Revised Chapter 24 FAQ’s for QMAP (Beginning 7/1/17)
Updated 12/19/2019

General information

What is QMAP?

• QMAP stands for Colorado Qualified Medication Administration Personnel.
• The Colorado Qualified Medication Administration Personnel (QMAP) program operates under statutory and regulatory authority, in accordance with Sections 25-1.5-301 and 6 CCR 1011-1, Chapter 24 Medication Administration Regulations.
• The Qualified Medication Administration Personnel (QMAP) class teaches unlicensed staff members to safely administer medications in certain settings where it’s authorized by law.

Regulation changes

Are the QMAP regulations changing?

• Yes, on July 1st, 2017, the QMAP program was restructured to comply with the regulatory changes.
• The Chapter 24 Medication Administration Regulations are being updated to meet the new statutes.
• Chapter 7 Assisted Living Residences regulations are in the process of being updated.
• DHS Youth Corrections will determine if their policies regarding their medication administration program will be updated.

What is the effective date for the changes?

•  The effective date is July 1, 2017.

Will the DIDD QMAP Program be affected?

• Yes, HCPF and CDPHE have determined that both QMAP programs will be joined.The basic core information is the same in both programs so it does not make sense to keep them separate.
• The formerly separate QMAP program for facilities serving those with intellectual and
• developmental disabilities (or “IDD”), or Program Approved Services Agencies, is now combined with the standard QMAP program, however these types of facilities may require additional skills training for QMAP’s, once they are hired.
• DIDD QMAP Instructors wanting to continue teaching (after 7/1/17) will need to apply to become an Approved Training Entity (ATE). See instructions below.
• DIDD ATE’s will need to submit a processing fee of $14  per student for the student to be added to the verification list.

Approved Training Entities (ATEs)

What is an approved training entity (ATE)?

• An ATE is an entity, state approved to manage and teach their own QMAP courses.
• An approved training entity can be an agency, association, facility, individual, institution or organization that is approved by the department to provide medication. administration students with a suitable classroom and clinical experience.

How do I get approved to be an approved training entity?

• Visit our QMAP web page and click on apply to become an approved entity. You must submit the application with all required supporting documents.

I have been teaching QMAP classes for several years, in order to continue to teach QMAP I either need to become an approved training entity or teach for an agency who has become an ATE?

• Yes, that is correct. Only state approved ATEs can teach a QMAP class.

Our QMAP trainers are external. They are nurses that we contract with to provide this training. Since they are not internal, do they also need to apply to become ATEs or are they covered since they are nurses and offer this training only to our agency employees?

•  If they are only providing services to your agency they can work under your ATE application and approval. They may also choose to become their own ATE.

QMAP instructor requirements

What are the requirements to be a QMAP instructor?

• You must be a Nurse (RN or LPN), Pharmacist, Physician or Physician Assistant with a current, active, unrestricted Professional License allowed to practice in Colorado.

Can a Medical Assistant (MA) teach the QMAP class?

•  No, an MA is not licensed and cannot teach a QMAP course.

I am currently in a 2 year BSN nursing program and have finished the first year. I was wondering if there is anyway I could just take the QMAP test without taking the class, as we have already covered medication administration and pharmacology in nursing school.

• No, until you become a licensed nurse/professional (i.e., LPN, RN, BSN, NP, etc.) in CO, you will have to take a QMAP course and become qualified in order to administer medications.

Application and curriculum

Do I need to create my own curriculum?

• Yes, the approved training entity will need to create their own curriculums, testing, etc.
• Training needs to comply with the Chapter 24 QMAP draft regulations and ​is provided by agencies, associations, facilities, individuals, institutions or organizations have been reviewed and approved by the department.

Can we use the same materials as last year?

• We have provided a “starter kit” which you can use to create your curriculum.

When I develop the curriculum and it is approved can this be shared with agencies that want to become an ATE or do they need to develop a separate curriculum?

• Curriculum from an ATE can be re-submitted by another for approval consideration.

In reading through the materials in the Starter Kit, I notice there is not something that directly replaces Test 1 and 2, the DIDD Certificate, or the Disclosure Form. Can we use the old ones when submitting the new curriculum?

