Section 801.710  Health Care Services

a)         The facility shall have a designated health authority who shall be responsible for the development and implementation of a plan for youth medical and mental health services, including emergency services, and youth health care pursuant to a written agreement, contract, or job description.  The health authority may be a physician, health administrator, or health agency.  When the authority is other than a physician, final medical judgements rest with a single designated physician.   The health authority shall meet at least quarterly with the Chief Administrative Officer on the development of facility health services and planning.

b)         The plan shall include procedures which govern the relationship and the activities of private physicians working with youth in the facility.

c)         Appropriate State and federal licensure, certification, or registration requirements and restrictions apply to  all personnel who provide health care services to youth.  The duties and responsibilities of such personnel shall be governed by written job descriptions approved by the health authority. Verification of current credentials and job descriptions shall be maintained on file in the facility.

d)         The youth's parents or guardian and the Licensing Administrator shall be notified in case of serious illness or injury, surgery, or death.

e)         The facility shall have a written agreement between the facility or the facility's health authority and a nearby urgent care center or hospital for all medical services that cannot be provided within the facility, including emergency services.  When a youth is in need of urgent care or hospital services, he or she shall be accompanied by a staff member who stays with the youth.  Notification shall be made to the Licensing Administrator and to the parent or guardian at the time of any admission or as soon as possible thereafter.  Continuous same sex security coverage for the admitted youth shall be provided consistent with the youth's medical condition.

f)          If medical services are delivered in the facility or through contract services, adequate space, equipment, supplies, materials, and training as determined by the responsible physician shall be provided for the performance of primary health care delivery and responses to medical emergencies.

g)         Health care policies shall be communicated orally and in writing to each youth on arrival at the facility and shall be in a language clearly understood by each youth.

h)         Youth medical complaints shall be monitored and responded to daily by medically trained personnel who document the complaint and the action taken.

i)          Treatment by health care personnel other than a physician, dentist, psychologist, optometrist, podiatrist, or similar provider shall be performed pursuant to written standing or direct orders by a physician or dentist.  Nurse practitioners and physician's assistants may practice within the limits of applicable laws and regulations.

j)          A history of each youth's immunizations shall be obtained when the health appraisal data are collected.  Immunizations shall be updated as required within legal constraints.

k)         In facilities housing females, obstetrical, gynecological, family planning, and health education services shall be provided as needed.

l)          Arrangements shall be made with health care specialists, for example, pediatricians, allergists, dermatologists, or otorhinolaryngologists, in advance of need in order to ensure timely and direct access to specialists.

m)        When facilities do not have full-time, qualified, licensed health care personnel on duty, a health-trained staff member shall be available on site at all times and shall coordinate the health delivery services in the facility under the joint supervision of the health authority and the Chief Administrative Officer.  A health-trained staff member is one who is minimally trained in accordance with Section 801.750.

n)         Questions regarding the appropriateness of medical treatment shall be referred through the Licensing Administrator to the Department's Medical Director.

o)         The plan shall address the management of serious and communicable diseases.  These policies and procedures shall be updated as new information becomes available.  The plan shall include:  an ongoing educational program for staff and youth; control, treatment, and prevention strategies that may include screening and testing, special supervision, or special housing arrangements, as appropriate; pre-release planning; notification to the Deputy Director; and protection of individual confidentiality pursuant to federal, State, and local laws and regulations.

p)         Any employee or youth suspected of having a communicable disease shall have a medical examination.

q)         The plan shall provide for the emergency detoxification of youth from alcohol, opiates, barbiturates, and similar drugs to be performed under medical supervision.

r)          The plan shall provide for the clinical management of chemically dependent youth.

s)         All informed consent standards in the jurisdiction where the facility is located are observed and documented for medical care.  The informed consent of parent, guardian, or legal custodian applies when required by law.  When health care is rendered against the patient's will, it shall be in accordance with federal and State laws and Department rules.