reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 2 - Louisiana Physician Order for Scope of Treatment › Section I-207 - Execution of the LaPOST Form

Current through Register Vol. 50, No. 6, June 20, 2024
A. A LaPOST
				  form can only be executed by a competent adult patient or if the patient is
				  incompetent or otherwise lacks capacity, a personal health care
				  representative.
B. The LaPOST form
				  must be completed by a physician based on patient preferences and medical
				  indications.
C. The LaPOST form
				  shall:
1. list the qualified patient's last
				  name, first name and middle initial, and date of birth;
2. list the qualified patient's life-limiting
				  and irreversible condition;
3.
				  check all physician orders that apply. Any section not completed implies full
				  treatment for that section;
4.
				  indicate with whom the physician discussed summary of goals and the basis for
				  the orders;
5. contain the
				  physician's signature;
6. contain
				  the patient or personal health care representative's signature and
				  date.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 2 - Louisiana Physician Order for Scope of Treatment › Section I-209 - Review of the LaPOST Form

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  LaPOST form should be reviewed periodically by the physician and the patient,
				  including, but not limited to, when:
1. the
				  patient is transferred from one care setting to another;
2. there is a substantial change in the
				  person's health care status; or
3.
				  the patient's treatment preferences change.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 2 - Louisiana Physician Order for Scope of Treatment › Section I-211 - Revocation of the LaPOST Form

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  LaPOST form may be revoked at any time by the patient or his/her personal
				  health care representative by expressing his/her intent verbally, in writing,
				  or by destroying the LaPOST form.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 40:1299.64.1-1299.64.6.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 3 - Meetings of Self-Help Organizations Dedicated to Recovery and Abstinence from Alcohol and Drugs in DHHR Facilities › Section I-301 - Purpose, Scope and Applicability

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  It is the policy of the Department of Health and Human Resources to encourage
				  members of self-help groups, such as, but not limited to, Alcoholic Anonymous
				  (AA), Narcotic Anonymous (N.A.), Tough Love, Women For Sobriety (W.F.S.) and
				  other bonafide self-help organizations dedicated to recovery and abstinence
				  from alcohol and drugs to establish regularly scheduled meetings in the
				  department's general hospitals with alcoholism and drug abuse treatment
				  programs, in mental health hospitals with such programs, and in outpatient
				  facilities operated and managed by OPRADA; and where appropriate, to support
				  patient access to community based meetings of such self-help groups.
B. The Office of Prevention and Recovery from
				  Alcohol and Drug Abuse is directed to develop written guidelines to assist DHHR
				  facilities and members of self-help groups in initiating a plan of cooperation
				  for implementing viable self-help groups within the department's general
				  hospitals, mental hospitals, and OPRADA community treatment facilities. These
				  guidelines shall incorporate a statement of the department's commitment to
				  utilize the A.A./N.A. and other bonafide self-help recovery programs in its
				  treatment of persons with alcohol and drug problems; provisions for designating
				  a DHHR staff person to serve as liaison with these groups, and with volunteer
				  members of such groups; recommendations for format and content of formal
				  agreements between DHHR facilities and group volunteers conducting group
				  meetings, such as: support of patient participation, protection of patients'
				  rights, confidentiality, specific agreement on time, place conduct of meeting,
				  responsibilities of facilities' staff and volunteers and facilities'
				  security.
C. These guidelines shall
				  also address recommended provisions for patients' access to community based
				  self-help group meetings. In developing these guidelines, OPRADA shall be
				  mindful of the department's ultimate responsibility for the patient,
				  responsibility which cannot be subject to contradictory decisions by self-help
				  group representatives.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S. 36:1
					 et seq.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 4 - Medically Futile Pregnancies › Section I-401 - Conditions that Shall Deem an Unborn Child "Medically Futile"