• You are required to create your own tests. If you choose to use current ones, you will need to update the information to meet the minimum required items.
• You will need to create your own certificate without CDPHE logo or branding.
• The disclosure form must also be updated to include information from Chapter 24.

The regulations state that the ATE must designate a Program Coordinator. If the agency will be submitting the student names and payments, how will it work when the ATE is teaching for different agencies, as well as from referrals? What do they need to put on the application for that section?

• The program coordinator will be "the individual designated by an approved training entity who acts as liaison to the Department and is responsible for transmitting the names of students who have passed the training entity’s competency examination, applicable fees and course content updates." Thus, whether the ATE will be training staff for just one agency or several, there will need to be one identified person affiliated with the ATE that acts as the conduit between the ATE and CDPHE. That is the name that should be entered within that section of the application.

On the application there is a field for Target audience? What is it?

• ATE’s can specify who their target audience will be for example:

• General - Anyone can attend.
• Employees only - Only staff employed by the ATE can attend.

If I select "general" when I specify my target audience, can I still teach QMAP to people who provided services to persons with DD? (Since communication and interpersonal skills as outlined on the curriculum checklist is required for all QMAP ATEs?)

• Yes, you can be an ATE and provide training for "general" populations as well as for persons within the IDD realm of services.

What are the seven rights of medication administration?

• Right client
• Right time
• Right medication
• Right dose
• Right route
• Right documentation
• Right to refuse

What are some of the Safety and Emergency Procedures for medication administration?

• Resident emergencies requiring immediate action:

• Seizures
• Choking/Know universal sign of choking – but be aware that residents may or may not be able to give the universal sign of choking

• The QMAP Role in an Emergency:

• Remain Calm
• Call or send for help
• Know your limitations
• Don’t move an injured resident
• Reassure the resident
• Take direction from nurse or doctor

What are the requirements for teaching the Medication Reference Resource Information section and where can I find Medication Reference Resource Information?

• This section of the rule states that the course content shall include classroom and skills practice in the following areas: when, where and how to properly navigate appropriate medication reference resources.
• Some examples of reference resources are pharmacists, books and online.

What information do I need to include to meet the requirement for Drug Diversion training?

• This section of the rule simply states that the course content shall include classroom and skills practice in the following areas and lists "drug diversion awareness". It is an expectation that the ATE simply address this topic, assure that individuals are aware of what a drug diversion is, may entail, and how to properly respond if witnessed, etc. The ATE may want to include the fact that drug diversions for licensed health facilities are a reportable situation via occurrences . As long as the ATE is demonstrating that they will cover/address "Drug Diversion Awareness" within their curriculum, CDPHE will not have any additional questions or concerns.

Can we submit the instructor manual if the student manual is not completed yet?

• As long as all the required minimum areas per rule are addressed, CDPHE does not have the specific authority to say exactly how it must be submitted. If the applying ATE can demonstrate that all the required areas are addressed within the instructor manual, that may very well be appropriate.

Can the G-tube training be taught during the QMAP class?

• G-tube training is separate and apart from the QMAP training. Anyone performing G-tube services must be trained and monitored per the 10 CCR 2505- 10.614 regulations surrounding this service. This should not be taught as part of the QMAP curriculum as it is an individual specific training required for persons needing gastrostomy services.
• Qualified medication administration persons shall not administer medication through a gastrostomy tube or administer insulin unless specifically authorized to do so pursuant to rules adopted by the Department of Health Care Policy and Financing or the Department of Human Services.

The company that we teach for does not use MRBs. They strictly use bubble packs for prescription medications. Is it a requirement that we teach about them if we do not use them?

• Yes, you must at least run through the basics with your students as that is a requirement of teaching the course per Chapter 24 regulations. That does not mean you can't tell your students that your agency does not prefer to use them and let them know they probably won't see them.
• It would be helpful for staff to know what an MRB looks like, how they are used and what is required on them. Sometimes people might bring them back from home or respite or may bring them to a day program.

