reglab/statecodes huggingface dataset:
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0034 - Non-Licensed Staff Providing Health Services

Current through Reg. 50, No. 138; July 16, 2024
(1) Aspects of
				medical care may be delegated to non-licensed staff that have been
				appropriately trained and experienced to perform those specific tasks of care.
				Competency to safely perform these tasks shall be verified by the Registered
				Nurse who has delegated the tasks to the non-licensed staff as per Chapter
				64B9-14, F.A.C., Delegation to Unlicensed Assistive Personnel.
(2) Non-licensed staff may assist in, at a
				minimum, these tasks:
(a) Self-administration
				of medications only when nursing staff is not present;
(b) Accompanying youth to medical
				appointments;
(c) Assisting the
				licensed nurse in the monitoring of youth who are placed on medical alert; and,
(d) Providing First Aid/Emergency
				Care.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0035 - Protocols and Procedures

Current through Reg. 50, No. 138; July 16, 2024
(1) All newly
				employed health care personnel, whether state-employed or contracted health
				care staff, shall receive a clinical orientation to department health care
				policies and procedures, given by a Registered Nurse or designated licensed
				health care professional.
(2) The
				facility Designated Health Authority shall review and approve treatment
				protocols for the onsite licensed nursing staff and non-licensed staff to
				utilize when administering care in response to commonly encountered complaints.
				These protocols must be within the scope of practice and level of expertise and
				training of the staff conducting the Sick Call process.
(3) Treatment protocols shall be specifically
				developed for:
(a) Registered
				Nurses;
(b) Licensed Practical
				Nurses; and,
(c) Non-licensed
				staff.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0036 - Service Agreements

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				facility Superintendent or Program Director shall be responsible for ensuring
				that service agreements are in place with health care providers that are
				routinely and/or frequently utilized by the program. Ancillary service
				contracts or written agreements may be executed with health care professionals
				in the community to provide additional health care as needed.
(2) Service agreements must contain, at a
				minimum:
(a) A general description of the
				services to be rendered;
(b) Fees
				or fee schedules; and,
(c) The
				lines of communication between health care providers and facility
				administrative staff.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0037 - Verification of Credentials

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				facility Superintendent, Program Director or designee are responsible for
				verification of credentials prior to contract execution for all health care
				providers at that facility.
(2) A
				copy of the following documentation shall be maintained in the health care
				provider's service agreement file at the facility and at the respective
				regional office:
(a) Current
				license;
(b) Resume; and,
(c) Current Basic, Advanced, or
				Pediatric Advanced Cardiac Life Support Certification that includes training on
				the automated external defibrillator.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0038 - Students or Interns

Current through Reg. 50, No. 138; July 16, 2024
(1) For students or interns in health care
				profession and licensure training programs, the same training requirements for
				licensure verification apply to the preceptor/supervising instructor from the
				academic institution.
(2) All
				student observation experiences must be pursuant to a written agreement with
				the academic institution.
(3) The
				students or interns must be under direct supervision by their respective
				preceptors/teachers at all times.
(4) The student or intern may directly
				observe the clinical interaction only with the youth's verbal
				consent.
(5) Departmental
				background screening is required for all students who enter a facility for
				observation, clinical rotation, internship, or any other educational or
				professional experience.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0039 - Interdisciplinary Risk Reduction/Quality Improvement

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities and programs shall implement a method of identifying and solving
				potential and actual problems in health care delivery to committed
				youth.
(2) Meetings shall be held
				no less than quarterly, whereby all disciplines that provide or oversee the
				provision of physical and mental health care, programming/operations and
				behavior management are represented. Additional meetings shall be held as
				needed when an adverse or sentinel event occurs or the potential for such an
				event is recognized.
(3) Simple
				Root Cause Analysis or another problem-solving methodology shall be conducted
				for review of actual adverse or sentinel events.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0042 - Medical Emergencies Upon Admission or During Screening

