorized by other provisions of the Revised Code to perform health-related activities or administer prescribed medication may do so pursuant to section 5123.42 of the Revised Code and rules adopted by the department under this chapter as part of the specialized services the developmental disabilities personnel provide to individuals who receive:
(1) Early intervention, preschool, and school age services offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code;
(2) Adult services offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code in a setting where seventeen or more individuals have been authorized to receive services;
(3) Adult services offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code in a setting where sixteen or fewer individuals have been authorized to receive services;
(4) Family support services offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code;
(5) Services from certified supported living providers, if the services are offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code;
(6) Residential support services from certified home and community-based services providers, if the services are received in a community living arrangement that includes not more than four individuals and the services are offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code;
(7) Services not described in paragraphs (B)(1) to (B)(6) of this rule that are offered or provided pursuant to Chapter 5123. or Chapter 5126. of the Revised Code;
(8) Services while residing in a residential facility with five or fewer beds; or
(9) Services while residing in a residential facility with six or more beds.
(C) Authorization of developmental disabilities personnel to activate a vagus nerve stimulator, administer prescribed epinephrine either by autoinjector or intranasally, and administer topical over-the-counter medication for the purpose of cleaning, protecting, or comforting the skin, hair, nails, teeth, or oral surfaces
In the case of individuals receiving services described in paragraphs (B)(1) to (B)(9) of this rule, developmental disabilities personnel, without nursing delegation and without certification issued in accordance with rule 5123-6-06 of the Administrative Code, may:
(1) Activate a vagus nerve stimulator if all provisions of paragraph (C) of rule 5123-6-05 of the Administrative Code are being followed.
(2) Administer prescribed epinephrine either by autoinjector or intranasally for urgent or emergency treatment of allergic reaction and anaphylaxis if all provisions of paragraph (D) of rule 5123-6-05 of the Administrative Code are being followed.
(3) Administer topical over-the-counter medication for the purpose of cleaning, protecting, or comforting the skin, hair, nails, teeth, or oral surfaces provided that:
(a) The topical over-the-counter medication is not being applied to an open wound;
(b) The topical over-the-counter medication is not being applied for specific treatment of a condition that requires a medical diagnosis including fungal infections; and
(c) All provisions of paragraph (E) of rule 5123-6-05 of the Administrative Code are being followed.
(D) Authorization of developmental disabilities personnel to perform health-related activities and administer prescribed medication
(1) When an individual receives services described in paragraph (B)(1) of this rule, trained and certified developmental disabilities personnel may, with nursing delegation:
(a) Perform health-related activities;
(b) Administer oral prescribed medication, administer topical prescribed medication, and administer topical over-the-counter musculoskeletal medication;
(c) Administer oxygen and metered dose inhaled medication;
(d) Administer prescribed medication through gastrostomy and jejunostomy tubes, if the tubes being used are stable and labeled;
(e) Administer prescribed insulin through subcutaneous injection, inhalation, and insulin pump; and
(f) Administer prescribed medication for the treatment of metabolic glycemic disorders through subcutaneous injection.
(2) When an individual receives services described in paragraphs (B)(2), (B)(7), and (B)(9) of this rule, trained and certified developmental disabilities personnel may, with nursing delegation:
(a) Perform health-related activities;
(b) Administer oral prescribed medication, administer topical prescribed medication, and administer topical over-the-counter musculoskeletal medication;
(c) Administer oxygen and metered dose inhaled medication;
(d) Administer prescribed medication through gastrostomy and jejunostomy tubes, if the tubes being used are stable and labeled;
(e) Administer prescribed insulin through subcutaneous injection, inhalation, and insulin pump; and
(f) Administer prescribed medication for the treatment of metabolic glycemic disorders through subcutaneous injection.
(3) When an individual receives services described in paragraphs (B)(3), (B)(4), (B)(5), (B)(6), and (B)(8) of this rule:
(a) Without nursing delegation, trained and certified developmental disabilities personnel may:
(i) Perform health-related activities;
(ii) Administer oral prescribed medication, administer topical prescribed medication, and administer topical over-the-counter musculoskeletal medication; and
(iii) Administer oxygen and metered dose inhaled medication.