Page 18 of the starter kit for QMAP states that after someone is a hospital inpatient, the doctor needs to write orders for all prescription and non-prescription medications prior to discharge? I know it takes days to sometimes weeks to get into a primary doc so I just wanted to clarify this.

• What this means is that the discharging physician from the hospital needs to ​write all orders from medications before the person leaves the hospital. This is pretty much standard procedure because some meds may have been added or taken off or titrated during the hospital stay.
• The only reason to take the person to the primary doctor following the hospital release is if instructed or if there continue to be issues with health or medications.

The information in the starter kit refers to all controlled medication being locked and counted with staff. Does controlled medication in a HHP home need to be locked up if they ensure the safety of the client in the home?

• All controlled meds need to follow the guidelines within Chapter 24: double locked and counted at change of shift.
• Please check the regulations for how this should happen when there are not rotating staff.

If the ATE wants to make changes to the course curriculum after it has been approved, does the Department have to approve these changes?

• Only if the changes significantly affect the curriculum being taught. The regulation states: Each ATE shall, prior to implementation, promptly provide the Department with information concerning any anticipated changes that significantly affect the approved course content or competency evaluation.
• If the course structure was being changed, but the content was not changed, the answer would be no.
• If the material used in the course is enhanced to provide clarity to a topic the answer would be no.

I manage detox and IRT programs and am looking for clarification on one of the aspects of the QMAP responsibilities. Specifically, the amount of time a QMAP has to give medication. ½ hour on either side of the allotted med time or 1 hour on either side? There appears to be some discrepancy in the materials I have reviewed on line and different QMAP approved training manuals. Is this something you can help with?

• You're correct in that the materials might not be standardized or consistent on the matter of medication windows and timing because the new regulations say that it needs to be addressed, but they don't provide specific details for a specific 'window'. Therefore, our guidance is to refer to current nursing best practices, and each service agency should document in their policies what (if any) window they are advising for medication administration.
• This is one of those things the agency is now responsible to train staff on rather than the ATE training this. The ATE should be teaching that the new regulations do not address any kind of window, meaning meds should be administered per the doctor's prescription order (i.e., a specific time or window must be adhered to) unless the agency they are working for has a policy directing some kind of window. If meds are administered using a window this must be in the agency's policies so the agency can determine med admin compliance with their policies.

I am trying to put together a Colorado Rules and Regs book for monitoring purposes. Recently, I believe the rule/reg related to medication administration was changed; specifically the administration time to 30 mins prior or after the scheduled med time. The previous rue/reg was administration 1 hour before or 1 hour after. Could you point me in the right direction to find this regulation, so I have the most current on record?

• The new regulations do not address any window for medication administration time. Because of this each service agency should document in their policies what (if any) window they are advising for medication administration. This is one of those things the agency is now responsible to train staff on rather than the ATE/Instructor training this. The ATE should be teaching that the new regulations do not address any kind of window, meaning meds should be administered per the describer's order unless the agency they are working for has a policy directing some kind of window.
• For the new regulations, FAQs on a QMAP's scope of practice, and other resources, please visit our website at: https://www.colorado.gov/pacific/cdphe/medication-administrationqmap

Costs and payment submission for ATEs

How much will QMAP classes cost?

• The approved training entity can set their own fee structure.

How much money will the department collect?

• The approved training entity will need to submit $14 per passing student to be added to the QMAP registry/online verification.

Is the e-check $14 per student plus only $1 for the entire roster or $1 per individual?

• An e-check is a flat $1 for the entire roster. Keep in mind that you do not need to submit the $1 as an extra payment; the system will automatically calculate it into your total.

Can an agency use a money order and is there a charge for a money order?

• Yes, this would need to be made out to CDPHE, contain the appropriate Reference ID, and mailed like a physical check. ​

Who should the e-check or money order be made out as payable to?

• The e-check should be made out to CDPHE​ ​and contain the appropriate Reference ID.

If the agency mails the check, am I notified upon receipt of the check to complete the individual student submissions?

• No, you would not be notified. Names would simply be entered into the registry once the check was received, and the Reference ID and fee amount were verified with the electronic roster.