Current through Reg. 50, No. 138; July 16, 2024
(1)
				During the admission and screening process, immediate emergency medical
				assessment and/or transfer by Emergency Medical Services (EMS) to the nearest
				hospital is required if a youth presents with an incapacitating medical illness
				or condition. In all situations, the staff shall not wait for a response from
				the Designated Health Authority, PA, or ARNP prior to calling 911 and
				contacting EMS.
(2) The Designated
				Health Authority is to be contacted at the next possible opportunity when a
				youth requires emergency transfer during admission and
				screening.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0043 - Routine Notification of the Designated Health Authority Upon Admission

Current through Reg. 50, No. 138; July 16, 2024
(1) In situations where a youth does not
				require immediate emergency transfer, the Designated Health Authority or
				designee must be notified of all youth admitted with a medical condition. This
				notification may be by telephone or verbally.
(2) The notification shall be documented in
				the youth's individual health care record (IHCR).
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0044 - Tuberculosis (TB) Control and Screening

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities shall implement routine screening for all youth for latent and
				active tuberculosis within 72 hours of admission, as well as environmental
				controls in the case of a youth with active Tuberculosis, in accordance with
				the Centers for Disease Control and Prevention recommendations.
(2) The medical evaluation and treatment of
				latent or active TB shall be the responsibility of the Designated Health
				Authority or designee.
(3) The
				Designated Health Authority or designee shall be responsible for the reporting
				all youth with confirmed TB disease to the Department of Health.
(4) If anti-tuberculosis medication is
				prescribed, it shall be noted on the youth's Infectious and Communicable
				Disease form (HS 018).
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0045 - Medical Alert System

Current through Reg. 50, No. 138; July 16, 2024
(1) Each
				facility shall implement a Medical Alert system. The Medical Alert system is
				required for non-licensed staff to use in making safety and security decisions
				as they relate to youth behavior and monitoring needs.
(2) Non-licensed staff shall also identify
				youth for inclusion in the Medical Alert system based on information obtained
				during intake screening, upon return from an off-site medical appointment or as
				the need may arise.
(3) A diagnosis
				of HIV/AIDS shall not be placed on the Medical Alert list per Chapter 381,
				F.S.
(4) All youth with Medical
				Grades of 3-5 shall be placed on the facility's Medical Alert System.
(5) The following medical conditions and
				issues warrant placement of a youth on Medical Alert:
(a) Allergies/Anaphylaxis;
(b) Medication interactions;
(c) Head trauma/injury;
(d) Pregnancy;
(e) Chronic medical conditions;
(f) Hearing, speech, visual, or physical
				impairment;
(g) Developmental
				disability or mental retardation; and,
(h) Medication side
				effects.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0046 - Healthcare Orientation of Committed Youth

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities shall conduct an orientation for youth to the health care delivery
				services upon admission, or at the next available opportunity after
				admission.
(2) The healthcare
				orientation shall be provided by a nurse, or at a minimum, by a non-licensed
				staff knowledgeable with the health care delivery system.
(3) Each facility shall make provisions for
				orientation of youth who are hearing or visually impaired.
(4) Orientation must be provided in Spanish
				or other languages that youth use as a primary language.
(5) For youth with cognitive deficits, the
				school district personnel (or teachers employed by the facility) shall provide
				information as to how to present this information to youth who are
				impaired.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0047 - Health-Related History (HRH)

Current through Reg. 50, No. 138; July 16, 2024
(1) The Health
				Related History (HS 014) shall be completed no later than seven (7) calendar
				days following the date of admission and prior to the youth engaging in
				strenuous exercise or being subjected to extreme outdoor weather conditions
				including, but not limited to, high heat indices and frigid temperatures. The
				Health Related History (HS 014, August 2009) is incorporated into this rule and
				is available electronically at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03802
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399.
(2) The Health Related History shall be
				conducted or reviewed by a nurse through interview of the youth and then made
				available to the Designated Health Authority or Physician Designee, PA, or
				ARNP, prior to conducting or reviewing the Comprehensive Physical Assessment
				(CPA).
(3) When a youth re-enters
				the department's custody or is placed in another facility, a nurse, together
				with the youth shall review the Health-Related History. Corrections and
				revisions shall be made at this time and documented on the page reserved for
				this purpose.
(4) Nursing
				assessments, including a summary of the health-related issues of the youth
				shall be documented. Medical Alerts based on the history are to be implemented
				as applicable.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.005 - Consent and Notification Requirements