Current through Register Vol. 50, No. 6, June 20, 2024
A. Pursuant to Act 545 of the 2022 regular
				  session of the Louisiana Legislature, the Department of Health establishes the
				  following exclusive list of anomalies, diseases, disorders, and other
				  conditions that shall deem an unborn child "medically futile" for purposes of
				  R.S. Title 14, Chapter 1, Part V, Subpart A:
1. achondrogenesis;
2. acrania;
3. anencephaly;
4. arcadia;
5. body stalk anomaly;
6. campomelic dysplasia;
7. craniorachischisis;
8. dysencephalia splanchnocystica
				  (Meckel-Gruber syndrome);
9.
				  ectopia cordis;
10.
				  exencephaly;
11. gestational
				  trophoblastic neoplasia;
12.
				  holoprosencephaly;
13. hydrops
				  fetalis;
14.
				  iniencephaly;
15. perinatal
				  hypophosphatasia;
16. osteogenesis
				  imperfecta (type 2);
17. renal
				  agenesis (bilateral);
18. short rib
				  polydactyly syndrome;
19.
				  sirenomelia;
20. thanatophoric
				  dysplasia;
21. triploidy;
22. trisomy 13;
23. trisomy 16 (full);
24. trisomy 18;
25. trisomy 22; and
26. a profound and irremediable congenital or
				  chromosomal anomaly existing in the unborn child that is incompatible with
				  sustaining life after birth in reasonable medical judgment as certified by two
				  physicians that are licensed to practice in the state of Louisiana.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 5 - Disclosure of Confidential Information › Section I-501 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. These
				  rules implement Section 7 of Title 44 of the Louisiana Revised Statutes by
				  establishing procedures whereby medical records may be exhibited to or copied
				  by persons legitimately and properly interested in the disease or condition of
				  patients.
B. It is the policy of
				  the department to protect, to the fullest extent possible, the privacy of
				  individuals, while permitting the disclosure of confidential information as is
				  required to fulfill the administrative responsibilities of the department, to
				  further scientific research, and to assist the patient/client.
C. These rules apply to every agency within
				  the department which maintains or makes use of medical or confidential
				  information concerning individuals. If an agency is governed by federal
				  regulations which provide stricter standards or confidentiality, these rules
				  shall be deemed superseded by the federal regulations, to the extent that they
				  are in conflict with the federal regulations.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 44:7.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 5 - Disclosure of Confidential Information › Section I-503 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Agency
-each hospital, clinic,
					 institution, school for the mentally deficient, mental health facility, office,
					 bureau, division, board, commission or other entity which has been placed
					 within the Department of Health and Human Resources, which maintains or makes
					 use of medical information concerning individuals.
Department
-the Department of Health and
					 Human Resources.
Designated Representative
-a physician or
					 mental health professional selected by a patient to review the patient's
					 medical record for the purpose of determining what information in the patient's
					 record will be disclosed to the patient.
Medical Emergency
-a situation where, in
					 competent medical judgement, disclosure of medical information is reasonably
					 necessary and any delay in attempting to procure the patient's consent to
					 disclosure of medical information would jeopardize the life or health of the
					 patient or could reasonably result in disfigurement or impairment of
					 faculties.
Medical Information
-the charts, records,
					 reports, documents, and other memoranda prepared by physicians, surgeons,
					 psychiatrists, nurses, and employees of the public hospitals, public mental
					 health facilities, public schools for the mentally deficient, public health
					 facilities and other agencies to record or indicate the past or present, mental
					 or physical condition of parents.
Mental Health Professional
-psychiatrists,
					 psychiatric social workers, psychiatric nurses and psychologists.
Minor
-any unemancipated individual who
					 has not attained the age of eighteen years.
Patient Identifying Information
-the name,
					 address, social security number, or similar information by which a patient's
					 identity can be determined with reasonable accuracy and speed.
Person
-any individual, partnership,
					 corporation, association, organization, state or federal department, or state
					 or federal agency.
Superintendent
-the superintendent of any
					 hospital that is an agency of the department and includes the director or the
					 highest ranking official of an agency not headed by a superintendent.
Tutor
-either parent of a minor where both
					 parents are living and married to each other; the parent having legal custody
					 of the minor; where the parents are separated or divorced; the surviving parent
					 of the minor if one of the parents is deceased; any court appointed tutor or
					 guardian; and the secretary of the department where custody of the minor has
					 been awarded to an office or agency of the department.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 44:7.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 5 - Disclosure of Confidential Information › Section I-505 - Confidentiality and Disclosure

