Library: Policy

340:100-5-29. Monitoring for tardive dyskinesia

Revised 9-15-23

(a) Scope and applicability. Developmental Disabilities Services (DDS) provides training for staff to regularly assess, monitor, and inform service recipients who are at risk for tardive dyskinesia (TD). Monitoring for TD applies to all service recipients who receive medication associated with a risk of TD. Providers of residential services funded by Oklahoma Human Services DDS or Oklahoma Health Care Authority have primary responsibility for implementation of OAC 340:100-5-29. Providers of other types of supports inform service recipients and encourage the implementation of OAC 340:100-5-29. Providers are required to meet standards per OAC 340:100-3-27. Service recipients:

(1) prescribed medication associated with a risk of developing TD are regularly assessed and monitored for symptoms of TD. The service recipient who is prescribed such medication, parent(s) of a minor service recipient, or, if applicable, service recipient's legal guardian is regularly informed about the risk of TD;

(2) assessed with signs or symptoms of TD are referred to the prescribing healthcare provider for further evaluation ;

(3) diagnosed with TD by a healthcare provider, parent(s) of a minor service recipient, or, if applicable, legal guardian are informed of the diagnosis; and

(4) diagnosed with TD continue to receive regular assessments and monitoring regarding the status of the diagnosis.

(b) Assessment and monitoring requirements. A trained rater or the prescribing healthcare provider or designee complete assessments using a standardized assessment scale. The Dyskinesia Identification System: Condensed User Scale (DISCUS) is the preferred assessment scale. DDS trains staff service providers identify to be DISCUS raters at no charge to the service provider. Identified staff may be contract staff or employees of the service provider. When rater training is needed, the service provider notifies DDS training staff.

(1) Service provider staff maintains information about service recipient exposure to medication associated with a risk of developing TD.

(2) Copies of assessment scales completed by provider staff, or documentation of assessment completion by a healthcare provider or designee, are filed in the service recipient's record per OAC 340:100-3-40.

(1) with an unknown history of medication exposure receive an initial DISCUS assessment. When the initial assessment:

(A) has a total score less than five, further assessments are not needed; or

(B) has a total score of five or more, items in (i) and (ii) must occur.

(i) A referral is made to the prescribing healthcare provider for additional evaluation.

(ii) Assessments continue to be completed every six months until a DISCUS score less than 5 is obtained. The assessment is repeated in one month and, if the score remains less than 5, further assessments are not needed;

(2) who are prescribed medication that may cause TD are assessed before medication is started or within 30-calendar days of medication initiation.

(A) Service recipients are routinely assessed every six months while receiving medication associated with a risk of TD.

(B) Assessments may be done more frequently if medications are changed or side effects are suspected or identified;

(3) who have medications discontinued which are associated with a risk of TD are assessed monthly as described in (A) through (C) of this paragraph.

(A) After four months with DISCUS scores of 5 or greater, monthly assessments are stopped, and assessments are repeated every six months.

(B) If a DISCUS score less than 5 is reported, assessments are completed monthly until two additional scores less than 5 are reported.

(4) who have medications introduced again that may cause TD are monitored according to OAC 340:100-5-29.