(b) With nursing delegation, trained and certified developmental disabilities personnel may administer:
(i) Prescribed medication through gastrostomy and jejunostomy tubes, if the tubes being used are stable and labeled;
(ii) Prescribed insulin through subcutaneous injection, inhalation, and insulin pump; and
(iii) Prescribed medication for the treatment of metabolic glycemic disorders through subcutaneous injection.
(4) When an individual living in a family home receives services from an unlicensed in-home care worker, a family member living in the home may be able to authorize health care tasks according to the provisions of section 5123.47 of the Revised Code. All requirements in section 5123.47 of the Revised Code must be met for family authorization to occur.
(5) A family member acting as paid developmental disabilities personnel may administer medication or perform health-related activities as described in section 5123.42 of the Revised Code without nursing delegation or a certificate issued under section 5123.45 of the Revised Code.
(E) Requirements that apply when developmental disabilities personnel activate a vagus nerve stimulator, administer prescribed epinephrine either by autoinjector or intranasally, or administer topical over-the-counter medication for the purpose of cleaning, protecting, or comforting the skin, hair, nails, teeth, or oral surfaces pursuant to section 5123.42 of the Revised Code
(1) Developmental disabilities personnel will successfully complete, initially and annually thereafter, a training course or courses as specified in rule 5123-6-05 of the Administrative Code.
(2) Developmental disabilities personnel may activate a vagus nerve stimulator, administer prescribed epinephrine either by autoinjector or intranasally, or administer topical over-the-counter medication for the purpose of cleaning, protecting, or comforting the skin, hair, nails, teeth, or oral surfaces only as authorized by the training courses completed and according to manufacturer's instructions and individual-specific indications.
(3) If an employer of developmental disabilities personnel or a county board believes the developmental disabilities personnel have not or will not safely activate a vagus nerve stimulator or administer prescribed epinephrine either by autoinjector or intranasally, the employer or county board will prohibit the developmental disabilities personnel from continuing or commencing to do so and make appropriate arrangements for emergency interventions by another means.
(4) If an employer of developmental disabilities personnel or a county board believes the developmental disabilities personnel have not or will not safely administer topical over-the-counter medication for the purpose of cleaning, protecting, or comforting the skin, hair, nails, teeth, or oral surfaces, the employer or county board will prohibit the developmental disabilities personnel from continuing or commencing to do so.
(5) Developmental disabilities personnel will not engage in an action that has been prohibited by their employer or a county board.
(F) Requirements that apply when developmental disabilities personnel perform health-related activities and administer prescribed medication pursuant to section 5123.42 of the Revised Code
(1) To perform health-related activities; administer oral prescribed medication; administer topical prescribed medication; administer topical over-the-counter musculoskeletal medication; administer oxygen and metered dose inhaled medication; administer prescribed medication through stable labeled gastrostomy and jejunostomy tubes; administer prescribed insulin though subcutaneous injection, inhalation, and insulin pump; and administer prescribed medication for the treatment of metabolic glycemic disorders through subcutaneous injection for individuals in the categories specified in paragraphs (B)(1) to (B)(9) of this rule and in accordance with paragraph (D) of this rule, developmental disabilities personnel will:
(a) Obtain the certification or certifications required by the department and issued in accordance with rule 5123-6-06 of the Administrative Code;
(b) Perform health-related activities and administer prescribed medication only as authorized by the certification or certifications held;
(c) Not perform health-related activities or administer prescribed medication for any individual for whom they have not received individual-specific training; and
(d) Not act without nursing delegation or act in a manner that is inconsistent with nursing delegation when nursing delegation is required in accordance with paragraph (D) of this rule.
(2) Prior to delegating to developmental disabilities personnel and in accordance with all standards and conditions set forth in Chapter 4723-13 of the Administrative Code, the delegating nurse will:
(a) Assess the individual and complete an evaluation of the conditions under which the delegated tasks or delegated prescribed medication administration will be done.
(b) Select developmental disabilities personnel that, as applicable:
(i) Are certified pursuant to rule 5123-6-06 of the Administrative Code; and
(ii) Comply with all standards and conditions set forth in Chapter 4723-13 of the Administrative Code.
(c) Ensure developmental disabilities personnel have received individual-specific training for each individual for whom they perform health-related activities or administer medication.
(d) Document the assessment of the individual and individual-specific training.