Do the agencies I teach for collect the funds before I teach the class and give me a check made out to CDPHE before I begin the class? Would I  then be responsible for putting a check in the mail and entering the  names of the QMAP’s on the CDPHE website? Can I have the agency submit a Money Order made out to CDPHE to ensure sufficient funds?

• As the ATE, you can determine how you'd best like to develop and operate the exact process. CDPHE requires that the ATE be responsible for collecting all funds from QMAP staff or agencies. Then, the ATE program coordinator is responsible for routing all funds ($$/each QMAP name) directly to the department in order to have the trained staff names added to the database.

How long does it take for the QMAPs name to show up on the website, once the roster is sent and the payment has been made?

• As soon as both the payment and roster are received and connected by our fiscal program, the names are verified in the system.

Can IDD instructors submit student information online as we have been doing previously?  

• No, as of July 1, 2017, all QMAP classes must be taken from an ATE. ATEs will need to follow the new process for payment and student entries.

Have changes been made to the payment submission portal?  

• The portal now three fields: ATE ID, Testing Date, and Price. This is a change from only entering the ATE ID and date of the class in the same field.

Can existing QMAPs taking the course as a refresher?

• This is fine, but you do not need to re-submit their name on a roster, unless they want an updated QMAP qualification date. If this is the case, you are still required to pay the $14 processing fee. You do not need to specify whether they are a refresher/retesting or not.

How do I calculate the electronic portal fee?

• The portal automatically calculates your fees (e.g. $1, etc.) in addition to your payment, so you should only enter the amount owed from the roster submitted, nothing extra.

Qualified Medication Administration Personnel (QMAP)

QMAP settings

Is this course applicable for medical assistants working in the ambulatory care setting?

A QMAP is permitted to administer medications in the following authorized settings:

• Assisted living residences

• Adult foster care facilities
• Alternative care facilities
• Residential child care facilities
• Secure residential treatment centers
• State certified adult day programs
• Program approved service agencies (PASA) serving people with intellectual and developmental disabilities

I would like some clarification on what kind of programs are approved for QMAPs. I will be working at a program, which is a day shelter for people who are HIV+, and I’m wondering if it would be a location approved for QMAPs? Would it be considered an adult day program?

• Adult daycare facilities providing services in support of persons as defined in section 25.5-6-303(1), C.R.S.-a residential facility which provides alternative care services and protective oversight to eligible persons, which meets ... in this part 3, unless the context otherwise requires: (1) " Adult day care facility" means a facility which meets all applicable state and federal requirements and is certified by the state to provide adult day care services to eligible persons. (2) "Adult day care services" means health and social services provided on a less than twenty-four-hour basis to eligible persons in state-certified adult day care facilities …
• Facilities that provide treatment for persons with mental illness as defined in section 27-65-102(7), C.R.S, except for those facilities which are publicly or privately licensed

hospitals-As used in this article 65, unless the context otherwise requires: (1) "Acute treatment unit" means a facility or a distinct part of a facility for short-term psychiatric care, which may include treatment for substance use disorders, that provides a total, twenty-four-hour, therapeutically planned and professionally staffed environment for persons who do not require inpatient hospitalization but need more intense and individual services than are available on an outpatient basis, such as crisis management and stabilization services.

• Secure residential treatment centers as defined in section 26-6-102(9), C.R.S.-means a facility operated under private ownership that is licensed by the department pursuant to this part 1 to provide twenty-four-hour group care and treatment in a secure setting for five or more children or persons up to the age of twenty-one years over whom the juvenile court retains jurisdiction pursuant to section 19-2-104 (6), C.R.S., who are committed by a court pursuant to an adjudication of delinquency or pursuant to a determination of guilt of a delinquent act or having been convicted as an adult and sentenced for an act that would be a crime if committed in Colorado, or in the committing jurisdiction, to be placed in a secure facility.
• If your program doesn't fit any of these settings, you may still be able to use QMAPs for medication administration, but that will be the judgment and call of your regulatory authority.

QMAP student requirements

Can we teach QMAP to staff who work with students in our school program?

