216-40-10 R.I. Code R. § 18.5

Current through June 12, 2024

Section 216-RICR-40-10-18.5 - Organization and Management

18.5.1Governing Body and Management

A. Each facility shall have an organized governing body or equivalent legal authority, ultimately responsible for:

1. The program and operation of the school-based health center;

2. The appointment of an administrator who shall be directly responsible for the management and operation of the school-based health center;

3. The assurance of the quality of care and services; and

4. The compliance with all Federal, State and local laws and Regulations pertaining to safety, sanitation, communicable and reportable diseases, smoking policies and other health and safety requirements relevant to school-based health centers and all Rules and Regulations of this Part.

B. The governing body or equivalent legal authority shall ensure appropriate personnel, physical resources, and equipment to facilitate the delivery of schoolbased health center services, during established hours of operation.

C. The governing body or equivalent legal authority shall adopt written policies defining the responsibilities for the operation and performance of the schoolbased health center and identifying purposes and means of fulfilling such. In addition, the governing body or equivalent legal authority shall establish administrative/clinical policies pertaining to no less than the following:

1. The scope of health and medical services to be provided, as described in the School-based Health Alliance, Core Competencies, June 2017, incorporated by reference at § 18.2(B) of this Part;

2. Maintain linkages and referrals with other health care facilities to assure continuity of care;

3. Quality assurance for patient care and services;

4. Development and implementation of a staffing/personnel plan, which must include a description of the school's certified nurse-teacher role in the procedures for patient referrals, student and family communication, care coordination and delivery of services;

5. Any written agreements, memoranda of understanding and/or other terms and conditions agreed to between the school-based health center or the entity operating the school-based health center and the school district and/or collective bargaining agent; and

a. Such written agreements, memoranda of understanding and/or other terms and conditions agreed upon by the school-based health center and the school district and/or collective bargaining agent must be submitted to the Department for review.

6. Such other matters as may be relevant to the organization and operation of the school-based health center.

18.5.2Quality Improvement

A. The governing body shall ensure that there is an effective, ongoing, schoolbased health center wide quality improvement program to evaluate the provision of patient care. The quality improvement activities at the school-based health center shall be coordinated with and integrated into the quality improvement activities for similar services at other health care facilities operated by the licensee.

B. The organized school-based health center wide quality improvement program shall be ongoing and shall have a written plan of implementation.

C. The school-based health center shall take and document appropriate remedial action to address problems identified through the quality improvement program. The outcome(s) of the remedial action shall be documented.

18.5.3Pending and Actual Labor Disputes/Actions

Health care facilities shall provide the Department with prompt notice of pending and actual labor disputes/actions pursuant to R.I. Gen. Laws § 23-17-48.

18.5.4Medical Oversight

Each school-based health center shall have a physician licensed in this State who shall be responsible for the achievement and maintenance of the quality of health care services and the establishment of policies and procedures for health care services based on recognized standards of practice.

18.5.5Personnel

A. A certified nurse-teacher must be employed and present in any elementary or secondary school with a school-based health center on-site and/or available for consultation either in-person or remotely during the school-based health center hours of operation.

B. The school-based health center shall be staffed with appropriate professional and ancillary personnel who shall be assigned duties and responsibilities that are consistent with licensure/certification requirements, their training and experience, and services rendered. Staff performing functions requiring certification and/or licensure shall be duly licensed in Rhode Island as required by statute.

C. Each school-based health center shall have at least one (1) appropriately qualified health professional staff person on duty at all times when services are provided.

D. A health care facility shall require all persons who examine, observe, or treat a patient of such facility to wear a photo identification badge which includes the information required by R.I. Gen. Laws § 23-17-47. This badge shall be worn in a manner that makes the badge easily seen and read by the patient or visitor.

E. The school-based health center shall have written job descriptions that define qualifications, responsibilities, and supervision of all school-based health center personnel.

18.5.6Health Screening

Upon hire and prior to delivering services, a pre-employment health screening shall be required for each individual who has or may have direct contact with a patient of the school-based health center. Such health screening shall be conducted in accordance with Part 20-15-7 of this Title, Immunization, Testing, and Health Screening for Health Care Workers.

18.5.7Rights of Patients

A. Consistent with R.I. Gen. Laws § 23-17-19.1(16), each school-based health center shall observe each of the following age-appropriate rights with respect to each patient who utilizes the facility.

B. Each patient can expect to:

1. Be treated respectfully.

2. Receive the information needed to make intelligent choices about the health care received.

3. Receive information concerning treatment and be informed of the medical consequences of refusing treatment.

4. Receive private, confidential care.

5. Have the ability to refuse the release of medical records.

6. Receive referrals for care that the provider is unable to meet.

7. Have the ability to register complaints regarding the care received or lack thereof.

8. Have school-based health center respond in a reasonable manner to the request of a patient's physician for medical services to the patient. The school-based health center shall also respond in a reasonable manner to the patient's request for other services customarily rendered by the school-based health center to the extent the services do not require the approval of the patient's physician or are not inconsistent with the patient's treatment;

9. Be furnished with the identities of all other health care and educational institutions that the school-based health center has authorized to participate in the patient's treatment and the nature of the relationship between the institutions and the school-based health center;

10. Upon request, be informed of any research project, and be offered the right to refuse to participate in the project. The school-based health center shall also comply with any additional provisions for research stipulated by the school department.

11. Have the ability to examine any pertinent school-based health center Rules and Regulations that specifically govern the patient's treatment;

12. Be offered treatment without discrimination as to race, color, religion, national origin, sexual orientation, disability, or source of payment.

C. Each school-based health center shall display in a conspicuous place in the licensed school-based health center a copy of the "Rights of Patients"?, including but not limited to, the patient rights stated above.

216 R.I. Code R. § 216-RICR-40-10-18.5

Amended effective 12/19/2021