Current through Reg. 50, No. 138; July 16, 2024
The following are the requirements for the authorization of
				 health care services to youth in the physical custody of the department.
(1) The Authority for Evaluation and
				Treatment (AET) is the means by which the department obtains the consent of the
				parent or guardian for basic health and mental health evaluation and treatment.
				Covered services and exclusions are described on the form. The AET is not
				required for emergency services. Under no circumstances shall emergency
				services be withheld pending provision of a signed AET. The AET (HS 002,
				February 2010) is incorporated into this rule and is available electronically
				at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03805
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399.
(a)
				The department's Juvenile Probation Officer (JPO) or Facility Superintendent is
				responsible for ensuring that the AET is signed and dated by the parent or
				guardian at the first available opportunity.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.0052 - Special Consent

Current through Reg. 50, No. 138; July 16, 2024
(1) Additional consent is required in special
				circumstances through the Parental Notification of Health Related Care: General
				(HS 020, January 2014) and is incorporated into this rule and is available
				electronically at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03808
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399. Informed consent is required for the
				following:
(a) Hospitalization;
(b) Surgery;
(c) Dental services other than
				evaluations;
(d) Any procedure or
				service of an invasive nature;
(e)
				Any procedure where the benefit to the child is uncertain; and,
(f) Any procedure or service that the parent
				or guardian has previously prohibited.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.006 - Sick Call

Current through Reg. 50, No. 138; July 16, 2024
(1) Sick Call shall be conducted only by a
				licensed nurse or higher licensure level.
(2) Sick Call shall be regularly scheduled in
				each facility.
(3) All youth with a
				complaint, illness, or injury shall have the opportunity to access care through
				the Sick Call process.
(4) Review
				and triage of Sick Call requests shall be conducted as follows:
(a) A licensed nurse, or higher licensure
				level, shall review, triage promptly, and screen for urgency all Sick Call
				requests such that emergency conditions are not delayed for the next regularly
				scheduled sick call session.
(b)
				When a licensed health care professional is not on site, the shift supervisor
				shall review all sick call requests as soon as possible, within four (4) hours
				after the request is submitted. Issues requiring attention prior to the next
				scheduled Sick Call shall be addressed as per Rule   63M-2.009, F.A.C.
1. A Registered Nurse, or higher licensure
				level health care staff, after review of the Sick Call requests, shall make an
				assessment while conducting Sick Call, and determine whether a nursing or
				medical intervention is appropriate.
2. If a facility utilizes a Licensed
				Practical Nurse (LPN) without the presence of a Registered Nurse, the LPN shall
				conduct the Sick Call. The LPN shall review all sick call requests daily
				(either telephonically or in person) with someone at the level of a Registered
				Nurse or a higher licensure level.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.008 - Periodic Evaluations

Current through Reg. 50, No. 138; July 16, 2024
(1) A periodic
				evaluation by a Physician, PA or ARNP shall be conducted for youth in a
				facility who:
(a) Have at least one chronic
				medical condition, or
(b) Have a
				communicable disease, or
(c) Are
				prescribed medications for at least three (3) consecutive
				months.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.010 - Girls Gender Responsive Medical Services

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				Designated Health Authority or physician designee, PA or ARNP shall be
				responsible for appropriate gender responsive and age-related health care and
				services in addition to routine medical care and services.
(2) Gender responsive medical care shall
				include all of the following conditions:
(a)
				Gynecological and menstrual conditions, including STI testing and
				treatment;
(b) Contraceptive
				management;
(c) Prenatal and
				postnatal care for pregnant girls, including a six-week postpartum follow-up
				visit;
(d) Lactation support for
				breastfeeding;
(e) Childbirth
				education, parenting skill education, family planning, infant care
				education;
(f) Anorexia, Bulimia,
				and additional specialized female adolescent complex medical
				conditions;
(g) Specialized
				nutritional management;
(h)
				Aftercare Planning;
(i) Education
				about girls' health, hygiene and grooming needs.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.021 - Pharmacy Permits and Licenses

