N.M. Admin. Code § 8.14.14.17

Current through Register Vol. 35, No. 21, November 5, 2024

Section 8.14.14.17 - MEDICAL AND BEHAVIORAL HEALTH CARE

A. The center shall have written policies and procedures that provide for the delivery of health care services, including medical, dental, and behavioral health care, under the control of a designated health authority. When this authority is other than a health care provider, final medical judgment rests with a designated, responsible, licensed physician. Arrangements are made with the health care provider in advance of need.

B. Medical, including psychiatric and dental, matters involving medical judgment are performed by a licensed physician and/or dentist respectively. The center's policies and procedures that are applicable to center staff are also applicable to health care providers.

C. The center shall have written health care policies and procedures approved by the responsible physician and/or health authority that provide for a regular schedule of examinations, emergency protocols, inventory of all medical materials dispensed, and medical record retention.

D. The center shall have written policies and procedures that shall address the management of serious, communicable, and infectious diseases.

E. The department of health shall be notified of any outbreak of an infectious disease.

F. The center shall enter into an agreement with a nearby medical service provider and/or hospital for all medical services that the center cannot provide.

G. Appropriate state and federal license, certification or registration requirements, and restrictions apply to staff who provide health care services to juveniles. Verification of current credentials and job descriptions are kept on file in the center and/or in the county where the center is located.

H. The center shall have written policies and procedures requiring that first aid kits are available. A medical provider approves the contents, locations, and procedure for periodic inspections.

I. The center shall have written policies and procedures that provide for medical examination of any staff or juvenile suspected of carrying a communicable disease.

J. At the time of a juvenile's admission, program staff shall be informed of juveniles' special medical, physical, and behavioral health conditions that might require additional attention, further evaluation, or safety monitoring.

K. The center shall have written policies and procedures requiring a medical and behavioral health evaluation be performed by medical providers and behavioral health clinicians on all juveniles, within 72 hours of arrival at the center. All findings and evaluations are recorded.

L. The center shall have written policies and procedures requiring that juveniles be informed orally and in writing of the process for accessing medical and behavioral health services.

M. Juveniles' medical and behavioral health complaints are monitored and responded to daily, or as needed, and are documented.

N. The center shall provide sick call for non-emergency medical service, conducted by a physician or medical provider.

O. Sick call is available to each juvenile at least weekly.

P. The center shall have written policies and procedures that provide for the prompt notification of a juvenile's parent/guardian/custodian in case of illness, surgery, injury, or death.

Q. The center shall provide access to 24-hour emergency medical and behavioral health care.

R. The center shall have written policies and procedures that provide for screening, care, and/or referral for care of juveniles who display behavioral health, developmental, or intellectual delay needs. When such juveniles are identified, proceedings are instituted pursuant to the Children's Code.

S. The center shall have written policies and procedures for detoxification services, performed under medical supervision, from alcohol, opiates, barbiturates, and other drugs. The center shall not provide detoxification services unless they are approved and staffed by medical providers.

T. The center shall have written policies and procedures that provide for proper management of pharmaceuticals and address the following subjects:

(1) handling psychotropic medications,

(2) medication receipts,

(3) storage,

(4) dispensing,

(5) administration,

(6) distribution,

(7) inventory,

(8) all controlled substances, and

(9) syringes and needles.

U. The center shall have written policies and procedures that provide that all staff administering or distributing medication have training from a medical provider, and are accountable for administering medications according to orders. The administration of medications are recorded on a form approved by the responsible physician and/or pharmacist including the appointment of a treatment guardian ad litem as required under the Children's Code.

V. The center shall have written policies and procedures that provide that stimulants, tranquilizers, and psychotropic drugs that require intramuscular administration are prescribed only by a physician and are administered by a physician, registered nurse, or medical provider.

W. The center shall have written policies and procedures that prohibit the use of stimulants, tranquilizers, or psychotropic drugs for purposes of behavior management or experimentation and research.

X. The center shall have written policies and procedures that prohibit the use of juveniles for medical, pharmaceutical, or cosmetic experiments. This policy does not preclude individual treatment of a juvenile based on the need for a specific medical procedure that is not generally available.

Y. The center shall have written policies and procedures requiring that a health record be kept on each juvenile containing the following:

(1) the completed receiving screening form;

(2) health appraisal data forms;

(3) all findings, diagnoses, treatments, dispositions, prescribed medications and their administration, laboratory, x-ray, and diagnostic studies;

(4) signature and title of staff documenting the information;

(5) consent and refusal for treatment forms;

(6) release of information forms;

(7) place, date, and time of health encounters;

(8) health service reports, e.g., dental, behavioral health, and consultations;

(9) treatment plan, including nursing care plan and progress reports; and

(10) discharge summary of hospitalization and other termination summaries.

Z. The method of recording entries in the records, the form and format of the records, and the procedures for their maintenance and safekeeping are approved by the health authority.

AA. The center shall have written policies and procedures upholding the principle of confidentiality of the health record:

(1) the active health record shall be maintained separately from the detention record;

(2) access to the health record shall be controlled by the medical provider in accordance with HIPAA; and

(3) medical providers and behavioral health clinicians may share with the center administrator information regarding a juvenile's medical and behavioral health management and ability to participate in programs.

BB. The center shall have written policies and procedures that provide when a juvenile is in need of hospitalization, security staff accompanies and stays with the juvenile at least during admission. If the juvenile is admitted, the center administrator notifies the court.

CC. The center shall have written policies and procedures to handle all behavioral health emergencies and all necessary services (including placement change) for any juvenile experiencing a behavioral health emergency. Juveniles are afforded access to behavioral health care and crisis intervention services in accordance with their needs.

(1) During any and all medical or behavioral health required observations, staff visually checks the juvenile every five minutes. Each check is documented, the juvenile's behavior described, and the reason for the juvenile to remain on observation noted.

(2) Juveniles placed on observation are visited at least one time each day by staff from administrative, supervisory, medical, behavioral health, or education. A log recording who required the observation, persons visiting the juvenile, the person authorizing the release, and the time of release is maintained and available for inspection by the department.

N.M. Admin. Code § 8.14.14.17

8.14.14.17 NMAC - N, 7/31/01, Adopted by New Mexico Register, Volume XXIX, Issue 24, December 27, 2018, eff. 1/1/2019