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KANSAS ADMINISTRATIVE REGULATIONS
AGENCY 28 DEPARTMENT OF HEALTH AND ENVIRONMENT
ARTICLE 4. MATERNAL AND CHILD HEALTH
FAMILY FOSTER HOMES FOR CHILDREN AND YOUTH
Date:
08/31/2009
Document:
28-4-341. Health care policies.
(a) Health services for youth.
(1) Each secure residential treatment facility, in consultation with a physician, shall develop written health care policies that cover the following:
(A) A health history checklist and review for each youth upon admission, as documented on forms approved by the department;
(B) follow-up health care, including a health examination and referrals, for concerns identified in the health history checklist and review;
(C) dental screening upon admission and follow-up emergency dental care as needed;
(D) preventive dental care for youth;
(E) chronic care, convalescent care, and preventive care, if medically indicated;
(F) care for minor illness, including the use and administration of prescription and nonprescription drugs;
(G) care for youth under the influence of alcohol or other drugs;
(H) consultation regarding individual youth, if indicated;
(I) infection control measures and universal precautions to prevent the spread of blood-borne infectious diseases;
(J) maternity care as defined in K.A.R. 28-4-279; and
(K) medically indicated seclusion.
(2) Each facility shall designate as a medical consultant a physician licensed to practice in Kansas.
(3) Each facility shall obtain written consent from each youth's parent or legal guardian for medical and dental care.
(4) The medicine cabinet shall be located in an accessible, supervised area. The cabinet shall be kept locked. Medications taken internally shall be kept separate from other medications. All unused medication shall be safely discarded.
(5) All medications shall be administered by a designated staff member qualified to administer medications. Prescription medication shall be given from a pharmacy container labeled with the following:
(A) The youth's name;
(B) the name of the medication;
(C) the dosage and the dosage intervals;
(D) the name of the prescribing physician; and
(E) the date the prescription was filled.
Any changes of prescription or directions for administering a prescription medication shall be authorized, in writing, by a physician with documentation placed in the youth's record.
(6) All medication, including nonprescription medication, shall be given only in accordance with label directions, unless ordered differently by a physician. A record shall be kept in the youth's record documenting the following:
(A) The name of the person who gave the medication;
(B) the name of the medication;
(C) the dosage; and
(D) the date and time it was given.
(7) Each licensee shall make the following arrangements for emergency care:
(A) The secure residential treatment facility shall have a written record of the name, address, and telephone number of a physician licensed in Kansas to be called in case of emergency.
(B) Policies and procedures shall ensure the continuous care of youth who require emergency medical treatment.
(C) If a staff member accompanies a youth to the source of emergency care, the staff member shall remain with the youth for the duration of the emergency.
(D) Supervision of the other youth in the secure residential treatment facility shall not be compromised.
(E) The health history checklist and health assessment shall be taken to the emergency room with the youth.
(8) The licensee shall report each instance of suspected abuse or neglect and each incident resulting in the death of or in a serious injury to any staff member or youth that requires treatment at a hospital. The report shall be made within 24 hours, excluding weekends and holidays, to the department and the county health department in which the secure residential treatment facility is located. The licensee shall submit each written incident report to the department within five working days. If an injured youth is taken to a hospital or seen by a physician, the licensee shall ensure that the parent or legal guardian or custodian is notified as soon as possible. If suspected abuse or neglect of a youth occurs, the licensee shall ensure that the Kansas department of social and rehabilitation services is notified.
(9) The licensee shall ensure that any injury to a youth or staff member that is a result of suspected criminal action is reported immediately to the local law enforcement officials.
(10) The licensee shall ensure that any death of staff or a youth within the secure residential treatment facility is reported to the local law enforcement officials.
(b) Physical health of youth.
(1) The licensee shall ensure that a health history checklist is completed for each youth at the time of admission. This checklist shall be completed by the person who admits the youth, using forms supplied or approved by the department.
(A) The health checklist shall serve as a guide to determine if a youth is in need of immediate medical care.
(B) The licensee shall ensure that the secure residential treatment facility's physician is contacted for any youth who is taking a prescribed medication at the time of admission so that treatment is not interrupted.
(C) The licensee shall ensure that a physician is contacted for any youth who has acute symptoms of illness or who has a chronic illness. Communicable diseases shall be reported to the local county health department within 24 hours, excluding weekends and holidays.
