Section 148-37-7 - SERVICE TYPESFacilities providing the following services must comply with core rules, Sections 3-6 and 8, in addition to the specific standards set forth in applicable parts of this Section.
A.SHELTERS FOR HOMELESS CHILDRENShelters for Homeless Children provide overnight lodging only.
1.Hours of operation. The Facility must open for daily operation no earlier than 4 p.m., and must cease operation no later than 9 a.m. the following morning.2.Guardian notification. The Facility may allow the admission of a child into care for up to three hours without first notifying the child's guardian. The Facility must make good faith efforts to notify a guardian of a child's admission within the first day. If unsuccessful, the Facility must notify the guardian on the day following admission. If the guardian cannot be reached, the Facility must notify the Department of Health and Human Services in accordance with the mandatory reporting law, 22 M.R.S. §4011-A. The Facility may admit the youth without notifying the guardian if the youth seeking admission indicates that notification of the guardian may result in harm to the child. The Facility must make an immediate referral to the Department of Health and Human Services.
3.Guardian information. The program must make good faith effort to provide the guardian with rules of the program, procedures related to communication with youth, copy of grievance procedures and/or formal complaint process, a description of any religious affiliation, and contact information for the program.4.Intake assessment. The intake assessment must be completed within 12 hours of admission.5.Orientation. Shelters for Homeless Children must provide safety orientation on the youth's first night in the shelter. For repeated stays, a safety orientation on the youth's first night is required if the youth has not been at the shelter in 30 days or more.6.Ratio. There must be a minimum of one direct care worker for every 10 youth.7.Medication administration and storage. During Shelter hours, the Shelter for Homeless Children must keep prescription medication in a locked area and must make available to youth for supervised self-administration. When necessary, the Shelter for Homeless Children may store medication during non-shelter hours and administer youth's medication in accordance with the following: a. The Facility must document the reason for storing and administering the medication; and b. The Facility must document the administration in the youth file.8.Physical plant. Sheets and pillow cases must be changed daily.9.Discharge requirements. The Facility must document the youth's discharge date and intended destination when known.B. EMERGENCY CHILDREN'S SHELTEREmergency Children's Shelters provide homeless youth and runaways with referrals and walk-in access to short-term residential care on an emergency basis.
1.Guardian notification. The Facility may allow the admission of a child into care for up to three hours without first notifying the child's guardian. The Facility must make good faith efforts to notify a guardian of a child's admission within the first day. If unsuccessful, the Facility must notify the guardian on the day following admission. If the guardian cannot be reached, the Facility must notify the Department of Human Services in accordance with the mandatory reporting law, 22 M.R.S. §4011-A. The Facility may admit the youth without notifying the guardian if:
a. The youth seeking admission indicates that notification of the guardian may result in harm to the child, provided that the Facility makes an immediate referral to the Department of Human Services; orb. The Facility obtains confirmation from the Department that the Department has declared the need for short term emergency services and/or has obtained a court order ordering the child to stay at the Facility.2.Guardian permission. The Facility must allow the admission of a child into care for up to 48 hours without the permission of the child's guardian.3.Intake assessment. The intake assessment must be completed within two business days of admission.4.Ratio. There must be a minimum of one direct care worker for every six youth during awake hours and a minimum of one direct care worker for every 10 youth during sleeping hours.5.Notes. The Facility must require at least one note per day in each youth's record which provides progress towards care plan goals and objectives. These notes must be written, dated, and signed by a direct care worker who worked with the resident during that day.6.Medication. Facilities may allow youth to self-administer medication. a.Self-administration. If the Facility allows a youth to self-administer medications the Facility must: i. Assess a youth's ability to responsibly self-medicate;ii. Assess youths' knowledge of their medications and make referrals to medical professionals when youth are unclear or need more information or training about their medications; andiii. Document compliance with subsections (i) and (ii) above in writing.b.Staff responsibilities.Staff must assist youth with self-administration of medications. Assisting with self-administered medications includes, but is not limited to: reminding the youth to take their medications, reading instructions for utilization, uncapping medication containers, and providing the proper liquid and utensils with which to take medications. Staff must supervise and observe youth self-administration of medication.c.Medication administration record (MAR). The MAR must notate that the medication is self-administered and the staff person who supervised the administration.7.Physical plant. Bed linens must be changed at least weekly or more often if necessary.C.TRANSITIONAL LIVING PROGRAMTransitional Living Programs may provide specialized services including but not limited to pregnant and parenting transitional living programs. The Department may provide technical assistance to ensure a Transitional Living Program with a different program type, and not specified by this rule, meets the health and safety needs of the youth served.