• This QMAP does not cover typical school type settings. School programs are managed by CDHS and they use Qualistar to teach their med course. You can research the specific statute for clarification: 26-6-102 or contact Qualistar for more information on school program requirements.
• This QMAP can be used for 24 hour residential child care programs, day programs and residential facilities operated for people with developmental disabilities.

I have a school who is interested in using grant money to send students through the qmap course. Some students are 17 years old. Is there an exception to the age rule?

• No, there are no exceptions. The regulations state that students must be at least 18 years of age.

QMAP classes

Where can I find information on becoming a QMAP?

• You can find the list of the QMAP trainers at https://docs.google.com/document/d/1LdZr12VPRO833LgA7AYVF8LEAn_PsKUBlfiY-xCn2Wo/pub. Visit the trainer's websites to find out their class schedule, testing dates and prices.
• Additionally, you can find more information about QMAP's at https://www.colorado.gov/pacific/cdphe/medication-administrationqmap.

Will there be a limit on the number of classes held?

• No, the ATE will be able to conduct as many classes as they want.

Will there be a limit on the number of students per class?

• No, there will be no limit on number of students in attendance for each class.

Can an individual who is already a QMAP take an ATE’s course as a refresher?

• Yes, but you do not need to resubmit their names on a roster unless they want an updated QMAP qualification date. If this is the case, you are still required to pay the processing fee. On the roster, you do not need to specify whether they are a refresher/retesting.

Can an ATE offer a test-out option for QMAP students?

• No. You cannot offer test-out options for anyone who is not yet a QMAP, no matter how long they may have already been administering medications in other settings (i.e., private settings). If they are not in the registry, they must complete the entire course, including the full course instruction, written/typed exam, and the skills practicum.

Will agencies and students find instructors and classes in the same manner?

• As of 7/1/17, the department will no longer be maintaining a list of classes. Students will need to directly contact individual ATEs and/or refer to their individual websites for course offering specifics. Approved Training Entities (ATEs) will be found at the following page: https://docs.google.com/document/d/1LdZr12VPRO833LgA7AYVF8LEAn_PsKUBlfiY-xCn2Wo/pub.

Additional required and on the job training for QMAPS

Do employers need to provide any training?

• Yes, employers will need to conduct on the job training and an evaluation of the individual QMAP to ensure they meet facility needs.

What does it mean when it says employees require additional training from a PASA?

• This language is referring to a few of the DIDD specific regulations that fall outside the authority of the QMAP or ATE process. For example, as you are likely familiar with, gastrostomy services are permitted within the IDD realm of services, however that is because of permitting regulations (10 C.C.R. 2505-10, SECTION 8.614). G-tube services are outside the scope of what is taught or trained within an ATE's QMAP course. The individual PASA would be responsible for assuring any/all staff administering G-tube services are trained and can demonstrate competency as required. The other services that may occur within the IDD realm of services that are not prescriptively included within an ATE's training authority include: PRN medications, psychotropic medication due process, etc. These are all areas that have IDD specific regulations for which the individual PASA must train and assure competency before a staff person can begin administering medications to any individuals in service.

With the new requirement of "on the job training,” how will that be tracked if someone is from another company?

• The agency, not the approved training entity (ATE), is responsible for providing on the job training (OJT) for any new employee before a QMAP may administer medications unsupervised, regardless of the agency they came from.

When will the final QMAP be submitted to the database if the "on the job training" is completed through another agency?

• There is no requirement for the ATE to track the OJT of passing QMAPs.
• Approved Training Entities (ATEs) will submit their rosters of all QMAPs passing the course to CDPHE. As soon as CDPHE obtains the roster and verifies the $14 payment for each passing QMAP, CDPHE will update the verification page

QMAP duties and medication administration

Can we put a QMAP to work administering meds if they’ve passed the test with proof, completed their internal training and got checked off to do so, but their name isn’t yet processed into the QMAP registry?

• No. An individual cannot operate as a QMAP until one’s name is processed into the registry. According to Ch. 24: 2.18, a “Qualified medication administration person” or “QMAP” means an individual who passed a competency evaluation administered by the Department before July 1, 2017, or passed a competency evaluation administered by an approved training entity on or after July 1, 2017 and whose name appears on the Department’s list of persons who have passed the requisite competency evaluation.

