Brainstorming Creative Solutions with the Behavioral Health Facility*
Facilities that are willing to consider accepting a person with a bleeding disorder (BD) may need help thinking creatively about the ways in which they can safely and comfortably accommodate a person who uses infusion or injection medications. This document provides some options that you might suggest to a facility that is considering making reasonable accommodations to support your patient but is having difficulty developing a plan.
Access to BD Medication
Secure, climate controlled storage for medication and associated medical supplies
Provision of a private space in which to administer the BD medication
Ensure that only the BD medication is administered and the supplies are not misused
The assistance of a provider to administer the medication
Most BD medication needs to be procured at a specialty pharmacy.
Patients may be able to bring medication that they had previously received into the facility.
The person with BD or their family may be able to get the medication directly from the hemophilia treatment center’s 340B program.
The facility may be able to procure the medication directly from a specialty pharmacy.
The person’s BD treatment team can help develop the plan for access to BD medication.
The medication may need to be provided to the urgent care or ED setting in the event of an emergency.
Most BD medication is shelf-stable at room temperature for at least 3 months. However, some BD medication will require refrigeration.
Medications and supplies need to be stored in a locked office or at the medication/nursing station.
As the person with BD progresses through treatment, medication could be stored in a locker in the person’s room if the facility deems appropriate given the status of the behavioral health issues.
The clean, semi-private space could include a medication room, nursing office, or counseling office.
As the person with BD progresses through treatment, administration of BD medication could be performed in the person’s room if the facility deems appropriate given the status of the behavioral health issues.
If the person is self-administering the BD medication, have a staff member observe to ensure that nothing other than the prescribed BD medication is administered and that the supplies are not misused.
Infusions and injections need to be performed by a competent individual. This competent individual may be a provider on staff at the facility, a provider from a medical unit from the same healthcare system, a contracted provider, such as a visiting nurse, a provider at an external facility (either onsite or at an outpatient facility such as a hemophilia treatment center (HTC) or emergency department(ED)), or a trained family member or caretaker.
Facility should work with the BD treatment team to identify a qualified individual to assist with the administration of BD medication.
As the person with BD progresses through treatment, they may be able to work towards self-infusion/injection in a monitored environment. This will prepare them to care for themselves independently post-discharge.
In an emergency, a person with a BD may need to be brought to an urgent care or ED setting to receive BD medication.
Facilities may require a “single use case agreement” in order to feel comfortable allowing outside providers to administer infusions within their facility. If a facility says that their license does not allow outside providers, this is an avenue to explore.