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Medical records shall be confidential and may only be disclosed as authorized
				  by these rules.
B. Patient's
				  medical records shall continue to be confidential after the patient is
				  discharged from an agency or is no longer receiving treatment from an
				  agency.
C. Secondary medical
				  information shall be disclosed in the same manner as primary medical
				  information for disclosures made pursuant to
				  §509 of these
				  rules. For disclosures made pursuant to
				  §507 an agency
				  shall disclose secondary medical information only if such disclosure is clearly
				  intended by the patient and if the preparer of the secondary medical
				  information authorizes its disclosure. Whenever an agency denies a request for
				  disclosure of secondary medical information pursuant to this rule, the agency
				  shall refer the person requesting the secondary medical information to the
				  preparer of the information. For purposes of this rule, primary medical
				  information means medical information that has been prepared by a person who is
				  an employee of or a contractor with the agency which has custody of the
				  information. Secondary medical information means medical information that is
				  contained in the agency's patient record that was prepared by someone who is
				  not an employee of or a contractor with the agency.
D. Any disclosure made pursuant to these
				  rules, whether with or without the patient's consent, shall be limited to
				  information necessary in light of the need or purpose for the disclosure, as is
				  determined by the superintendent.
E. Records Concerning Disclosure
1. When medical information is disclosed
				  pursuant to
				  §507 of these
				  rules, a copy of the consent form shall be placed in the patient's record. A
				  notation shall be made on the consent form indicating the time and date
				  disclosure was made and the name of the person by whom disclosure was made.
				  When medical information is disclosed pursuant to
				  §509 of these
				  rules, except pursuant to §509 A, a written memorandum shall be made in
				  the patient's record containing the following information:
a. the name of the patient;
b. the time and date on which disclosure was
				  made;
c. the purpose of the
				  disclosure;
d. the person to whom
				  disclosure was made;
e. the person
				  by whom disclosure was made;
f. the
				  information disclosed;
g. a brief
				  description of the basis for disclosure such as patient consent, medical
				  emergency, scientific research, program evaluation, audit, etc. If disclosure
				  does not contain any patient identifying information, no disclosure record is
				  required. (A sample disclosure record is attached.)
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 5 - Disclosure of Confidential Information › Section I-507 - Disclosures with the Patient's Consent

Current through Register Vol. 50, No. 6, June 20, 2024
A. Consent to disclosure of medical
				  information must be in writing and must contain the following:
1. the name of the patient;
2. the name of the agency which is to make
				  the disclosure;
3. the name or
				  title of the person to whom disclosure is to be made;
4. the purpose or need for
				  disclosure;
5. the extent or nature
				  of the information to be disclosed;
6. the date on which the consent is
				  given;
7. statement that consent is
				  subject to written revocation at any time, except to the extent that action has
				  already been taken on it;
8.
				  specification of the date, event or condition upon which consent will expire
				  without written revocation;
9. the
				  signature of the patient or person authorized by these rules to sign in lieu of
				  the patient;
10. the signature of
				  at least one witness. Each consent form must bear original signatures. Copies
				  of signed consent forms are not acceptable. (Sample consent forms are attached
				  in appendix.)
a. Any consent given under
				  these rules is revocable in writing at any time, except to the extent that
				  action has been taken in reliance thereon. Consent shall continue to be
				  effective until it is specifically revoked in writing, or until the time, date
				  or condition specified has occurred.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 5 - Disclosure of Confidential Information › Section I-509 - Disclosures without the Patient's Consent

Current through Register Vol. 50, No. 6, June 20, 2024
A. Disclosures among Office and Department
				  Employees
1. Disclosure of medical
				  information among the employees of an agency is authorized without the consent
				  of the patient where the employee has a legitimate need for the information in
				  connection with his duties. For purposes of this rule, "employees of an agency"
				  shall include persons under contract with the agency and the employees of
				  private contractors providing services to an agency. The superintendent is
				  authorized to determine what constitutes legitimate need.
2. Disclosure of medical information from one
				  agency to an employee of another agency is authorized without the consent of
				  the patient only in the following situations:
a. when the disclosing agency is required by
				  state law or regulation to provide medical information to the receiving
				  agency;
b. when the disclosing
				  agency and the receiving agency participate in a cooperative program and the
				  medical information is maintained for the purposes of the cooperative
				  program;
c. when an agency has
				  referred one of its patients, clients or residents to another agency for
				  evaluation or treatment; and
d.
				  when an agency cannot perform its function without access to medical
				  information and consent to disclosure of medical information cannot reasonably
				  be obtained.
3. The
				  superintendent of the disclosing agency shall determine whether one of the four
				  enumerated situations exists.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 5 - Disclosure of Confidential Information › Section I-511 - Disclosures to Patients