Can QMAPs transcribe meds?

• Not in the sense of transcribing a physician’s order given verbally (i.e., over the phone). The only people who can do that are those medical professionals who have transcription of meds within their scope of practice. However, a QMAP may copy (transcribe) this order, once written, to the MAR.

Can QMAPs use an epi-pen?

• ​Regulations now allow staff to be trained in the use of them, without a delegation, so they can be used when needed without requiring a call to 911.
• You can find more information detailed information here: https://www.colorado.gov/pacific/cdphe/epinephrine-auto-injector

We have individuals we provide services for that carry epinephrine pens for emergency use due to life threatening allergies.  Both individuals would require staff assistance to use the pens. The Chapter 24 rules clearly state that QMAP trained staff can only administer epinephrine injections when directed to do so by a 911 emergency call operator. We are concerned about the delay in treatment and instances where a 911 operator may not be available (areas of poor reception, a dead battery on a phone, etc.).

• In Chapter 24 following the 911 instruction is also "(B) Has completed anaphylaxis training program conducted by a nationally recognized organization and is authorized to use an Epinephrine injector pursuant to 25-47-103 CRS."
• Legislation was put into place last year that allowed businesses to administer Epi-pens after they had taken a course in how to do this. Many First Aid classes now teach this process including the American Red Cross among several others. So, if your staff are trained they can assist someone with this.

Would Solu-Cortef, an emergency drug for Addison’s Crisis, fall under the epi-pen regs?

I have chosen not to allow QMAPs to give and to just call 911, because the signs and symptoms of Addison’s crisis are vague. Plus QMAPS need to call 911 anyways to get an “order” to give epi.

• QMAPs should not be making this judgement about when this is needed and in addition, it appears that this is an inject-able medication beyond the "scope" of a QMAP.

 Is a QMAP is allowed to check blood sugars on a resident?

• Blood glucose/finger sticks are not a part of the standard QMAP training; however, in both ALR and IDD facilities, including those agencies providing services under the HCBS DD, SLS and CES waivers as well as Residential Care Facilities (RCFs also known as IDD group homes), a QMAP may be allowed to perform such tasks with proper delegation, training, and performance monitoring on the part of licensed/nursing staff.

Can a QMAP dial up an insulin pen?

• A QMAP may monitor a person who does this on their own. They may coach and assist  the person but could not dial up the pen unless this has been assessed and determined to be appropriate for delegation by an R.N. and all rules for delegation are in place per the Nurse Practice Act.

Can you tell me if QMAP’s are allowed to perform finger sticks for glucose monitoring? What about insulin administration?

• Blood glucose/finger sticks are not a part of the standard QMAP training; however, in both ALR and IDD facilities, including those agencies providing services under the HCBS DD, SLS and CES waivers as well as Residential Care Facilities (RCFs also known as IDD group homes), a QMAP may be allowed to perform such tasks with proper delegation, training, and performance monitoring on the part of licensed/nursing staff.  
• For additional QMAP questions, you can visit our website's FAQ, or other resources housed there.

Can a QMAP give a resident an ordered PRN, if given direction by a nurse via the phone or MUST a nurse be on-site in order to guide the QMAP to give an ordered PRN medication?

• As long as there's a physician's order, it is not expected that an RN will be on site for every QMAP medication administration.

Can over the counter medications be given by a QMAP (with physicians order) IE: Tylenol PRN?

• Yes, if the resident requests it.
• PRN medications may be given when the individual meets the criteria for administration of a medication. For example, if an individual states that they have a headache, the administrator would look on their PRN MAR to see if the prescriber has ordered anything for a headache.
• The facility must have written physician ordered for each PRN. Clients need to be able to ask for PRN medications, if they cannot an assessment of the client must be made by someone designated by the facility and must not be a QMAP.
• Administration of PRN medications needs to be documented on the MAR. When documenting a PRN medication, you must document the date, time and reason the medication was given.  In addition, the result must be documented.  The result of a PRN medication is the effect of the medication (i.e., Was the temperature reduced? Was the pain relieved? Was the indigestion resolved? Was there no change?).  