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				Detention and Residential Program facilities are required to obtain and
				maintain the appropriate Board of Pharmacy permits/licenses as per Chapter
				64B16-28, F.A.C. Each facility is responsible for complying with all federal
				and state laws, rules and regulations governing this permit practice.
(2) A Pharmacy and Therapeutics Committee
				(PTC) shall be established and meet at least quarterly in facilities as defined
				in Rule   64B16-27.300, F.A.C., Standards of Practice - Continuous Quality
				Improvement Program. Each facility shall identify the Pharmacy and Therapeutics
				Committee members in the facility's medication management operating procedures,
				based upon the requirements as stated in Rule   64B16-27.300,
				F.A.C.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.022 - Verification and Procurement of Medications Prescribed Prior to Admission

Current through Reg. 50, No. 138; July 16, 2024
(1) Facility and/or Program staff must
				continue all currently prescribed medications to youth prior to entering the
				department's custody.
(2) A duly
				licensed Physician, PA or ARNP must make all changes in medication regimens
				subsequent to an appropriate assessment. Under no circumstances may staff in a
				facility discontinue an appropriately prescribed medication that the youth is
				receiving upon admission.
(3) Upon
				admission to a facility, the youth and parent or guardian (if available), shall
				be interviewed about the youth's current medications. Refer to required forms
				HS 051 (Probation Medical and Mental Health Clearance Form for Detention
				Centers) or HS 010 (Facility Entry Physical Health Screening for Residential
				Commitment Programs).
(4)
				Medication verification shall also take place during the completion of the
				Health-Related History, and/or the Comprehensive Physical Assessment.
(5) Only medications from a licensed
				pharmacy, with a current, patient-specific label intact on the original
				medication container may be accepted into a Department facility.
(6) Medications may not be administered
				unless all of the following have been met:
(a)
				The youth reports that he or she is taking a prescribed oral
				medication;
(b) Either the youth or
				the parent/guardian has brought the valid, patient-specific medication
				container to the facility;
(c) The
				substance in the medication container has been verified as the correct
				medication; and,
(d) The
				medication is properly labeled.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.023 - Transfer of Youth's Medications

Current through Reg. 50, No. 138; July 16, 2024
(1) Medication
				Acceptance (to be utilized when youth is being transported):
For youth being transported through the Statewide
				 Transportation Offender Program, there shall be, at a minimum, a 7-day supply
				 of medications for transport to accompany the youth. A medication pack card
				 shall be utilized when available for transport with the youth that includes the
				 remaining doses of medication.
(2) When nursing staff are not on site,
				medication verification shall be completed by trained non-licensed staff for
				those youth who arrive from home for transport. This shall be completed by
				review of medication labels, determining last dose(s) provided, (by verifying
				with the parent/guardian when available), and determining if medication is
				scheduled to be taken during the transport of the youth. The Non-Licensed Staff
				Medication Record (HS 054, September 2010) shall be utilized to document when
				the non-licensed staff delivers medication to the youth. The Non-Licensed Staff
				Medication Record (HS 054, September 2010) is incorporated into this rule and
				is available electronically at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03819
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399.
(3) The residential commitment program shall
				provide a transport packet to detention center staff when a youth is delivered
				to the detention center for transport. The transport packet must include:
(a) Photo of youth;
(b) Expanded face sheet;
(c) Authority for Evaluation and
				Treatment;
(d) Parental
				Notification of Health Related Care: General;
(e) Medication (minimum 7 day
				supply);
(f) Medication
				Administration Record (current medication order if applicable);
(g) Suicide risk form/Mental Health
				Alert;
(h) Current Health Related
				History and Comprehensive Physical Assessment;
(i) Current Immunization record; and,
(j) Youth Transport Card (HS 055,
				September 2010), which is incorporated into this rule and is available
				electronically at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03820
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399; and,
(k) The completed Medication Receipt,
				Transfer & Disposition Form (HS 053, September 2010) for transfers from one
				Residential Commitment Program to another.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.024 - Receipt and Storage of Medications