Current through Register Vol. 50, No. 6, June 20, 2024
A. Patient's
				  Right of Access to Medical Information
1.
				  Every patient has a qualified right of access to medical information concerning
				  himself which is maintained by an agency.
2. Any patient who seeks to exercise his
				  right of access to medical information concerning himself shall direct his
				  request in writing to the superintendent of the agency which maintains the
				  records. This request shall contain sufficient information to enable the agency
				  to locate the records sought and shall designate a representative who would be
				  willing to review the records and inform the patient of its contents or allow
				  the patient to inspect his record, at the representative's
				  discretion.
3. The patient shall be
				  granted direct access to medical information concerning himself only if the
				  superintendent determines that direct access is not likely to have an adverse
				  effect on the patient. If the superintendent believes that he is not qualified
				  to determine, or if he does determine, that direct access to the patient is
				  likely to have an adverse effect on the patient, the record shall be sent to
				  the designated representative. The patient shall be notified in writing when
				  the record is sent to the designated representative. The designated
				  representative shall review the patient's record and shall inform the patient
				  of its contents or allow the patient to inspect the record, at the
				  representative's discretion.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 6 - Uses and Disclosures of Information for Public Health Emergency Preparedness Activities › Section I-601 - Purpose and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose of
				  this rule is to authorize health care providers operating in the state of
				  Louisiana to use and disclose protected health information (PHI) to the
				  Louisiana AtRisk Registry, or any other reporting database or registry employed
				  by the Louisiana Emergency Support Function (ESF) 8, for the sole purpose of
				  participating in emergency preparedness training activities, which includes
				  exercises to test the AtRisk Registry.
B. The scope of this rule covers all
				  hospitals, home health agencies, hospice agencies, and other health care
				  providers who are enrolled in the Louisiana AtRisk Registry. The rule
				  authorizes health care providers to use and disclose PHI to the Louisiana
				  AtRisk Registry, or any other reporting database or registry employed by ESF 8,
				  for the purpose of participating in public health emergency preparedness
				  activities, unless prohibited by other state or federal law or regulation. This
				  Chapter does not authorize unlawful disclosure of patient PHI.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 40:4,
					 40:5
					 and 29:766(E).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 6 - Uses and Disclosures of Information for Public Health Emergency Preparedness Activities › Section I-603 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Unless otherwise specifically provided herein, the
					 following words and terms used in this Part are defined for the purposes
					 thereof as follows:
At Risk Registry-
a database used by
					 Louisiana Emergency Support Function (ESF) 8 to manage patient information
					 related to the Medical Institution Evacuation Plan.
Disclosure-
has the same meaning as set
					 forth in
					 45
					 C.F.R. §
											160.103.
Emergency Preparedness-
has the same
					 meaning as set forth in
					 R.S.
					 29:723.
Health Care Provider-
has the same meaning
					 as set forth in
					 45
					 C.F.R. §
											160.103.
Home Health Agency-
has the same meaning as
					 set forth in LAC 48:I.9101.
Hospice-
has the same meaning as set forth
					 in LAC 48:I.8201.
Hospital-
has the same meaning as set forth
					 in LAC 48:I.9303.
Protected Health Information (PHI)-
has the
					 same meaning as set forth in
					 45
					 C.F.R. §
											160.103.
Public Health Authority-
has the same
					 meaning as set forth in  45 C.F.R. § 160.501.
Use-
has the same meaning as set forth in
					 45
					 C.F.R. §
											160.103.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. 40:4, 40:5 and
					 29:766(E).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 6 - Uses and Disclosures of Information for Public Health Emergency Preparedness Activities › Section I-605 - Permitted Uses and Disclosures for Public Health Emergency Preparedness Activities

Current through Register Vol. 50, No. 6, June 20, 2024
A. Protected health
				  information (PHI) of patients of home health agencies and hospice agencies may
				  be used and disclosed for emergency preparedness training activities and for an
				  actual event when:
1. the patient of the home
				  health agency or hospice agency or the patients legal representative has signed
				  a Health Insurance Portability and Accountability Act (HIPAA)-compliant
				  authorization for use and disclosure of PHI; and
2. the home health agency or hospice agency
				  certifies on a weekly basis that the patient meets at least one of the
				  following criteria:
a. the patient lives
				  alone, without a caregiver and is unable to evacuate himself;
b. the patient has a caregiver, but the
				  caregiver is physically or mentally incapable of complying with an evacuation
				  order;
c. the patient does not have
				  the financial means to comply with an evacuation order; or
d. the patient refuses to evacuate.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 6 - Uses and Disclosures of Information for Public Health Emergency Preparedness Activities › Section I-607 - Treatment of Protected Health Information

