|(a) Timing of Health Screening. Except as provided
in subsection (i) of this section, a health screening shall be conducted
on each resident within two hours after admission.
(b) Persons Qualified to Conduct Health Screening.
The health screening shall be conducted by:
(1) an appropriately supervised licensed vocational
nurse (LVN), a registered nurse (RN), a nurse practitioner, a physician
assistant, or a physician;
(2) a qualified and properly trained person who is
operating under delegation from a physician in accordance with Texas
Occupations Code §157.001, including a medical assistant, emergency
medical technician, or paramedic; or
(3) an individual who has been trained on administering
the facility's health screening by a person listed in paragraph (1)
or (2) of this subsection.
(c) Training Requirements for Health Screening. The
training shall include instruction on:
(1) how to take medical history;
(2) how to make the required observations;
(3) how to determine the appropriate disposition of
a resident based on observations and responses to questions; and
(4) how to document the findings on the screening instrument.
(d) Health Screening Instrument. The health screening
instrument shall be approved by an RN, nurse practitioner, physician
assistant, or physician and shall include:
(1) mental health conditions and treatment, including
(2) observation of the following:
(A) general appearance, such as sweating, tremors,
anxious, disheveled, or appropriate;
(B) behavior, such as disorderly, erratic, or appropriate;
(C) state of consciousness, such as alert, responsive,
(D) ease of movement, such as ability to walk and move
limbs, gait, and bodily deformities;
(E) breathing, such as persistent cough, hyperventilation,
or normal; and
(F) skin condition, such as lesions, swelling, yellowing,
rashes, scars, tattoos, bruises, and/or needle marks;
(3) history of or current serious infectious disease
(4) recent communicable illness symptoms, such as chronic
cough, coughing up blood, lethargy, weakness, weight loss, loss of
appetite, fever, and/or night sweats;
(5) history of or current sexually transmitted infections;
(6) history of or current illnesses or chronic health
(B) asthma or other respiratory problems;
(C) dermatological conditions;
(D) seizure disorder;
(E) eye conditions; and
(F) other acute or chronic conditions as determined
by the health service authority;
(7) history of or current gynecological problems;
(8) current or recent pregnancy;
(9) current use of medication(s) including name, dosage,
frequency, time of last dose taken, and name of prescribing physician;
(10) dental problems;
(11) use of alcohol or illegal drugs, including type,
amount, time of last use, and past treatment;
(12) drug withdrawal symptoms;
(13) special health requirements, such as dietary needs,
physical disabilities, or prosthetics;
(14) evidence of physical trauma;
(15) recent injuries;
(16) weight and height; and
(17) any other health concerns reported by the resident.
(e) Screening Methodology. The health screening shall
be administered by directly questioning the resident, observing the
resident's behavior and physical condition, and reviewing any available
records. If any of the information is unknown at the time of the health
screening, the screener shall indicate this by entering "unknown,"
"not applicable," or a line in the space or electronic field provided
for this information on the health screening form.
(f) Disposition and Medical Referral.
(1) The individual who completes the screening shall:
(A) document the disposition of the youth, such as
referral to emergency services or placement in the general population
with later referral for medical follow up; and
(B) sign the screening instrument and document his/her
title and the date and time of the screening.
(2) For residents who are identified by the screening
instrument as requiring follow-up consultation with a health care
professional, facility staff shall:
(A) contact the health care professional designated
by the screening instrument as soon as possible but no later than
24 hours after completion of the screening, unless the screening instrument
provides otherwise; and
(B) ensure the resident receives follow-up medical
care as directed by the health care professional.
(3) The facility shall maintain and implement written
policies and procedures to ensure that residents identified with potential
medical problems (e.g., asthma, diabetes) are appropriately supervised
until medical follow-up is received.
(4) For residents who report taking prescription medication,
facility staff shall document whether the resident's parent, guardian,
or custodian has provided the facility with the medication and a written
request to administer the medication. If the medication or written
request has not been provided, facility staff shall contact a health
care professional within 24 hours after completion of the screening
to receive instruction.
(g) Results of Screening. The results of the health
screening and any needed follow-up medical care shall be communicated
to appropriate staff. The completed health screening form shall be
(h) Contagious or Infectious Disease. Any finding of
the health screening that indicates a significant potential health
risk to the staff or residents from a contagious or infectious disease
shall be reported immediately to the facility administrator and the
affected resident shall be placed in medical isolation until proper
medical clearance is obtained.
(i) Intra-Jurisdictional Custodial Transfer. A health
screening is not required for intra-jurisdictional custodial transfer
of residents if the post-adjudication facility receiving the resident
is located within the same premises as the pre-adjudication facility.
If the two facilities are not located within the same premises, evidence
of physical trauma is the only item required for the health screening.