Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.090 - Facility-Based Community Corrections

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				section applies to programs operated or contracted by the department that
				provide greater than four (4) hours of continuous care for youth. The minimal
				requirements of this rule section do not supplant the more extensive
				requirements of this rule chapter that apply to youths who are
				residentially-committed or detained
.
The parent(s) or legal
				guardian of youth in facility-based community corrections programs are
				responsible for their child's health services.
(2) Each facility-based community program
				shall have in place procedures for the provision of medical care for youth in
				need of health care services while youth are physically present at the program.
				These procedures include:
(a) Medical/Physical
				intake screening: Each facility shall develop a health screening process at the
				time of admission. Staff shall interview the youth using either the DJJ
				Facility Entry Physical Health Screening form (HS 010), or their own screening
				form which, at minimum, screens for acute illness/injury and chronic health
				conditions that may require attention while physically present at the program
				(e.g., diabetes, pregnancy, heart conditions, asthma, Crohn's disease, food and
				environmental allergies). Where there is question or concern related to a
				youth's medical condition, the parent(s)/legal guardian shall be contacted. The
				department's Problem List (HS 026) shall document any identified chronic health
				condition(s) and shall be maintained in the youth's confidential case
				file.
(b) Non-emergency care: Each
				program shall have at least one first aid kit that shall be secured in a
				designated location inaccessible to youth. For youth experiencing
				non-life-threatening illness or injury that requires medical attention beyond
				first aid, the program shall have appropriate transportation in the event the
				youth's parent(s) or legal guardian are not available to provide
				transportation. Non-licensed staff members who provide first aid or emergency
				care shall maintain required certifications as per chapter 63H-2, F.A.C., and
				are authorized to provide care only within their training. Any complaint of
				severe pain, including dental pain, shall be treated as an emergency, with
				immediate referral by contacting the parent(s) or legal guardian, or through
				access to emergency medical care. Documentation of referral or of onsite first
				aid shall be maintained in the youth's confidential case file.
(c) Emergency care: When care is needed
				beyond onsite first aid, staff shall refer the youth to outside medical
				services. Signs and symptoms of the need for emergent, off-site care include,
				but are not limited to, tremors, severe sweating, injury, physical illness,
				distress, difficulty moving, intoxication, fainting or unresponsiveness. All
				staff shall have immediate access to contact Emergency Medical Services (EMS)
				by calling "911" under any circumstances that require immediate medical
				attention or evaluation. Drills shall be conducted as follows to ensure access
				to emergency care:
1. Emergency drills, both
				announced and unannounced, shall be conducted for each shift, on at least a
				quarterly basis. The drills shall simulate an episodic care event calling for
				immediate first aid or the administration of CPR techniques, and the initiation
				of emergency procedures to follow when a life-threatening emergency occurs. CPR
				and AED techniques shall be demonstrated at least annually. All staff from all
				shifts who have direct contact with youth must participate in at least one
				emergency CPR drill annually.
2.
				Documentation of drills shall be maintained by the
				facility.
(d) Medication
				management: When a youth is currently prescribed a medication that may be
				required to be provided while the youth is onsite, the program shall verify the
				prescription and obtain consent to provide the medication. The parent(s) or
				legal guardian is responsible for supplying the youth's medication. Facility
				staff are responsible for ensuring any prescribed medications are obtained from
				the parent(s) or legal guardian. Pursuant to chapter 64B9-14, F.A.C.,
				(Delegation to Unlicensed Assistive Personnel), a Registered Nurse may delegate
				non-licensed trained staff to assist the Registered Nurse or Licensed Practical
				Nurse with the youth's self-administration of medication(s).
1. Facilities may utilize non-licensed staff
				to provide medications to youth for self-administration only when there is no
				licensed health care professional staff onsite, and only as authorized by
				chapter 64B9-14, F.A.C.
2. Training
				of non-licensed staff to assist youth with self-administration of oral
				medications shall only be conducted by a Registered Nurse or higher licensure
				level.
3. The Registered Nurse must
				supervise the trained staff member by periodically performing direct
				observation of skills, inspecting the Medication Administration
				Record(s)/Medication Distribution Log (MAR/MDL) and the required documentation
				assigned to the staff member.
4.
				All medications shall have the pharmacy label with the youth's identifying
				information and directions for the medication. The medication shall be secured
				in an area designated for medication storage.
5. Information and directions from the
				prescription bottle shall be transferred to the MDL/MAR. If directions are
				unclear, the pharmacy will be contacted for clarification.
6. The non-licensed staff member assisting
				youth with self-administration of medications shall not perform any additional
				facility duties during medication delivery.
7. The non-licensed staff member shall assist
				youth with self-administration of medication within one hour of the scheduled
				time of the ordered medication.
8.
				Self-administration of medications by non-licensed staff shall include, at a
				minimum, the following:
a. Assist no more than
				one youth at a time with medication;
b. Wash his or her hands prior to medication
				delivery;
c. Remove the
				prescription container from the storage area, holding the container;
d. Maintain control of the medication
				container at all times;
e. Direct
				the individual youth to approach the area for medication administration when
				called;
f. Compare the youth with
				the photograph attached to the MAR/MDL and confirm the youth's identity
				verbally;
g. The youth and staff
				member together identify and verify the medication the youth is to take by
				checking the label and comparing the label to the MAR/MDL. The staff member
				shall not permit youth to take any medication that has a discrepancy between
				the medication prescription label and the MAR/MDL;
h. Confirm the allergy status of the youth as
				described in paragraph (2)(a) and ask whether the youth is experiencing any of
				the side effects or adverse reactions indicated by the manufacturer;
i. Remove the medication from the container
				while the youth observes, and hand the youth the exact amount of ordered
				medication. When the medication is a liquid, the staff member shall pour the
				exact volume of liquid ordered into a measured container and hand it to the
				youth;
j. Directly observe that the
				youth swallows the medication; and
k. Both the youth and the staff member shall
				initial that the dosage was provided on the MAR/MDL.
9. The facility shall maintain a medication
				inventory process which shall include, at a minimum, the following components:
a. A perpetual and shift-to-shift inventory
				of all controlled substances.
b. A
				weekly accounting of the stored prescription and non-prescription
				medications.
c. Reporting criteria
				and methods of managing and investigating inventory discrepancies, including
				unexplained losses of controlled substances. Facilities shall notify the
				appropriate department branch regional staff of the unexplained
				loss.