New York Codes, Rules and Regulations › Title 18 - DEPARTMENT OF SOCIAL SERVICES › Chapter II - Regulations of the Department of Social Services › Subchapter C - Social Services › Article 3 - Child-care Agencies › Part 441 - General › Section 441.22 - Health and medical services

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
(1) Each authorized agency is responsible for
			 providing comprehensive medical and health services for every foster child in
			 its care.
(2) Each authorized
			 agency is responsible for providing comprehensive behavioral health services to
			 every foster child placed in its care in a congregate setting in accordance
			 with the standards set forth in this paragraph and as directed by the Office of
			 Children and Family Services.
(i) Initial
			 assessments/screenings.
(a) Within 72 hours
			 of the child being placed in an agency's congregate care program the child must
			 be screened using a validated, industry accepted instrument for, at minimum,
			 suicidality; chemical dependence requiring immediate medical intervention; and
			 any current prescribed medications. Also, within 72 hours, an individualized
			 crisis intervention plan must be developed with the child. Such plan must be
			 child specific and include preferred de-escalation strategies and interventions
			 to address acute physical behavior and to reduce the risk of physical or
			 psychological harm to such child. For the purposes of this section, a
			 congregate care program includes an institution, group residence, group home,
			 and agency operated boarding home.
(b) The individualized crisis intervention
			 plan must be reviewed after each incident involving the child for which the
			 crisis intervention plan is used. Upon review, the plan should be updated if
			 necessary. Additionally, the individualized crisis intervention plan must be
			 reviewed at each treatment team meeting and updated as necessary.
(c) Within 30 days of a child being placed
			 within an agency's congregate care program, the agency, utilizing a qualified
			 mental health professional, must utilize validated industry accepted
			 instruments to assess the child for service needs related to mental,
			 behavioral, and developmental health; education; social and family connections;
			 substance use/abuse, and sexual assault/trafficking. Such assessments must
			 include consideration for the youth's sexual orientation and gender identity
			 where developmentally appropriate. These assessments/evaluations must be
			 documented in the child's case record and utilized to inform planning for the
			 child and their family in a way that protects sensitive information.
(ii) Support team and plans.
			 Within 30 days of the child being placed in a congregate care setting, a
			 support team must meet to develop the child's support plan which must be
			 reviewed and/or updated on a regular basis as defined below:
(a) The support plan must be reviewed with
			 the child and their parent/guardian or discharge resource every 30 days, and
			 updated if/when necessary
(b) The
			 support team must meet and review/update if necessary, at the following
			 intervals:
(I) For youth 12 years old and
			 younger by days 30, 90, 180, and then every 30 days thereafter(II) For youth 13
			 years old and older by days 30, 90, 210, 330, and then every 30 days
			 thereafter
(c) The
			 support team must consist of, at minimum, the child (when age appropriate); the
			 child's parent/guardian or discharge resource, as appropriate; a clinical team
			 member who works with the child; the child's agency case planner; and when
			 available, the case manager. Other parties who should be considered for members
			 of the team include, but are not limited to, other medical personnel relevant
			 to the care or treatment of the child; agency education staff; home school
			 district representatives; agency child care staff with strong knowledge of the
			 child; and other relevant service providers.
(d) The support team must document the review
			 and any changes to the child's support plan within seven calendar days of the
			 support team meeting.
(e) The
			 support plan must include: treatment goals that are achievable and
			 quantifiable, and in a manner understood by the child; clear objectives to
			 assist the child in achieving said goals; and specific roles for staff in
			 assisting the child in achieving the goals.
(f) The support plan must also contain a
			 review of any medications the child is prescribed; if the child is prescribed
			 psychiatric medications, the support team in consultation with the prescribing
			 psychiatrist and/or a medical professional must note all medications, including
			 dosage, as well as any changes regarding these medications from previous
			 months; the support team must also note any effects, both assumed positive
			 effects and side effects, of the prescribed medications.
(g) The support plan must be responsive to
			 the individual child's expressed sexual orientation, gender and gender
			 identity.
(iii) The
			 individualized crisis intervention plan and the support plan required by this
			 paragraph must be recorded in the child's case record.
(iv) Ongoing services. Where indicated
			 mental, behavioral, and substance use/abuse services must be provided on a
			 regular basis. The services may be delivered in individual and group
			 modalities. At a minimum such services must include:
(a) a determination by a qualified mental
			 health professional regarding the frequency of the service and the modality or
			 modalities that must be used. Such determination must be based on a
			 professional assessment and document in the child's case record.
(b) group sessions must be incorporated into
			 the program schedule and be conducted by staff trained in the curriculum,
			 treatment, and topics being facilitated.
(c) Any exceptions to the above referenced
			 mandates must be documented by the child's clinician in their treatment
			 plan.