1.Intake assessment. The intake assessment must be completed within two business days of admission.2.Notes. The Facility must require at least one note per week in each youth's record which includes progress towards care plan goals and objectives. These notes must be written, dated, and signed by a direct care worker who worked with the youth.3.Medication. Facilities may allow youth to self-administer medication and to administer medication to their children. Requirements in this rule governing youth self-administration apply equally to a youth's administration of medication to their child(ren). a.Self-administration. If the Facility allows a youth to self-administer medications the Facility must: i. Assess a youth's ability to responsibly self-medicate and ability to administer medication to the youth's child(ren);ii. Assess youths' knowledge of their medications and make referrals to medical professionals when youth are unclear or need more information or training about their medications; and iii. Document compliance with subsections (i) and (ii) above in writing.b.Staff responsibilities. Staff must assist youth with self-administration of medications. Assisting with self-administered medications includes, but is not limited to, reminding the youth to take their medications, reading instructions for utilization, uncapping medication containers, and providing the proper liquid and utensils with which to take medications. Staff must supervise and observe youth self-administration of medication.c.Medication Administration Record (MAR). The MAR must notate that the medication is self-administered and the staff person who observed the administration.4.Physical plant.a. Household cleaners, kitchen utensils, and other daily use items do not need to be locked.b. Bed linens must be changed at least weekly or more often if necessary.5.Transitional living program serving youth with young children.a.Intake Assessment. The intake assessment must include strengths and needs around prenatal health and care, postpartum care, parenting skills, and needs of the youth's child.b.Safety requirements.i. Electrical outlets in areas used by infants, toddlers, and preschool children must be protected by safety caps, plugs, or other means.ii. Facilities must comply with Maine's Lead Poisoning Control Act regarding the use of lead-based paint on toys, furniture, or any interior or exterior surfaces per 22 M.R.S. Ch. 252. The Facility must screen for potential lead hazards at least annually, unless (a) the Facility was constructed in 1978 or later, (b) the Facility has been certified as lead-safe within the previous 12 months, (c) the Facility has been certified as lead-free, or (d) the Facility does not serve any children under 6 years of age.iii. Any medications, toxic substances (including, but not limited to, cleaning supplies, pesticides, and solvents), matches, lighters, fireworks, power tools, and other items dangerous to young children must be kept where young children cannot access them.iv. Strings and cords (e.g. those that are found on window shades) long enough to encircle a young child's neck (six inches or more) must not be accessible to young children unless engaged in a recreational or educational activity with an adult.v. Toys and equipment must be kept clean and in safe working order.vi. Heating units must be shielded to prevent injuries and burns.vii. Air conditioners, electric fans, and heaters must be mounted and anchored out of all young children's reach or have safeguards that keep any child from being injured.viii. A step, low platform, or other means must be placed next to toilets and sinks, for children who need help reaching and using them.ix. Items that pose a tipping hazard must be secured in a way that prevents tipping.x. Bed linens must be changed at least weekly or more often if necessary.c.Napping and resting. Infants must be placed on their backs on a flat surface for sleeping, unless the child's parent provides a physician's recommendation. Written documentation from the physician must be stored in the child's file. The provider must ensure that: i. A crib or play yard that meets current Consumer Product Safety Commission (CPSC) safety standards is provided for each child up to 18 months of age.ii. Bassinets that meet current CPSC safety standards may be used for infants up to five months of age, within appropriate weight limits. A bassinet may not be used for an infant who can independently lift their chest off the sleep surface.iii. Cribs, bassinets and play yards for infants less than 12 months old must not include soft or loose bedding including, but not limited to: bumper pads, pillows, quilts, comforters, blankets, sleep positioning devices, bibs or stuffed toys.iv. Staff must educate and work with parents on safe sleep practices.d.Training. Staff and youth must receive training in Prevention of Sudden Infant Death Syndrome (SIDS) or Sudden Unexplained Infant Death (SUID), Shaken Baby Syndrome, and safe sleep practices. Staff must receive this training annually.10- 148 C.M.R. ch. 37, § 7