| (5) Meal Requirements. The CSCD director or facility
director shall ensure that at least three meals, including two hot
meals, are provided during each 24-hour period. Variations may be
allowed based on weekend and holiday food service demands, or in the
event of emergency or security situations, provided basic nutritional
goals are met.
(n) Health Care.
(1) Access to Care.
(A) Residents shall have unimpeded access to health
care and to a system for processing complaints regarding health care.
(B) The facility shall have a designated health authority
with responsibility for health care pursuant to a written agreement,
contract, or job description. The health authority may be a physician,
health administrator, or health agency. In the event that the designated
health authority is a free community health clinic, one which provides
services to everyone in the community regardless of ability to pay,
then the CCF is not required to enter into a written contract or agreement.
A copy of the mission statement of the free community health clinic
and a copy of the criteria for admission shall be on file in lieu
of a contract between the two agencies.
(C) Each CCF shall have a policy defining the level,
if any, of financial responsibility to be incurred by the resident
who receives the medical or dental services.
(2) Emergency Health Care.
(A) Twenty-four hour emergency health care shall be
provided for residents, to include arrangements for the following:
(i) On site emergency first aid and crisis intervention;
(ii) Emergency evacuation of the resident from the
facility;
(iii) Use of an emergency vehicle;
(iv) Use of one or more designated hospital emergency
rooms or other appropriate health facilities;
(v) Emergency on-call services from a physician, advanced
practice nurse, physician assistant, dentist, and a mental health
professional when the emergency health facility is not located in
a nearby community; and
(vi) Security procedures providing for the immediate
transfer of residents, when appropriate.
(B) A training program for direct care personnel shall
be established by a recognized health authority in cooperation with
the facility director that includes the following:
(i) Signs, symptoms, and action required in potential
emergency situations;
(ii) Administration of first aid and cardiopulmonary
resuscitation;
(iii) Methods of obtaining assistance;
(iv) Signs and symptoms of mental illness, retardation,
and chemical dependency; and
(v) Procedures for patient transfers to appropriate
medical facilities or health care providers.
(C) First aid kits shall be available in designated
areas of the facility. Contents and locations shall be approved by
the health authority.
(3) Health Screening and Medical Examinations. Medical,
dental, and mental health screening shall be performed by qualified
health care personnel on all offenders within 10 working days prior
to or after admission to the facility. The purpose of the screening
is to determine if the offender has any disease, illness, or condition
that precludes admission. The health screening shall include the following:
(A) Questionnaires for health screening shall be established
to document inquiries into and observations of the following:
(i) Current illness and health problems, including
sexually transmitted and other infectious diseases;
(ii) Dental problems;
(iii) Mental health problems, including suicide attempts
or ideation;
(iv) Use of alcohol and other drugs, which includes
types of drugs used, mode of use, amounts used, frequency of use,
date or time of last use, and a history of problems that may have
occurred after ceasing use, for example, convulsions; and
(v) Other health problems designated by the responsible
health authority.
(B) Observation by qualified health care personnel
of:
(i) Behavior, which includes state of consciousness,
mental status, appearance, conduct, tremor, and sweating;
(ii) Body deformities, ease of movement, and so forth;
and
(iii) Conditions of skin, including trauma markings,
bruises, lesions, jaundice, rashes, infestations, and needle marks
or other indications of drug abuse.
(C) Medical Examinations.
(i) A new resident admitted to the facility who was
not transferred from a jail or other correctional facility shall have
a medical history and physical examination completed within 10 working
days prior to or after admission to the facility.
(ii) TB screening of residents shall be completed within
seven calendar days of admission into the residential facility and
repeated annually thereafter. If a resident was confined in a jail
or other correctional facility immediately prior to admission to a
CCF, a TB screening test that was completed no more than 30 days prior
to transfer to a residential facility may be accepted, provided that
a TB questionnaire is completed and filed with the TB screening test
results.
(iii) Medical examinations shall be conducted for any
employee or resident suspected of having a communicable disease.
(4) Serious and Infectious Diseases.
(A) The facility shall provide for the management of
serious and infectious diseases.
(B) The CCFs shall have policies and procedures to
direct actions to be taken by employees concerning residents who have
been diagnosed with human immunodeficiency virus (HIV), including,
at a minimum, the following:
(i) When and where residents shall be tested;
(ii) Appropriate safeguards for staff and residents;
(iii) Staff and resident training;
(iv) Issues of confidentiality; and
(v) Counseling and support services.
(5) Dental Care. Access to dental care shall be made
available to each resident.
(6) Medications--General Guidelines.
(A) Staff who dispense medication shall have the proper
training and credentials. Staff who supervise self-administration
of medication shall be appropriately trained to perform the task.
(B) Policy and procedure shall direct the possession
and use of controlled substances, prescribed medications, supplies,
and over-the-counter (OTC) drugs. Prescribed medications shall be
dispensed according to the directions of the prescribing physician,
advanced practice nurse, or physician assistant.
(C) Each residential facility shall have a written
policy in place that sets forth required procedural guidelines for
the administration, documentation, storage, management, accountability
of all resident medication, inventory, disposal of medications, handling
medication errors, and adverse reactions.
(D) If medications are distributed by facility staff,
records shall be maintained and audited monthly and shall include,
but not be limited to the date, time, name of the resident receiving
the medication, and the name of the staff distributing the medication.
(E) Each facility shall ensure that the phone number
of a pharmacy and a comprehensive drug reference source is readily
available to the staff.
(7) Medication Storage.
(A) Prescription and OTC medications shall be kept
in locked storage and accessible only by staff who are authorized
to provide medication. Syringes, needles, and other medical supplies
shall also be kept in locked storage.
(B) All controlled/scheduled medications shall be stored
under double lock and key.
(C) Each facility shall ensure that all medications,
syringes, and needles are stored in the original container.
(D) Medications labeled as internal and external use
only shall not be stored together in the same medication box or medication
drawer.
(E) Sample prescription medications provided by physicians
shall be stored with proper labeling information that includes the
name of the medication; name of the prescribing physician, advanced
practice nurse, or physician assistant; date prescribed; and dosage
instructions.
(F) Medications that require refrigeration shall be
stored in a refrigerator designated for medications only. A thermometer
shall be maintained inside the refrigerator with the temperature checked
and recorded daily on a temperature log.
(G) The facility shall have a written policy approved
by the local medical authority that states the acceptable temperature
range for the medication refrigerator, and a written policy for what
actions shall be taken by staff in the event the refrigerator temperature
is above or below the approved temperature range.
Cont'd... |
