Header:
KANSAS ADMINISTRATIVE REGULATIONS
AGENCY 28 DEPARTMENT OF HEALTH AND ENVIRONMENT
ARTICLE 4. MATERNAL AND CHILD HEALTH
DETENTION CENTERS AND SECURE CARE CENTERS FOR CHILDREN AND YOUTH
Date:
08/31/2009
Document:
28-4-356. Health care policies.
(a) Health services for juveniles.
(1) Each center, in consultation with a physician or community health nurse, shall develop written health care policies which cover:
(A) Health history checklist and review for each juvenile upon admission, as documented on forms approved by Kansas department of health and environment;
(B) follow-up health care, including 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 juveniles in secure care;
(E) chronic care, convalescent care and preventive care when medically indicated;
(F) care for minor illness, including the use and administration of prescription and nonprescription drugs;
(G) care for juveniles under the influence of alcohol or other drugs;
(H) consultation regarding individual juveniles when indicated;
(I) infection control measures and universal precautions to prevent the spread of bloodborne infectious diseases recommended in "Update: Universal Precautions for Prevention of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings" as published in the Morbidity and Mortality Weekly Report, June 24, 1988, Vol. 37 No. 24 which are hereby adopted by reference;
(J) maternity care as defined in K.A.R. 28-4-279; and
(K) medically indicated isolation.
(2) Each center shall have a physician licensed to practice in Kansas designated as the medical consultant to the health program.
(3) Each center shall obtain a written consent from each juvenile'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. Internal and external medicines shall be kept in separate sections of the cabinet. All unused medication shall be safely discarded.
(A) Prescription medication shall be administered by a designated staff member, from a pharmacy container labeled with the juvenile's name, the name of the medication, the dosage, the dosage intervals, the name of the physician and 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 in the juvenile's file.
(B) All medication, including non-prescription medication, shall be given only in accordance with label directions, unless ordered differently by a licensed physician. A record shall be kept in the juvenile's file documenting the name of the person who gave the medication, the name of the medication, the dosage and the date and time it was given.
(5) Arrangements for emergency care shall be made as follows.
(A) The center shall have a written statement of the name, address and telephone number of a physician licensed in Kansas to be called in case of emergency.
(B) Policy and procedures shall ensure continuous care of juveniles who require emergency medical treatment.
(C) When a staff member accompanies a juvenile to the source of emergency care, the staff member shall remain with the juvenile for the duration of the emergency. Supervision of the other juveniles in the center shall not be compromised. The health history checklist and health assessment shall be taken to the emergency room with the juvenile.
(6) Any incident resulting in death or serious injury to any staff member or juvenile, or any instance of suspected abuse or neglect, shall be reported immediately to the Kansas department of health and environment bureau of adult and child care, and the county health department. A written incident report shall be submitted to the bureau within five working days. Each parent or legal guardian shall be immediately notified when serious injury to, death or hospitalization of a juvenile occurs. When suspected abuse or neglect of a juvenile occurs, the Kansas department of social and rehabilitation services shall be notified in accordance with statutory requirements.
(7) Any injury to a juvenile or staff member that is a result of suspected criminal action, shall be reported immediately to the local law enforcement officials and district attorney's office for their disposition.
(8) Any death of staff within the center or of a juvenile shall be reported to the local law enforcement officials and district attorney's office for appropriate action.
(b) Physical health of juveniles.
(1) A health history checklist shall be completed for each juvenile at the time of admission. This checklist shall be completed by the person who admits the juvenile, using forms supplied or approved by the Kansas department of health and environment.
(A) The health checklist shall serve as a guide to determine if a juvenile is in need of immediate medical care.
(B) The center's physician shall be contacted for any juvenile who is taking a prescribed medication at the time of admission so that treatment is not interrupted.
(C) The center's physician shall be contacted for any juvenile who has acute symptoms of illness or who has a chronic illness. Communicable diseases shall be reported within 24 hours or by next working day to the local county health department.
(2) Within 72 hours of admission, juveniles shall have a review of the health history checklist by a physician or nurse. 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 nurse shall determine whether a full screening and health assessment are necessary.
(A) When necessary, the screening and health assessment shall be conducted by a licensed physician or by a nurse certified by the Kansas department of health and environment to conduct such 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 Kansas department of health and environment.
(B) Medical and dental records shall be kept on forms provided or approved by the Kansas department of health and environment and shall be kept current.
(C) Each juvenile shall receive a tuberculin skin test. A chest x-ray shall be taken of all positive tuberculin reactors and those with a history of previous positive reaction. The proper treatment or prophylaxis shall be instituted. The results of this follow-up shall be recorded in the juvenile's record and the county health department shall be kept informed of the results.
(D) A current health record shall be kept for each juvenile which includes the juvenile's current immunization record, health history checklist, documentation of the review of the health history checklist and the decision regarding the need for screening and health assessment, tuberculin skin test report, medical contacts and entries regarding the juvenile's health care plan.
(E) The health record shall accompany the juvenile when transferred to another facility. A copy of the health record shall be kept in the juvenile's file at the center.
(3) Written policy and procedures shall prohibit the use of tobacco in any form by juveniles while in care.
(c) Dental health of juveniles.
(1) Emergency dental care shall be available for all juveniles. Each secure care center juvenile record shall include a report of a dental examination obtained within one year before or 60 days after admission.
(2) The center staff shall develop plans for dental health education and shall supervise the juveniles in the practice of good dental hygiene.
(d) Personal health of staff members and volunteers.
(1) Each person caring for juveniles shall be:
(A) Free from communicable disease;
(B) Free from physical, mental or emotional handicaps as is necessary to fulfill the responsibilities listed in the job description and protect the health, safety and welfare of the juveniles; and
(C) Free from impaired ability due to the use of alcohol or other drugs.
(2) Each staff member who will have contact with the juveniles 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 such examinations.
(3) Results of the health examination shall be recorded on forms supplied or approved by the Kansas department of health and environment and kept on file at the center. 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, according to current Kansas department of health and environment guidelines, shall be required. Documentation of 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, according to Kansas department of health and environment guidelines, shall be required. The results of this follow-up shall be recorded in the person's health record. The Kansas department of health and environment shall be informed of each case described within this paragraph.
(6) Volunteers shall present written proof of freedom from active tuberculosis before serving in the center.
(7) Smoking shall not be permitted in the facility.
(e) Personal hygiene.
(1) Each juvenile shall bathe upon admission and be given the opportunity to bathe daily.
(2) Each juvenile shall be given the opportunity to brush their teeth after each meal.
(3) Each juvenile shall be furnished with toothpaste and a toothbrush. Pump soap shall be available at all community sinks and showers.
(4) Facilities for shaves and haircuts shall be made available. No juveniles shall be required to have a hair cut unless a physician determines that a hair cut is medically necessary.
(5) Each juvenile's washable clothing shall be changed and laundered at least twice a week. Underwear and socks shall be changed and laundered daily. Clean and serviceable footwear of appropriate size shall be issued to each juvenile.
(6) Each female juvenile shall be provided personal hygiene supplies with regard to her menstrual cycle.
(7) Clean, individual bath and face towels shall be issued to each juvenile at least twice a week. Bed linen shall be changed at least once a week.
(8) Each juvenile shall be allowed to have at least eight hours of sleep each day. Fourteen hours of activity shall be provided.
|