Rule 290-2-29-.19 - Second Chance Home Programs-Health Services(1)Second Chance Home Programs. Health Services. Health services for residents and infants shall be provided according to the best standards for maternal and child health which the local community affords and shall conform to standards established by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. Responsibility for the health supervision of the home shall be placed in one (1) licensed physician appointed by the governing board. The home shall have an isolation room available. There shall be an arrangement with the hospitals accepting residents for confinement which ensures that the residents are protected from interviews with persons seeking to effect or facilitate an independent placement.(2)Second Chance Home Programs. HealthServices. Within 30 days of admission, an assessment of the resident's medical and dental health shall be completed by the designated intake human services professional.(3)Second Chance Home Programs. HealthServices.Prenatal Care.The home shall ensure that residents have access to prenatal health care, delivery, and immediate postpartum health care, and postpartum convalescent health care for the period post delivery and prior to discharge from the home.(4)Second Chance Home Programs. HealthServices. Prenatal Care.The program of prenatal care shall include: (a) A complete medical and obstetrical history before admission to the home;(b) A general physical examination of the resident shall be provided within 72 hours (excluding weekends and holidays) of admission unless such an examination has been completed within one (1) year prior to admission. The admission physical shall include a pregnancy test, complete blood count (CBC), and T. B. test;(c) Periodic examinations during pregnancy according to the standard of care for the community. Such examinations shall occur at minimum, monthly during the first seven (7) months, every two (2) weeks during the eighth month and every week during the ninth month;(d) Medical care at time of delivery, including hospitalization, and nursing care where indicated;(e) Confinement in an accredited birthing facility meeting recognized standards, with facilities for dealing with complicated cases or emergencies; and(f) Paramedical services, including nursing, nutrition, and health education.(5) Second Chance Home Programs. Health Services. Postpartum Care. The home shall ensure that each resident is informed of the need for a postpartum examination, unless the examination is provided before her discharge from the home. Provisions shall be made for all residents to receive a postpartum examination within 8 weeks after confinement if she remains in residence. Provisions shall be made to ensure the resident's return to a public health clinic or physician, physician's assistant, advanced practice registered nurse, or midwife for necessary checkups and medical instruction on postpartum care that may be indicated.(6) Second Chance Home Programs. Health Services. Postnatal Care. The home shall ensure that each resident is informed of the need for postnatal examination for her infant, unless the examination is provided before the infant's discharge from the home. Provisions shall be made for a complete physical examination by a physician, physician's assistant, advanced practice registered nurse, midwife, or public health clinic within the first 24 hours or sooner if indicated. A repeat examination shall be completed within the first 10 days. The repeat physical examination shall be completed by a physician, physician's assistant, advanced practice registered nurse, registered nurse, midwife, or public health clinic.(7)Second Chance Home Programs. Health Services. Medical Care. The home shall ensure that all residents receive an annual physical examination completed by a physician, physician's assistant, advanced practice registered nurse, or public health clinic. The examination shall include basic diagnostic laboratory, including but not limited to Complete Blood Count (CBC) and basic urinalysis; required immunizations; a TB test; and vision and hearing screens.(8)Second Chance Home Programs. HealthServices.Medical Care. A home shall ensure that residents receive timely, qualified medical and dental care when they are ill and that they continue to receive necessary follow-up medical care. Arrangements shall be made with at least one (1) physician and one (1) dentist or a health care agency that provides physician and dental services for the medical care of the residents. Residents shall receive annual medical check-ups and semiannual dental check-ups.(9) Second Chance Home Programs. Health Services. Pediatric Care. The home shall ensure that all minor residents receive appropriate Early Periodic Screening and Diagnostic and Treatment Services (EPSDT) as required for age and development.(10)Second Chance Home Programs. HealthServices.Dental Care. A general dental examination of the resident shall be provided for within 30 days of admission unless such an examination has been completed within six (6) months prior to admission. Such examinations shall be done by a licensed dentist and shall be repeated at least every six (6) months.(11)Second Chance Home Programs. HealthServices.Emergency Care. The home shall ensure that residents receive timely, qualified medical or psychological care in cases of medical emergencies (life-threatening, limb-threatening, or function-threatening conditions). Policies shall be in place for the emergency medical care of residents with a local hospital or other health care facility that provides emergency services or with a local physician.(12) Second Chance Home Programs. Health Services. Medications. The home shall develop and implement policies and procedures for the use and management of over-the-counter, general prescription, and psychotropic medications. All direct care staff shall receive orientation on the policies and procedures.
