Section 411.720  Health Care Services

a)         Each child and youth shall be screened for communicable diseases within 24 hours after arrival at the facility.

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

c)         Children's and youth's medical complaints shall be monitored and responded to daily by a registered nurse who documents the complaint and the action taken.

d)         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 assistants may practice within the limits of applicable laws and regulations.

e)         Consent for medical care shall be obtained from the guardian and documented in the client file. The informed consent of child or youth, parent, guardian, or legal custodian shall be obtained 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.

f)         The child's or youth's parents, caseworker, Department's Office of the Guardian, licensing representative and regional administrator shall be notified in case of serious illness or injury, surgery, or death.

g)         A registered nurse shall be available on site at all times and shall coordinate the health delivery services in the facility under the joint supervision of a licensed physician and the facility director.

h)         Questions regarding the appropriateness of medical treatment shall be referred through the child's or youth's caseworker to the Department's Office of the Guardian.

i)          The facility shall develop a written health plan that shall address the management of serious and communicable diseases. The plan shall be updated as new information becomes available. The plan shall include: an ongoing educational program for staff and children, including Universal Precautions, control, treatment, and prevention strategies that may include screening and testing, special supervision, or special housing arrangements, as appropriate; discharge planning; and protection of individual confidentiality pursuant to federal, State, and local laws and regulations. The plan shall provide for the emergency detoxification of children and youth from alcohol, opiates, barbiturates, and similar drugs to be performed under medical supervision.  The plan shall provide for the clinical management of chemically dependent children and youth.

j)          At the time a child or youth is admitted, program and secure child care staff shall be informed of special medical and mental health concerns on a need-to-know basis.

k)         Emergency medical, dental, and mental health care shall be available to children and youth on a 24 hour basis. Availability of these services shall be outlined in a written plan that includes arrangements for the following:

1)         On-site emergency first aid and crisis intervention;

2)         Emergency evacuation of the children and youth from the facility;

3)         Use of an emergency medical vehicle;

4)         Use of one or more designated hospital emergency rooms or other appropriate health facilities;

5)         Emergency on-call physician, dentist, and mental health professional services when the emergency health facility is not located in a nearby community;

6)         Security procedures when transportation is required for children and youth; and

7)         Process to notify the caseworker, parents, and Guardian ad Litem.