Current through Register Vol. 50, No. 6, June 20, 2024
A. For both emergency preparedness training
				  activities and actual public health emergency events, the health care provider
				  shall upload patient protected health information (PHI) to the Louisiana At
				  Risk Registry.
1. The Louisiana AtRisk
				  Registry shall maintain PHI on a secure File Transfer Protocol (FTP)
				  server.
2. After an event or
				  training, all data uploaded to the Louisiana AtRisk Registry FTP server shall
				  be deleted and be non-recoverable.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 7 - Disposition of an Unclaimed Body Held by a DHHR Hospital or Residential Facility › Section I-701 - Facility Responsibility

Current through Register Vol. 50, No. 6, June 20, 2024
A. It is
				  the policy of the Department of Health and Human Resources that Superintendents
				  of all DHHR hospitals and residential facilities adhere to
				  R.S.
				  9:1551; 17:2274, 2275; regarding the
				  disposition of a body unclaimed by relative or friends.
1. Under the language of
				  R.S.
				  17:2274(A), the DHHR
				  institution in which the deceased lived prior to death would temporarily retain
				  the custody of the unclaimed body. If the decedent had no known assets or
				  property of sufficient value to defray the expenses of burial and burial must
				  be at public expense, the superintendents of such facilities shall first notify
				  the department's Office of Hospitals, Bureau of Anatomical Services that they
				  have custody of an unclaimed body and that there are no legal impediments to
				  releasing the body. This notice shall be given to the Bureau of Anatomical
				  Services (hereafter referred to as BAS), no later than 36 hours after the death
				  of the patient.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 7 - Disposition of an Unclaimed Body Held by a DHHR Hospital or Residential Facility › Section I-703 - Bureau of Anatomical Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Upon receipt of this notice, the BAS may accept the unclaimed body solely for
				  the purposes of promoting anatomical knowledge and research and organ
				  transplant. BAS may authorize immediate eye enucleation from any body made
				  available to it. Expenses incurred in connection with the notice or delivery
				  and transportation of bodies are paid by the BAS. The bureau distributes bodies
				  to Louisiana medical and dental schools and the schools must hold any body
				  received from BAS for at least 90 days during which time any friend or relative
				  of the decedent may claim the body for burial.
B. In the event the BAS declines to accept
				  the body, and the body remains unclaimed, the institution would then notify the
				  coroner and the coroner would arrange for burial. Coroners may also authorize
				  eye enucleation from unclaimed bodies (R.S.
				  17:2352, 2354.1 and 33.1561).
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. 9:1551,17:2274, 17:2275, 17:2352,
					 17:2354.1,
					 13:1561.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 7 - Disposition of an Unclaimed Body Held by a DHHR Hospital or Residential Facility › Section I-705 - Stillbirths

Current through Register Vol. 50, No. 6, June 20, 2024
A. The BAS must be
				  notified of unclaimed stillbirths (DHHR's Office of General Counsel Opinion No.
				  79-20). A stillbirth is defined as a birth "... after at least 20 weeks of
				  gestation, or a weight of 350 grams or more, in which the child shows no
				  evidence of life after complete birth" (R.S.
				  40:32(5).
B. It should be noted, however, that the BAS
				  has little need for stillborns and normally cannot bear the transportation
				  costs involved, especially from distant parts of the state. Therefore, the
				  bureau will most likely decline to accept the unclaimed stillbirth. If the
				  bureau declines to accept the unclaimed stillbirth, the coroner is notified and
				  is responsible for burial in a manner which complies with R.S. 8:651-662,
				  9:1551, and 33:1561.1.
C. As there
				  is no requirement that death certificates be issued for fetal deaths where the
				  fetus is less than 20 weeks in gestation or weighs less than 350 grams, burial
				  is not required and a DHHR hospital may dispose of such fetuses as it deems
				  appropriate in the best interest of public health (DHHR's Office of General
				  Counsel Opinion 79-20).
D. Each
				  DHHR hospital and residential facility shall accept this as their policy and
				  procedure on the disposition of bodies unclaimed by relatives or friends, and
				  if the decedent had no known assets or property of sufficient value to defray
				  the expenses of burial, and burial must be at public expense. This material
				  shall be made available to all appropriate staff.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. 9:1551, 17:2274, 17:2275, 40:32(5),
					 8:651-662, 33:1561.1.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 9 - Notification of Next of Kin in Cases of Death in a DHHR Institution/Facility › Section I-901 - Purpose and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A. It is the policy
				  of DHHR that every reasonable effort shall be made to locate and notify
				  promptly the next of kin (or guardian/custodian) of any patient/client who dies
				  in a DHHR institution or facility. Written procedures shall be adopted in every
				  institution or facility for the notification of next of kin to minimize any
				  emotional stress or undue hardship in the event of the death of
				  patient/client.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 33:1568.1,
					 33:1561.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 9 - Notification of Next of Kin in Cases of Death in a DHHR Institution/Facility › Section I-903 - Applicability