(2) Within 72 hours of admission, a physician or a nurse certified by the department to conduct screening and health assessments shall review the health history checklist. Based upon health indicators derived from the checklist or in the absence of documentation of a screening within the past 24 months, the physician or certified nurse shall determine whether or not a full screening and health assessment are necessary.
(A) If necessary, the screening and health assessment shall be conducted by a licensed physician or by a nurse certified by the department to conduct these examinations.
(i) The screening and health assessment shall be completed within 10 days of admission.
(ii) The screening shall be based upon health assessment and screening guidelines provided or approved by the department.
(B) Medical and dental records shall be kept on forms provided or approved by the department and shall be kept current.
(C) The licensee shall ensure that each youth receives a tuberculin skin test. A chest x-ray shall be taken of all positive tuberculin reactors and those with a history of positive reaction. The proper treatment or prophylaxis shall be instituted. The results of this follow-up shall be recorded in the youth's record, and the county health department shall be informed of the results.
(D) Each licensee shall maintain a current health record that includes the following for each youth:
(i) The youth's current immunization record;
(ii) a health history checklist;
(iii) documentation of the review of the health history checklist;
(iv) documentation of the decision regarding the need for screening and health assessment;
(v) the tuberculin skin test result;
(vi) a list of medical contacts; and
(vii) entries regarding the youth's health care plan.
(E) The health record shall accompany the youth when transferred. A copy of the health record shall be kept in the youth's record at the secure residential treatment facility.
(3) The licensee's written policies and procedures shall prohibit the use of tobacco in any form by youth while in care.
(c) Dental health of youth.
(1) Each licensee shall make emergency dental care available for all youth. Each youth's record shall include a report of a dental examination obtained within one year before or 60 days after admission.
(2) The secure residential treatment facility staff shall develop plans for dental health education and shall supervise the youth in the practice of good dental hygiene.
(d) Personal health of staff members and volunteers.
(1) Each person caring for youth shall meet the following requirements:
(A) Be free from communicable disease;
(B) be free from physical, mental, or emotional handicaps to the extent necessary to fulfill the responsibilities listed in the job description, and protect the health, safety, and welfare of the youth; and
(C) be free from impaired ability due to the use of alcohol or other drugs.
(2) Each staff member who may have contact with any youth shall receive a health examination within one year before employment. This examination shall be conducted by a licensed physician or a nurse authorized to conduct these examinations.
(3) Results of the health examination shall be recorded on forms supplied or approved by the department and kept on file. Health assessment records may be transferred from a previous place of employment, if the transfer occurs within one year of the examination date.
(4) The initial health examination shall include a tuberculin skin test. If there is a positive reaction to the tuberculin skin test or a history of previous positive reaction, a chest x-ray shall be required. Proof of proper treatment or prophylaxis shall be required. Documentation of the test, x-ray, and treatment results shall be kept on file in the person's health record.
(5) A tuberculin skin test or a chest x-ray shall be required if significant exposure to an active case of tuberculosis occurs or if symptoms compatible with tuberculosis develop. If there is a positive reaction to the diagnostic procedure, proof of proper treatment or prophylaxis shall be required. The results of this follow-up shall be recorded in the person's health record. The licensee shall inform the department of each case described in this paragraph.
(6) Each licensee shall require all volunteers to present written proof of freedom from active tuberculosis before serving in the facility.
(7) Smoking shall not be permitted in the facility.
(e) Personal hygiene.
(1) The licensee shall ensure that each youth bathes upon admission and that each youth is given the opportunity to bathe daily.
(2) The licensee shall give all youth the opportunity to brush their teeth after each meal.
(3) The licensee shall furnish each youth with toothpaste and a toothbrush. Pump soap shall be available at all community sinks and showers.
(4) Each licensee shall make facilities for shaves and haircuts available.
(5) Each youth's washable clothing shall be changed and laundered at least twice a week. The licensee shall ensure that clean underwear and socks are available to each youth on a daily basis.
(6) Each female youth shall be provided personal hygiene supplies with regard to her menstrual cycle.
(7) The licensee shall ensure that clean, individual bath and face towels are issued to each youth at least twice a week. Bed linen shall be changed at least once a week.
(8) The licensee shall allow each youth to have at least eight hours of sleep each day. Fourteen hours of activity shall be provided.
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