(13)Second Chance Home Programs. Health Services.Medications. The home shall maintain a list of non-prescription medications approved for use by pregnant women. No resident shall be given a non-prescription medication by staff members of the home unless the resident exhibits symptoms that the medication is designed to relieve and it is listed on the approved list.(14) Second Chance Home Programs. Health Services. Medications. The home shall maintain a list of non-prescription medications approved for use by the pediatrician for each individual resident under 6 years of age. The approved list shall be maintained in each resident's file.(15)Second Chance Home Programs. HealthServices.Medications. Prescription Medications. No resident shall be given a prescription medication unless the medication is prescribed for the resident by an authorized health care professional.(16)Second Chance Home Programs. HealthServices.Medications. Prescription medications shall only be given to a resident as ordered in the resident's prescription. A home shall not permit such medications prescribed for one (1) resident to be given to any other resident.(17) Second Chance Home Programs. Health Services. Medications. A resident's attending physician shall be notified in cases of medication errors, adverse reactions, or if the prescription medication does not appear to be effective as soon as the home becomes aware of such an event.(18)Second Chance Home Programs. HealthServices. Medications. A home shall designate and authorize classes of staff, such as residential staff, to handout medications and supervise the taking of medications. Only designated and authorized staff shall handout and supervise the taking of medication.(19)Second Chance Home Programs. HealthServices. Medications. The home shall maintain a record of all medications and nutritional supplements handed-out by authorized staff and taken by residents to include: name of resident taking medication, name of prescribing physician and date of prescription (if the medication is prescription or psychotropic), required dosage, date and time taken, dosage taken, and name and signature of staff member who handed-out and supervised the taking of the medication.(20)Second Chance Home Programs. HealthServices. Medications. Self-Administration/Self-Possession of Medications.(a) Residents may possess and self-administer a metered dose or dry powder inhaler for relief of asthma, or before exercise to prevent onset of asthma symptoms, while at school or in the community, if the following conditions are met: 1. There is written approval from the resident's physician or other health care provider and the resident or parent or legal guardian (if resident is under 18) to possess and use the inhaler;2. The director of the home or designee has received a copy of the written approvals from the physician and the parent or legal guardian; or3. There is on file a written emergency care plan prepared by a licensed physician in collaboration with the resident and his or her parent or legal guardian. The plan shall contain specific instructions on the resident's needs including what to do in the event of an emergency.(b) Residents with a need for emergency medication may also be allowed to self-possess and self-administer such medication, provided that they meet the same conditions established above. Residents who are prescribed epinephrine to treat anaphylaxis shall be allowed to self-possess and self-administer the medication if they meet the conditions stated above.(c) A resident whose parent or legal guardian and physician provide written permission will be able to self-administer and self-possess his/her own medications.(d) A medication that a resident possesses must be labeled and prepared by a pharmacy or pharmaceutical company and include the dosage and frequency of administration.(e) The director of the home or designee may discontinue a resident's right to self-administer and/or self-possess if there is misuse by the resident. The denial shall follow a consultation with the parent or legal guardian.(21)Second Chance Home Programs. HealthServices. Medications. All medication shall be stored in labeled containers as prepared by a pharmacy, physician, or pharmaceutical company with the resident's name, the name of the medication, dosage, and the frequency of administration.(22)Second Chance Home Programs. HealthServices. Medications. All prescription and non-prescription medications, including medications requiring refrigeration, shall be kept in a locked storage cabinet or container which is not accessible to the residents and stored separate from cleaning chemicals and supplies or poisons. The keys to the locked cabinets or containers shall not be accessible to residents.(23)Second Chance Home Programs. HealthServices. Medications. All expired medications shall be discarded according to the community standard and not handed-out for use. The home shall remain responsible for the safeguarding of such medications even after discarding.(24)Second Chance Home Programs. HealthServices.Medical Records. A complete medical record shall be maintained on each resident. This record shall include: 1) Report of the medical and obstetrical history obtained prior to admission;2) Reports of all examinations while resident is in the home;3) Delivery information on the infant if applicable;4) Physician's discharge report if applicable.(25)Second Chance Home Programs. HealthServices.First Aid Supplies. Each living unit shall have a first aid kit and instruction manual; such kit shall contain scissors, tweezers, gauze pads, cotton balls, adhesive tape, thermometer, assorted band-aids, antiseptic cleaning solution, and bandages.(26)Second Chance Home Programs. HealthServices.Nutrition. The home shall follow the guidelines of the US Department of Agriculture in providing food that meets residents' individual nutritional requirements. Modifications to diet and nutrition shall be in accordance with the American College of Obstetrics and Gynecology (ACOG) and/or the American Academy of Pediatrics (AAP).(27)Second Chance Home Programs. HealthServices.Nutrition. The home shall make provision for three (3) regularly scheduled meals daily and provide for additional nutrition between meals, mid-morning, afternoon, and evening, as needed and desired by residents.(28)Second Chance Home Programs. HealthServices.Nutrition. The home shall provide any special diet prescribed by a resident's physician.(29)Second Chance Home Programs. HealthServices.Nutrition. The home shall offer nutritional counseling and guidance to all residents. Content of the counseling and guidance program must meet generally accepted standards in regard to nutrition during pregnancy and lactation.(30) Second Chance Home Programs. Health Services. Healthcare Crises. Detailed written summary reports shall be made to the Department via email or fax on the required incident intake information form (IIIF) within 24 hours in the case of any home outbreak or significant increase in institution-associated infections above the norm or baseline in a home or employees who work there. If the outbreak or epidemic has an unexpected pattern of cases, suspected cases, deaths, or increased incidence of disease that is a major public health concern, then such outbreak or epidemic shall be reported immediately via telephone to the Department.Ga. Comp. R. & Regs. R. 290-2-29-.19
O.C.G.A. Secs. 49-5-3, 49-5-8.
Original Rule entitled "Second Chance Home Programs-Health Services" adopted. F. Dec. 15, 2011; eff. Jan. 4, 2012.