Section 11.04 - Routine Medical Care(1) "Routine medical care" shall include but is not limited to the following: (c)Comprehensive Physical Examination. Documenting the finding of an unclothed physical examination including a complete system review pertinent to the age of the child, fundoscopic examination of the eyes for children over five years of age, and observation of the teeth and gums for children three years of age or older.(e)Developmental Assessment. The child's current levels of functioning in the below-listed areas, as appropriate to the child's age. 1. gross motor development, including strength, balance, and locomotion2. fine motor development, including eye-hand coordination3. language development, including expression, comprehensive and articulation4. self-help and self-care skills5. social interaction and emotional development6. cognitive skills, including problem-solving and reasoning abilities.(f)Diseases Dangerous to the Public Health, Treatment of. See M.G.L. c. 112, § 12F and 105 CMR 300.100: Diseases Reportable to Local Boards of Health.(g)Drug Dependency Treatment. See M.G.L. c. 112, § 12E.(h)Family Planning Services.(i)Fractures, Treatment of(k)Immunization against diphtheria, pertussis, tetanus, measles, poliomyelitis, mumps, rubella and such other communicable diseases as may be specified from time to time by the Department of Public Health. See M.G.L. c. 76, § 15 and 105 CMR 200.100: Physical Examinations Required by Primary Care Provider or School Physician.(l)Laboratory Tests and Special Medical Studies when determined by the examining physician to be necessary.(n)Nutritional Status Assessment. The evaluation of the child's nutritional health in light of dietary practice and the entire health assessment (that is, history, physical examination, height and weight measurements, and the laboratory tests) and documentation of any nutritional disturbance or dysfunction.(p)Pregnancy Treatment. See M.G.L. c. 112, § 12F.(q)Preventive Health Services.(r)Psychiatric Assessment, Evaluation, or Treatment on out-patient basis or up to 90 days on in-patient basis.(s)Treatment commonly prescribed for a specific physical illness, which treatment does not pose risks of permanent serious side effects or risk of death, see Custody of a Minor, 375 Mass. 733, 379 N.E.2d 1053, 1064 (1978) or is determined not to be extraordinary medical treatment by using the analysis outlined in 110 CMR 11.00.(t)Tubercular Skin Test or Chest X-ray.(u)Venereal Disease Treatment. See M.G.L. c. 112, § 12F.(2)Consent. The Department may consent to routine medical care for a child in the care of the Department or a child in the custody of the Department or a child who is a ward of the Department.(3)Parent's Religious Beliefs Regarding Routine Medical Treatment. If parents refuse to sign a standard Voluntary Placement Agreement because they refuse to delegate to the Department the power to consent to routine medical treatment for their child on the basis that such routine medical treatment conflicts with the parents' sincere religious beliefs, the Department shall elect one of the following actions: (a) Amend the standard Voluntary Placement Agreement by adding the following paragraph: "Whereas the undersigned parents hold sincere religious beliefs opposed to all medical treatment, the Department shall have the right to approve only medical, psychological and dental care, testing or studies for the child relative to:
2. diseases dangerous to the public health;4. emergency medical treatment; and5. routine physical examination and laboratory test."(b) Determine whether the parents' refusal to delegate to the Department the power to consent to the medical treatment constitutes medical neglect, and if so, institute appropriate court action on that basis.Amended by Mass Register Issue 1475, eff. 8/5/2022.