(e) Comply with all standards and conditions for nursing delegation in accordance with Chapter 4723-13 of the Administrative Code.
(3) When delegating nursing tasks that are not taught as part of the curriculum specified in rule 5123-6-06 of the Administrative Code, the delegating nurse will train and verify the skills of developmental disabilities personnel in accordance with Chapter 4723-13 of the Administrative Code.
(4) The employer of developmental disabilities personnel, or the county board for independent providers, will ensure that developmental disabilities personnel have received individual-specific training for each individual for whom they perform health-related activities or administer prescribed medication. Developmental disabilities personnel will not perform health-related activities or administer prescribed medication for any individual for whom they have not been specifically trained.
(5) When nursing delegation is required, the delegating nurse will ensure that developmental disabilities personnel have received individual-specific training provided by the delegating nurse or by another licensed nurse in coordination/communication with the delegating nurse for each individual for whom the developmental disabilities personnel perform health-related activities or administer prescribed medication.
(6) If the employer of developmental disabilities personnel believes or is notified by the county board, the department, a delegating nurse, or the quality assessment registered nurse that developmental disabilities personnel have not safely performed or will not safely perform health-related activities, or have not safely administered or will not safely administer prescribed medication, the employer will:
(a) Prohibit the action from commencing or continuing;
(b) Immediately make other staffing arrangements so that performance of health-related activities or administration of prescribed medication are completed as prescribed and in compliance with the requirements of this chapter;
(c) If applicable, immediately notify the county board via the major unusual incident reporting system pursuant to rule 5123-17-02 of the Administrative Code; if applicable, the county board will notify the quality assessment registered nurse;
(d) If applicable, immediately notify the delegating nurse; and
(e) Enter a notation in the certification record of the developmental disabilities personnel in the medication administration information system database described in rule 5123-6-07 of the Administrative Code.
(7) If the employer of developmental disabilities personnel discovers or is notified by the county board, the department, a delegating nurse, or the quality assessment registered nurse that developmental disabilities personnel have committed a medication/treatment error, the employer will:
(a) Prohibit the action that contributed to the medication/treatment error from commencing or continuing by identifying the causes and contributing factors that led to the medication/treatment error and creating a concise, written plan of improvement that addresses the causes and contributing factors to ensure safe and accurate performance of health-related activities and administration of prescribed medication;
(b) If applicable, immediately make other staffing arrangements so that performance of health-related activities and administration of prescribed medication are completed as prescribed and in compliance with the requirements of this chapter;
(c) If applicable, immediately notify the county board via the major unusual incident reporting system pursuant to rule 5123-17-02 of the Administrative Code; if applicable, the county board will notify the quality assessment registered nurse;
(d) If applicable, immediately notify the delegating nurse; and
(e) Enter a notation in the certification record of the developmental disabilities personnel in the medication administration information system database described in rule 5123-6-07 of the Administrative Code except when the medication/treatment error is not related to the actions of the developmental disabilities personnel (e.g., an individual declines medication).
(8) If the delegating nurse believes that developmental disabilities personnel have not safely performed or will not safely perform health-related activities, or have not safely administered or will not safely administer prescribed medication, the delegating nurse will:
(a) Prohibit the action from commencing or continuing;
(b) Immediately notify the employer of the developmental disabilities personnel;
(c) If applicable, immediately notify the county board via the major unusual incident reporting system pursuant to rule 5123-17-02 of the Administrative Code; if applicable, the county board will notify the quality assessment registered nurse; and
(d) Enter a notation in the certification record of the developmental disabilities personnel in the medication administration information system database described in rule 5123-6-07 of the Administrative Code.
(9) Developmental disabilities personnel will not engage in an action that has been prohibited by their employer or the delegating nurse.
(10) A registered nurse will reassess nursing delegation and the needs of the individual on an ongoing basis, but at least annually. The frequency of reassessment is determined by the delegating registered nurse. The reassessment will include a determination that:
(a) Nursing delegation continues to be necessary;
(b) The individual and circumstances continue to adhere to standards and conditions for nursing delegation in accordance with Chapter 4723-13 of the Administrative Code; and
(c) The developmental disabilities personnel continue to demonstrate the skill to accurately perform the nursing tasks, health-related activities, and prescribed medication administration being delegated.
Last updated August 13, 2026 at 8:23 AM
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