Get Self-administration Of Medication Assessment - Illinois Department ... - Dhs State Il

Filling out the Self-Administration Of Medication Assessment (SAMA) from the Illinois Department of Human Services is an essential step toward ensuring the appropriate medication management for individuals. This guide will provide you with clear, step-by-step instructions to help you accurately complete the form online.

Follow the steps to successfully complete the assessment.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by filling in the client’s name, Social Security number, and Medicaid ID number at the top of the form. Make sure all details are accurate.
3. Next, move to the ‘Program Participation’ section. Indicate whether the client is willing to participate in the self-administration of medication program by selecting 'YES' or 'NO'. If 'NO', stop here and complete page 3.
4. If 'YES' is selected, proceed to the assessment items. For each task listed, indicate the client's ability by placing the appropriate letter in the ‘HOW’ box and ‘MANNER’ box.
5. Complete each item in the assessment and ensure all responses reflect the client's actual capabilities accurately. If any items are marked 'NO', proceed to determine if self-medication training is appropriate.
6. Once all items are completed, if all have been marked 'YES', proceed to page 3 to complete the certification of independence. If not, document the necessary steps for developing a self-medication training program.
7. On page 3, fill out the descriptive information including the client’s name, ID numbers, and select the appropriate program type.
8. Identify the client's independence by checking the relevant box regarding self-medication training and complete the 'Certification of Independence' if applicable.
9. Lastly, certify the document by having a licensed nurse complete the necessary signatures and dates.
10. Save your changes and have the option to download, print, or share the completed assessment form as needed.

Complete the Self-Administration Of Medication Assessment online to ensure effective medication management.