Can a QMAP administer a PRN antipsychotic drug haldol to a resident who is unable to make decision to take more than the scheduled doses?

• The administration of psychotropic med PRNs depends on the service the client is receiving.
• This is not allowed for someone receiving services in the IDD waivers. There are specific requirements in these waivers, beyond the QMAP regs, that would not allow any prn psychotropic medications.

• Psychotropic meds cannot be given PRN except in residential treatment facilities for the mentally ill or if the client understands the purpose of medication and is capable of requesting it.
• A QMAP should not be making a judgment about when to use a psychotropic or how much to administer - this is beyond their med administration scope. This kind of decision should be made by a licensed professional such as a nurse
• The facility must have written physician ordered for each PRN.

I am employed at the County Health Department.  My question pertains to administering vaccinations.  I was reading the state website on “QMAP” where individuals can enroll in courses for medication administration.  I read where QMAP can administer medications in certain settings.  

My question is this: Can a QMAP individual go to sites, such as schools, and senior centers and administer immunizations?  A licensed RN or LPN would be on site and the QMAP would be operating under medical orders? 

• No, the settings and mode of administration would be outside of a QMAP's scope of practice. QMAPs are not allowed to perform injections, except in an emergency situation requiring an Epi-pen, but with guidance and training only. The approved settings are listed on the QMAP website here, along with an FAQ link and other resources.

QMAP qualification and verification

Will QMAPs need to requalify every 5 years?

• If a QMAP completed qualified training on or after 06/10/2011, the QMAP no longer expires. However, an employer can require retesting.
• While state regulations no longer require a QMAP to re-qualify every 5 years, it is a QMAP’s ethical duty to keep their knowledge and skills current and accurate.

What happens to the Q-Maps that have taken the course before the new changes?

• Any/all QMAPs completing qualified training on 6/10/11, or thereafter, will not need to re-qualify and their QMAP qualification will not expire. However, it’s good practice for employing facilities to have a policy in place which requires QMAPs to maintain quality standards. This may include refresher courses and/or retesting.

Will the QMAP online verification change?

• Yes, the layout and search functions will be updated.
• The online verification only provides names of individuals who have successfully passed the QMAP competencies and in no way should be considered fully trained.
• If you can’t find a name, that person is not considered a qualified QMAP.

Is there anyway that I can have a copy of my certification? My new job wants a copy of it and I’m not sure how to get one.

• Online verification is the only official means of verifying a QMAP status. The online verification page is located at  https://www.colorado.gov/pacific/cdphe/qmap-verification.
• The Colorado Department of Public Health and Environment no longer issues Recognition of Completion documents for individuals who have completed the QMAP training and passed the testing. It is your responsibility to conduct an online verification after completing the exams.

Can a QMAP qualification be revoked and taken out of the registry?

• No, QMAP qualifications cannot be revoked. Neither the statute or regulation with regard to this program grants the authority for the sanction and/or removal of the qualification.
• As it is neither a license nor certification, our registry is simply to verify that an individual has taken the training and passed a QMAP course through an Approved Training Entity (ATE).
• Our regulations don't allow our program to track individual work performance and we aren't allowed to revoke or remove anyone. For resident/patient safety, we rely on both a potential employer's background check to screen people for these offenses and our division's complaints/occurrence reporting programs for any follow up on these types of issues.
• Furthermore, the licensee/facility is responsible for patient safety.

Can I revoke a QMAP certification after a staff member had a verified MANE?

• No,however,you can take away the QMAP duties as part of the person's employment with your agency any time you do not think they are being safe. The agency is ultimately responsible for Med Admin. You are not required to allow people you do not trust to continue to administer medications.
• If there is MANE and the person has been reported to law enforcement and there is a record of this, it would make it harder to get a position where they can work with vulnerable people after that.

Is a QMAP qualification transferable to other facility types?