Current through Register Vol. 50, No. 6, June 20, 2024
A. In accordance
				  with
				  R.S.
				  33:1568.1, it is the duty of the coroner to
				  make every reasonable effort to notify the next of kin in all cases of deaths
				  for which he has jurisdiction, including but not limited to deaths enumerated
				  in
				  R.S.
				  33:1561(A).
B. Additionally, Act 250 passed in the 1983
				  regular session of the Louisiana Legislature states that in all other cases,
				  including cases where a person dies of natural causes, the following persons,
				  or their designees, shall make every reasonable effort to notify the next of
				  kin within 48 hours of discovery of the death:
1. the attending physician, if the patient
				  has been examined by the physician within 36 hours prior to death or the
				  medical officer on duty at the time of death; or
2. the administrator of the hospital in which
				  the person dies; or
3. the
				  administrator or executive director of the nursing home or other facility in
				  which the person dies; or
4. the
				  chief of police or other chief officer of a local law enforcement agency which
				  discovers the body of the deceased; or
5. if the patient/client is a prisoner from a
				  penal facility the physician shall notify the penal institution which has the
				  responsibility to notify the next of kin.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 11 - DHHR Policy on use of Restraints, Seclusions and Medications with Gary W. Classmembers › Section I-1101 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. The Department
				  of Health and Human Resources, through negotiating sessions with parties before
				  the special master in the Gary W. case, agreed to disseminate behavior
				  management policies interactive of those outlined in the Principal Order of
				  Gary W. et al vs. State of Louisiana et al, dated October 28, 1976. Each office
				  is responsible for assuring that internal behavior management practices comply
				  with this order. Illustrations of non-compliance as used in this policy were
				  provided by the special master's office. Reference numbers as used in this
				  policy (examples 3.8, 3.12) refer to specific sections of the Principal
				  Order.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. Gary W. et al vs. State of Louisiana et al,
					 Civil Action 74-2412.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 11 - DHHR Policy on use of Restraints, Seclusions and Medications with Gary W. Classmembers › Section I-1103 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Active Physical Restraints
-any device
					 which acts to limit or restrict mobility of an individual's body or body part
					 or parts excepting those devices specifically prescribed by a physician for
					 bracing or for therapeutic positioning. Examples of active physical restraints
					 include posey belts, ankle cuffs, safety restraints, and straight
					 jackets.
Legend Drug
-those drugs requiring a
					 prescription for dispensing under federal law.
Non-Legend Drugs
-those drugs which do not
					 require a prescription for dispensing under federal law (i.e., aspirin,
					 petroleum jelly, etc.).
Superintendent
-the person who is
					 primarily responsible for the operation of any facility; director;
					 administrator. This definition also includes the individual specifically
					 designated by the superintendent to act on his behalf during his absence from
					 the facility, such as the duty officer.
Qualified Professional
-
1. A psychologist with at least a master's degree from an
					 accredited program and with specialized training or two years of experience in
					 treating emotionally disturbed, mentally retarded or learning disabled children
					 whose condition is similar to the condition of the children being
					 served.
2. A physician licensed under state law to practice
					 medicine or osteopathy and with specialized training or two years of experience
					 in treating emotionally disturbed, mentally retarded or learning disabled
					 children whose condition is similar to that of the children being
					 served.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. Gary W. et al vs. State of Louisiana et al,
					 Civil Action 74-2412.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 11 - DHHR Policy on use of Restraints, Seclusions and Medications with Gary W. Classmembers › Section I-1105 - Medication and Chemical Restraint

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  (3.8) The medication prescribed for each child (classmember) shall be noted in
				  his records. At least monthly the attending physician shall review the drug
				  regimen of each child (classmember) under his care. All prescriptions shall be
				  written with a termination date, which shall not exceed 30 days. The child's
				  (classmember's) records shall state the effects of psychoactive medication on
				  the child (classmember). Unnecessary or excessive medication shall not be
				  administered by any child (classmember).
B. (3.9) Medication shall not be used as
				  punishment, for the convenience of staff, as a substitute for a treatment
				  program, or in quantities that interfere with the child's (classmember's)
				  treatment program.
C. (3.10) No
				  medication shall be administered except by persons who have been appropriately
				  trained.
D. Illustrations
1. A classmember was reported to be receiving
				  a high dosage of psychoactive medications, but was not participating in any
				  behavior modification program.
2.
a. A classmember receiving the following
				  medications was observed sleeping when he or she should have been in class and
				  at lunch:
i. haldol;
ii. dilantin;
iii. thorazine;
iv. phenobarbital; and
v. mellaril.
b. Staff described the classmember as lazy
				  and as one who sleeps excessively.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 11 - DHHR Policy on use of Restraints, Seclusions and Medications with Gary W. Classmembers › Section I-1107 - Seclusion and Time Out