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				medications shall be identified and secured in the locked area designated for
				storage of medications.
(2) All
				medications received from youth and parent/guardian shall be labeled with the
				youth's identifying information, and then secured in a designated area for
				medication storage. For controlled medications received from the youth, the
				perpetual inventory shall begin after receipt of the controlled
				medications.
(3) Prescription
				medications ordered from pharmacies shall be monitored to determine timely
				delivery.
(4) The prescribing
				practitioner, Designated Health Authority, physician designee, PA or ARNP shall
				be notified when a prescribed medication has not been received from the
				pharmacy within 24 hours of the order request.
(5) Each facility shall have access to an
				alternate back-up pharmacy.
(6) All
				non-controlled medications (prescription and over-the counter) shall be stored
				in a separate, secure, locked area that is inaccessible to youth.
(7) All controlled substances, including
				narcotics, shall have a perpetual inventory and shall be kept in a medication
				storage area behind a double-lock system.
(8) Internal medications shall be stored
				separately from externally applied medications. Eye drops shall be stored in a
				separate plastic bag or container.
(9) Refrigerated medications shall be kept in
				a refrigerator for medications only. No food or specimens shall be stored in
				this refrigerator, unless utilized as an adjunct to medication administration.
				A daily refrigerator log shall be utilized for temperature
				documentation.
(10) Each youth's
				medications shall be individually designated and clearly identified as
				belonging to a particular youth.
(11) Facilities that utilize stock
				prescription medications shall keep all records of the receipt of these
				medications for at least 2 years.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.025 - Inventory and Storage of Sharps

Current through Reg. 50, No. 138; July 16, 2024
(1) Sharps
				shall have a perpetual inventory, be securely stored and inventory checked
				weekly.
(2) The Designated Health
				Authority and the facility superintendent or program director shall be notified
				when any discrepancies are found in the perpetual and/or weekly inventory
				counts.
(3) A working inventory
				shall be kept in the area where sharps are to be used.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.026 - Inventory of Medications

Current through Reg. 50, No. 138; July 16, 2024
(1) Medication
				inventory shall include, at a minimum, the following components:
(a) A perpetual, daily running inventory of
				medication utilization for all stock prescription medications.
(b) Shift-to-shift inventory counting of
				controlled substances shall be conducted under the supervision of a licensed
				nurse. When no controlled substances are provided, a shift-to-shift count is
				not required. Supervisory level non-health care staff trained in the delivery
				and oversight of medication self-administration are allowed to assist with
				conducting the count. Only when a licensed nurse is not onsite is the trained
				non-health care staff permitted to conduct the count without a licensed nurse.
				This process shall be included in the facility's operating procedure regarding
				medication management.
(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.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.027 - Disposal of Medications

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				Designated Health Authority or physician designee shall be responsible for
				verifying the proper destruction and disposal of medications in accordance with
				Chapter 64F-12, F.A.C.
(2) Each
				facility must perform the following:
(a)
				Inventory Accountability;
(b)
				Monitoring pharmaceutical expiration dates;
(c) Quarantine of unusable medication; and,
(d) Disposal of medications.
1. A licensed health care professional shall
				be responsible for the disposal of medications. Non-controlled medications for
				disposal shall be inventoried prior to disposal and disposed of in the presence
				of a witness. The witness shall be a licensed health care professional or
				facility supervisor or designee.
2.
				All DJJ facilities shall follow Federal Regulations (CFR) Section 1307.21;
				(CFR) Section 1910.2030) and the Florida Department of Environmental Protection
				for the disposal of medications and biohazardous waste.
3. When a Reverse Distributor is not utilized
				for medication disposal, controlled medications shall be disposed of according
				to the method determined by the facility's Pharmacy and Therapeutics
				Committee.
4. Controlled
				medications shall be disposed of and destroyed beyond reclamation, per Division
				64B16, F.A.C, by a Pharmacist, Nursing staff, and administrator or
				designee.
5. All medication
				disposals shall be documented, and the documentation
				retained.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.030 - Routine Medication Administration