• Qualified medication administration curriculum is specifically developed for the administration of medications in Youth Services communities (e.g., less than 24-hour childcare, licensed day care, foster care, and youth camps). The program is through Healthy Child Care Colorado. The Colorado Department of Human Services (CDHS) childcare regulations are located here.
• Facilities regulated by the Department of Corrections has qualified medication administration curricula developed specifically for the administration of medication in correctional facilities (Youth Corrections). This program requires registration through Youth Corrections.

I’m from another state. Do I need to requalify/retest as a QMAP in Colorado, if I haven’t qualified here as of 06/10/2011?

• Yes, you will need to find an Approved Training Entity in the state of Colorado and take the approved course to qualify as a QMAP here. You will need to contact entities from this list directly (or their website (s)) to determine offering specifics: https://docs.google.com/document/d/1LdZr12VPRO833LgA7AYVF8LEAn_PsKUBlfiY-xCn2Wo/pub

Are medication administration/QMAP certifications from different state transferable to Colorado?

• No, Colorado does not have a system of QMAP reciprocity, so qualifications from another state cannot be used here.

Information for facilities and ATEs

Documentation requirements for ATEs and facilities

What documentation do facilities need to keep?

• The facility shall retain documentation of compliance with sections 3.2 through 3.7.

What documentation do ATEs need to keep and how long do they need to keep them?

• Approved training entities shall retain student competency evaluation records for a minimum of three years.

Does the agency get a copy of the student’s test?

• No, the agency will not get a copy of the student's test.

Do agencies need to provide proof of competency or observation of med passes?

• The agency/facility is responsible for ensuring competency of any new QMAPs that come to work for them.
• The agency will have to maintain documentation showing that they supervised the new QMAP until they ensured this person's competency in med admin.

Do the agencies need paper records of the disclosure forms?

Yes, the disclosure statement form verifies the person has never held a professional license to practice.

• It is the job of the agency/facility, not the job of the ATE, to maintain a copy of this form in the personnel file for the QMAP.

Will medication errors still need to be reported?

• Yes, but not to the state QMAP program. These need to be reported through the state’s Complaints and Occurrences program here.

The wording for requiring a disclosure statement says "as a condition of employment". Is a disclosure statement required for host home providers? They are contracted with our agency, but they are not employees.

• Yes, host home providers must sign a disclosure. Host home providers need to follow the same procedure as any unlicensed individual that is administering medication.

A couple of our host home providers are licensed to administer medications. Do they need to sign a disclosure as well, or is it only for QMAP individuals?

• If they are a licensed Nurse (RN or LPN), Pharmacist, Physician or Physician Assistant they do not need to sign a disclosure as they are working under their license.

Is there a specific QMAP Disclosure Statement Form that all Assisted Livings are supposed to use, or is every community different?

• There is not. You will need to develop your own.
• The disclosure form must also be updated to include information from Chapter 24.

In ALF, should residents on a Antipsychotics and/or Psychotropic Medications have med reviews every 3 months with documentation of GDR (gradual dose reduction) attempts or provider documentation risk versus benefit (like SNF)?

• If this is required by the overseeing physician, and/or in your facility's policy, then it should be adhered to. Otherwise, please contact Dee Reda, at (303) 692-2893, or dee.reda@state.co.us, for the specifics on the new regulations.

Do we need an informed consent “Black Box warning” signed in ALF when (or before) administering prescribed Antipsychotics and/or Psychotropic Medications?

• If this is required by the overseeing physician, and/or in your facility's policy, then it should be adhered to. Otherwise, please contact Dee Reda, at (303) 692-2893, or dee.reda@state.co.us, for the specifics on the new regulations.

Additional questions

Can nurses update Dr's medication orders and monitor medication administration for clients if they do not become an ATE?

• Yes, you can still update Dr's medication orders and monitor medication administration.
• Those with a current, valid IDD QMAP certification can continue to perform QMAP delegated tasks.

Can anyone alter or write on a prescription label?

• No prescription orders or medication labels can be altered. Only an ordering physician can do this, or a pharmacist with a physician's order.

For additional questions please feel free to contact the Qualified Medication Administration Personnel Program at cdphe_hfemsd_qmap@state.co.us.