Current through Register Vol. 50, No. 6, June 20, 2024
A. (3.11) No
				  child (classmember) shall be placed alone in a locked room, either as
				  punishment or for any other purpose. Legitimate "time out" procedures may be
				  utilized under close and direct professional supervision. DHHR interprets this
				  requirement as applicable to prescriptions for legend drugs only.
B. (3.12) These standards shall apply to
				  "time out" procedures:
1. (3.121) they are to
				  be imposed only when less restrictive measures are not feasible;
2. (3.122) placement shall be in an unlocked
				  room with a staff member constantly nearby in a place where the staff member
				  can supervise the child (classmember);
3. (3.123) the child (classmember) shall have
				  access to bathroom facilities as needed;
4. (3.124) the period of isolation or
				  segregation shall not exceed 12 hours unless renewed by a qualified
				  professional;
5. (3.125) except in
				  an emergency situation in which it is likely that a child (classmember) would
				  harm himself or others, the decision to a place a child (classmember) in "time
				  out" shall be made pursuant to a written order by a qualified professional,
				  following a personal interview with the child (classmember) and an evaluation
				  of the episode or situation said to require isolation or segregation. Any such
				  order must specify the terms and conditions of "time out" and the rationale for
				  the decision; and
6. (3.126)
				  emergency use of "time out" shall be limited to a period of not more than one
				  hour and shall conform to all of the provisions set forth in Paragraphs B.1-6
				  of this Section. (The attention of the parties is invited to the situation that
				  may be presented by a child (classmember) who may harm himself or others by
				  running away repeatedly. Their suggestions with respect to appropriate
				  additional provisions are invited.)
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 11 - DHHR Policy on use of Restraints, Seclusions and Medications with Gary W. Classmembers › Section I-1109 - Physical/Mechanical Restraint

Current through Register Vol. 50, No. 6, June 20, 2024
A. (3.13)
				  Physical restraints shall be employed only when absolutely necessary to protect
				  the child (classmember) from injury to himself or to prevent injury to others.
				  Restraints shall not be employed as punishment, for the convenience of staff,
				  or as a substitute for a treatment program. A child (classmember) shall be
				  restrained only if alternative techniques have failed and only if such
				  restraint imposes the least possible restriction consistent with its purpose;
				  and then only in accordance with the following standards.
1. (3.131) An order for restraint shall be in
				  writing and shall not be in force for longer than 12 hours.
2. (3.132) Except in an emergency situation
				  only qualified professionals may authorize the use of restraints.
3. (3.133) A child (classmember) placed in
				  restraint shall be checked at least every 30 minutes by staff trained in the
				  use of restraints, and a record of such checks shall be kept.
4. (3.134) Mechanical restraints shall be
				  designed and used so as not to cause physical injury to the child (classmember)
				  and so as to cause the least possible discomfort.
5. (3.135) Opportunity for motion and
				  exercise shall be provided for a period of not less than 10 minutes during each
				  two hours in which restraint is employed.
6. (3.136) Daily reports shall be made to the
				  superintendent by those qualified professionals ordering the use of restraints,
				  summarizing all such use of restraints, the types used, the duration, and the
				  reasons therefore.
7. (3.137)
				  Emergency use of restraints shall be authorized only by the superintendent of
				  the institution, shall be limited to a period of not more than one hour and
				  shall conform to all of the provisions set forth in Pararaphs 3, 4 and 5 of
				  this Section.
8. Illustrations
a. Staff reported to an auditor that
				  restraints were used with a classmember, but the auditor found no record of it
				  in the classmember's file.
b. Staff
				  of the special master's office were told that staff ties a classmember to
				  his/her wheelchair to avoid having to pursue him/her as the classmember is
				  active.
c. An ambulatory
				  classmember was observed by the judge and the special master restrained in a
				  rocking chair due to staff shortage.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 11 - DHHR Policy on use of Restraints, Seclusions and Medications with Gary W. Classmembers › Section I-1111 - Instructions to Offices