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				prescription and OTC medications shall be administered by licensed nursing
				staff when they are on duty.
(2)
				Medication delivery, including the security and control of the medications
				shall be the sole responsibility of the licensed nursing staff during the
				administration of the medications.
(3) A prescription medication shall not be
				removed from its original packaging or prescription container and placed in
				another container for subsequent administration until the time of medication
				administration.
(4) The same staff
				member shall prepare and administer the medications.
(5) The Five Rights of Medication
				Administration shall be verified during every medication delivery.
(6) Documentation of each individual dosage
				of medication administered to youth shall be maintained on the youth's
				Medication Administration Record (MAR) (HS Form 019). The Medication
				Administration Record (HS 019, October 2006) is incorporated into this rule and
				is available electronically at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03822
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399. The facility may utilize their
				Pharmacy vendor pre-printed Medication Administration Record as long as the
				form includes all information required on the Medication Administration Record
				that is incorporated by reference into Chapter 63M-2, F.A.C.
(7) A separate MAR form shall be used for
				each month. The previous months' MARs shall be filed in the youth's Individual
				Health Care Record.
(8) The youth's
				allergy and medical alert status shall be verified during every medication
				delivery.
(9) Prescription
				medication expiration dates shall be examined during each medication delivery.
				Outdated medications shall not be administered to a youth.
(10) The youth's photograph shall be attached
				or adjacent to the current MAR and visible for medication
				administration.
(11) Each
				medication shall be listed once on each MAR page, utilizing as many MAR pages
				as necessary to list all of the prescribed medications.
(12) Prescription medications and directions
				for use shall be documented on the MAR exactly as on the prescription
				container.
(13) The licensed nurse
				shall be responsible for monitoring the medication delivery and reporting any
				discrepancies to the Superintendent or Program Director and DHA or physician
				designee.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.032 - Youth Refusal of Medication

Current through Reg. 50, No. 138; July 16, 2024
(1) A youth's
				refusal to take a dosage of a prescribed medication shall be documented in the
				Chronological Progress Note section, in addition to "R" for Refusal (as
				indicated on the MAR form).
(2) The
				youth shall initial the MAR indicating refusal of medication. If the youth will
				not initial the refusal notation, this shall be included in the Chronological
				Progress Notes.
(3) A youth's
				refusal of three consecutive dosages of a prescribed medication excluding
				injectables requires notification to the DHA or prescribing
				Physician.
(4) A youth's refusal of
				prescribed injectable medications requires immediate notification to the DHA,
				physician designee or the prescribing psychiatric practitioner.
(5) Each facility shall conduct a review of
				medication refusals that required DHA or prescribing physician notification.
				The review shall be conducted by the Designated Health Authority, or physician
				designee, PA or ARNP and when applicable, the prescribing psychiatric
				practitioner.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.033 - Youth Hoarding of Medication and Swallowing Difficulties

Current through Reg. 50, No. 138; July 16, 2024
(1) The licensed nurse or non-licensed staff
				assisting with medication delivery shall verify whether a youth has swallowed
				his/her medications.
(2) Licensed
				health care professional staff shall notify the DHA/DMHA when a youth is found
				to be "cheeking" or not swallowing his or her medication(s).
(3) A practitioner's order or general
				authorization must be provided by the Designated Health Authority or physician
				designee in order for a youth's medications to be crushed and sprinkled or
				mixed with food.
(4) Licensed
				Health Care professional staff is responsible for notifying the Designated
				Health Authority or physician designee, PA or ARNP of a youth with swallowing
				difficulties or developmental disabilities, to obtain an order for an alternate
				method of providing oral medications. The alternate method shall be noted on
				the MAR.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.034 - Administration of Parenteral Medications

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Non-licensed staff shall not administer parenteral medications, or routinely
				administer any medication that is injected subcutaneously, intradermally,
				intramuscularly or intravenously.
(2) A non-licensed staff person may
				administer a percutaneous injection of a pre-packaged medication to a youth to
				prevent or treat an allergic reaction. The staff member must be trained in the
				use of this product in order to be permitted to administer the
				medication.
(3) Approval from the
				facility Superintendent or Program Director and the Designated Health Authority
				or Physician Designee is required for any youth to self-administers his/her own
				parenteral medication(s). Self-administration of parenteral medication by the
				youth shall only be under the supervision of the trained staff member who has
				control of the vial of medication. The Designated Health Authority shall
				approve all procedures for self-administration under these
				circumstances.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.035 - Medication Evaluations and Serum Drug Level Monitoring

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				Designated Health Authority or physician designee, PA or ARNP, or psychiatrist
				is responsible for ordering the appropriate laboratory testing, including serum
				drug testing, for medications prescribed prior to a youth entering a DJJ
				facility.
(2) Licensed health care
				professional staff is responsible for scheduling follow-up visits with the
				youth's prescribing practitioner for monitoring, laboratory testing and review
				of the results.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.036 - Adverse Drug Events and Medication Errors

Current through Reg. 50, No. 138; July 16, 2024
(1) All youth
				shall be monitored routinely for adverse drug events, and potential adverse
				drug events, including medication errors.
(2) Nursing and facility staff shall be
				notified of potential adverse drug effects and drug interactions through the
				Medical Alert system.
(3) Licensed
				health care professional staff shall monitor each youth daily, prior to
				administering medications, for potential medication side effects. For instances
				where licensed health care professional staff are not onsite and non-licensed
				staff members assist youth with medication administration, see paragraph
				  63M-2.031(8)(h), F.A.C.
(4)
				Licensed health care professional staff shall document side effect monitoring
				on the MAR on at least a weekly basis.
(5) Each facility shall monitor and identify
				all medication errors.
(6) The
				Designated Health Authority or physician designee, and the facility
				superintendent or Program Director shall review the medication error reports at
				least every two weeks. These findings shall be reviewed and summarized during
				the quarterly Pharmacy and Therapeutics Committee CQI meetings as per Rule
				  64B16-27.300, F.A.C.
(7) The
				Designated Health Authority and Superintendent or Program Director shall review
				the Corrective Action Plan and analysis of the causative events pertaining to a
				medication error to determine any existing trends.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.037 - Education of Youth on Medications

Current through Reg. 50, No. 138; July 16, 2024
(1) All youth
				who are prescribed medications shall receive instructions and education related
				to those medications.
(2)
				Medication education for a youth by an onsite licensed health care professional
				shall be recorded in the Individual Health Care Record.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.040 - Environmental and Exercise Precautions

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities shall address medical risks and complications associated with
				elevated heat index, exercise tolerance, and cold exposure.
(2) Facility staff shall instruct youth who
				are in distress during any type of activity to immediately stop the activity.
				The staff must notify health care personnel, or call "911" and assist the youth
				until emergency response arrival.
(3) The Designated Health Authority or
				physician designee, PA or ARNP shall determine whether the facility's full
				exercise regimen is appropriate for a youth with a chronic medical
				condition.
(4) No postpartum female
				shall participate in physical exercise until six (6) weeks postpartum with
				clearance by the facility OB/GYN or Nurse Midwife.
(5) All physical activity restrictions or
				limitations shall be communicated in writing to the facility Superintendent or
				Program Director.
(6) All
				facilities shall provide youth with periodic rest intervals and access to water
				and/or electrolyte replacement fluid during exercise.
(8) The Designated Health Authority or
				Physician designee, PA or ARNP shall inform the Superintendent or Program
				Director of youth who may be medically compromised by adverse environmental and
				exercise conditions.
(9) Anytime
				the health care staff determines that the health or physical safety of a youth
				has been compromised or is potentially compromised, they shall remove the youth
				from all physical activities without prior approval from program
				staff.
(10) Licensed health care
				professional staff shall intervene anytime a youth is in pain and unable to
				participate in physical activities.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.050 - Infection Control - Regulations and Training

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities shall conduct surveillance, screening and management of specific
				illnesses or potential infectious conditions.
(2) Each facility must develop and administer
				a comprehensive program of education and prevention regarding blood borne
				pathogens.
(3) An Exposure Control
				Plan shall be written.
(4) The
				elements of the Exposure Control Plan contain, at a minimum, the following:
(a) Risk Assessment; and,
(b) Methods of
				Compliance.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.051 - Needle Stick Injuries/Exposure

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities shall establish needle stick post-exposure intervention and
				treatment.
(2) If an exposure meets
				criteria for post-exposure treatment, the post-exposure chemoprophylaxis (PEP)
				must be offered and initiated immediately after the exposure.
(3) For a youth or staff exposure to bodily
				fluids or exposure to another person's blood, the Superintendent or Program
				Director shall arrange for a confidential medical evaluation and a follow-up
				post-exposure analysis and counseling as required by the OSHA Standard  29CFR 1910.1030.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.052 - HIV Counseling and Testing