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each office
				  will immediately notify its employees and those service providers for whom it
				  has funding authority of the following.
1.
				  The use of active physical restraints except as provided for in the Gary W.
				  Court Order is strictly prohibited by DHHR.
2. The use of medication for non-therapeutic
				  reasons as a chemical restraint is strictly prohibited by DHHR.
3. The use of seclusion is strictly
				  prohibited by DHHR.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 13 - DHH Policy on Reporting Alleged Abuse, Neglect, Mistreatment and Deaths of Gary W. Class Members › Section I-1301 - Policy Statement

Current through Register Vol. 50, No. 6, June 20, 2024
A. This
				  document is a revision to 13:299 (May, 1987), DHH Policy on Reporting Alleged
				  Abuse, Neglect, Mistreatment and/ or Deaths of Gary W. Classmembers. The
				  primary purpose of this document is to ensure a more effective, efficient and
				  responsive system of reporting incidents involving Gary W. class members.
				  Additional purposes include:
1. to
				  differentiate types of incident:
2.
				  to differentiate allegations of abuse/neglect from unusual occurrences which
				  are reported directly to the Gary W. Project Office and unusual occurrences
				  which are reported to the designated agency representative:
3. to provide procedures for reporting
				  unusual occurrences, abuse/neglect allegations and the death of a class
				  member;
4. to outline the
				  responsibilities of significant parties: E. to explain corrective action and
				  note the consequences for failure to implement corrective action.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 13 - DHH Policy on Reporting Alleged Abuse, Neglect, Mistreatment and Deaths of Gary W. Class Members › Section I-1305 - Where to Report Incidents

Current through Register Vol. 50, No. 6, June 20, 2024
A. Incidents
				  which must be Reported to the Gary W. Project Office. All incidents of:
1. physical abuse, sexual abuse, seclusion,
				  unauthorized or inappropriate use of restraint, and neglect must be reported to
				  the Gary W. Project Office;
2. any
				  injury to a class member, no matter what the cause, which requires more than
				  first aid (for example, any injury which requires: treatment by a physician,
				  hospitalization, stitches, or more than one visit by a health care provider);
				  or
3. elopement of class members
				  whose absence constitutes a recognized danger to the possible well being of
				  that class member or others would be reported immediately to the project
				  office. For class members not in this category, the decision for reporting the
				  absence shall be based on reasoned judgment, by taking into consideration the
				  client's habits, deficits, mental status, capabilities, health problems, and
				  similar considerations, but shall in no instance exceed 72 hours.
4. the occurrence of any of the above
				  incidents shall be reported by the project office to the Quality Assurance
				  Monitoring Group/Independent Monitoring Unit within 24 hours of their receipt
				  of the report.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 1 - General › Chapter 13 - DHH Policy on Reporting Alleged Abuse, Neglect, Mistreatment and Deaths of Gary W. Class Members › Section I-1307 - Responsibility for Investigations at Facilities Other Than Small Facilities and Other Than for Community Class Members

Current through Register Vol. 50, No. 6, June 20, 2024
A. Except as otherwise provided in the
				  following subsection, the state is responsible for investigating all incidents
				  which are reported to the Gary W. Project Office.
B. In its discretion, the Gary W. Project
				  Office may instruct the facility to investigate any incident which is reported
				  to the Gary W. Project Office, except that the state must investigate all
				  incidents listed in §1305. A .1 of this policy. In addition, the
				  state must investigate any injury to a class member which requires more than
				  first aid whose cause cannot be determined or which occurs at the facility and
				  may investigate any other injury which, in the discretion of the Gary W.
				  Project Office, should be investigated by the state.
C. The facility shall be responsible for
				  investigating all incidents which are reported exclusively to a designated
				  representative under §1305. B of this policy. The designated
				  representative who receives the incident report shall conduct the
				  investigation.
D. If the Gary W.
				  Project Office makes a decision to have the facility conduct an investigation
				  of an incident reported to the project office, it shall communicate that
				  instruction by telephone to a designated representative within 12 hours of
				  receipt of the incident report.
E.
				  Investigation of all incidents shall commence within 12 hours of the receipt of
				  the phone report of the incident. During this 12-hour period, the investigator
				  will visit the facility and meet with the class member. The investigation shall
				  be completed as soon as possible but, in any event, no later than 30 days after
				  it was started.
AUTHORITY NOTE:
					 Promulgated in accordance with Gary W., et al., vs. State of Louisiana, Civil
					 Action 74-2412.