Current through Reg. 50, No. 138; July 16, 2024
(1) All youth
				determined at risk for HIV infection shall be offered counseling, testing, and
				referral for medical treatment as indicated.
(2) The facility shall provide or facilitate
				the HIV counseling and testing. If the facility cannot provide the counseling
				and testing, the facility shall collaborate with the local County Health
				Department or other community providers for these services.
(3) HIV counseling shall only be conducted by
				a certified HIV counselor.
(4)
				Pursuant to Sections   381.004(3)   and   384.30, F.S., any test for the detection of
				HIV cannot be ordered without an informed consent from the individual being
				tested. The consent may be obtained and recorded on the Human Immunodeficiency
				Virus Youth Consent Form (HS 015, April 2010) which is incorporated into this
				rule and is available electronically at
http://www.flrules.org/Gateway/reference.asp?No=Ref-03823
,
				or may be obtained by contacting: DJJ, Office of Health Services, 2737
				Centerview Drive, Tallahassee, FL 32399.
(5) The facility shall facilitate
				confirmation of positive HIV test results when indicated, and provide medical
				follow-up.
(6) Parental
				notification of a youth's HIV testing without the youth's permission is
				prohibited per Chapter 381, F.S.
(7) HIV test results shall be disclosed only
				to the youth and the entities identified pursuant to Chapter 381,
				F.S.
(8) All pregnant youth shall
				be provided an HIV test unless, after counseling by the Physician, PA or ARNP
				as to the risks of transmission of HIV to the fetus, she refuses testing. When
				this occurs, she must sign a waiver (refusal) to decline the test. This shall
				be filed in the IHCR.
(9) HIV
				results shall be sealed in an envelope marked "confidential" and filed in the
				Individual Health Care Record.
(10)
				Youth who are HIV positive shall have an initial evaluation by a physician (if
				not previously obtained) who specializes in the management of infectious
				diseases in adolescents and children.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.053 - Lice (Pediculosis) and Scabies

Current through Reg. 50, No. 138; July 16, 2024
(1) All
				facilities shall conduct evaluation, identification, treatment, and containment
				of pediculosis (lice) or mites (scabies), including product-specific treatment
				and environmental control practices.
(2) Treatment protocols and facility
				procedures shall be developed and approved by the Designated Health Authority
				regarding lice and scabies.
(3)
				Orders and/or plans of care for multiple youth provided by a County Health
				Department may be substituted for facility procedures during a lice or scabies
				outbreak or to reduce the possibility of an outbreak.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.
Florida Administrative Code › 63 - DEPARTMENT OF JUVENILE JUSTICE › 63M - Medical › Chapter 63M-2 - HEALTH SERVICES › Section 63M-2.054 - Methicillin Resistant Staphylococcus Aureas (MRSA)

Current through Reg. 50, No. 138; July 16, 2024
(1) Each
				facility's DHA or designee shall be responsible for infection control
				requirements in accordance with the CDC for the identification, evaluation,
				treatment and containment of Methicillin-Resistant Staphylococcus Aureus
				(MRSA).
(2) Youth with open skin
				infections shall be referred to the DHA, or designee, PA or ARNP for a medical
				evaluation.
(3) A MRSA infection
				shall be considered in the differential diagnosis of all youth presenting with
				skin and soft tissue infections consistent with a staphylococcal
				infection.
(4) The DHA or designee
				or PA or ARNP shall determine the necessity for wound incision and drainage,
				use of warm compresses, and the need for antibiotic therapy.
(5) The DHA shall re-evaluate a youth at
				least one week after completion of antibiotic therapy for recurrent skin
				lesions and/or wound assessment to determine the need for further re-culture
				and treatment.
(6) Standard
				Precautions and/or Contact Precautions shall be used for all care for the
				prevention of cross-contamination of infection.
(7) Each facility shall implement
				environmental sanitation for maintaining infection control and preventing the
				spread of MRSA infection to others.
(8) Any youth with a skin infection shall
				receive infection control education that includes prevention and
				cross-contamination of infection.
Rulemaking Authority  985.64(2)  FS. Law Implemented
					  985.64(2),  985.145,  985.18 FS.
New 3-16-14.