§ 950-1-6-.06. Facility Services
(1) Section A - FOOD SERVICE
(a) A certified nutritionist, certified dietician, or licensed physician annually approves the menus provided in the Facility.
(b) Facility personnel develop advanced planned menus and substantially follow that schedule. In the planning and preparation of all meals, food flavor, texture, temperature, appearance, and palatability are taken into consideration.
(c) There is a single menu for staff and juveniles.
(d) Special diets as prescribed by medical or dental personnel are provided.
(e) The Facility provides:
1. weekly inspection of all food service areas including dining and food preparation areas and equipment
2. sanitary, temperature-controlled storage areas for all food
3. daily checks of refrigerator and water temperatures
(f) Written Policy, Procedure, and practice provide that staff members supervise juveniles during meals.
(2) Section B - SANITATION AND HYGIENE
(a) Safety and sanitation inspections of all internal and external areas and equipment are conducted weekly.
(b) All areas of the Facility comply with the sanitation and health codes of the County Health Department.
(c) The Facility makes provisions for routine vermin and pest control and trash and garbage removal.
(d) The Facility's potable water source, when derived from a private well, is annually inspected and approved by the County Health Department. If the water is provided through a public source, there is documentation that it is tested and approved by a recognized source annually.
(e) There is a housekeeping and maintenance plan in effect to ensure that the Facility is clean and in good repair. Specific duties and responsibilities should be assigned to both staff and juveniles.
(f) The Facility provides for the thorough cleaning, and when necessary, disinfecting of juvenile's clothing before being stored or before allowing the juveniles to keep or wear personal clothing.
(g) The Facility provides for the issue of suitable, clean bedding, and linens, including two sheets, pillow and pillowcase, one mattress, and sufficient blankets to provide comfort. There is provision for linen exchange, including towels, at least weekly.
(h) Written Policy, Procedure, and practice require that articles necessary for maintaining proper personal hygiene are provided to all juveniles.
(3) Section C - HEALTH CARE
(a) Written Policy, Procedure, and practice provide that the Facility has a designated Health Authority with responsibility for Health Care pursuant to a written agreement, contract, or job description. The Health Authority may be a physician, health administrator, or health agency.
(b) Written Policy, Procedure, and practice provide for access to Health Care. These policies are communicated in writing and orally to juveniles upon their arrival in the Facility in a language clearly understood by each juvenile.
(c) Dental care is provided to each juvenile under the direction and supervision of a dentist licensed in the state.
(d) Financial arrangements for the provision of medical and dental services, including routine services, hospitalization and/or emergency medical or surgical treatment, are made a part of the placement agreements for juveniles.
(e) Written Policy, Procedure, and practice provide that medical treatments carried out by Facility staff are performed pursuant to written standing orders or direct orders by personnel authorized by law to give such orders. Written standing orders are reviewed and approved annually; such approval is documented.
(f) The Facility arranges for the provision of mental health services to residents.
(g) There is a written suicide prevention and intervention program that is reviewed and approved by a qualified medical or mental health professional. All staff members with responsibility for juvenile supervision are trained in the implementation of the Program. This Program includes specific Procedures for intake screening, identification, and supervision of suicide-prone Youth.
(h) Written Policy, Procedure, and practice provide for the proper and safe storage and distribution of medication. This should include but is not limited to:
1. prescription and non-prescription medication
2. administering or distributing medications in a timely manner according to physician orders
(i) Written Policy, Procedure, and practice require medical, dental, and mental health screening be performed by health-trained staff on each juvenile at the time of entry into the Program. The screening includes:
1. Inquiry into:
(i) current illnesses and health problems, including sexually transmitted and other infectious diseases
(ii) dental problems
(iii) suicide ideation and/or history of attempts for suicide
(iv) mental health problems
(v) use of alcohol and other drugs, which includes types of drugs used, mode of use, amounts used, frequency, date and time of last use, and a history of problems that may have occurred after ceasing use
(vi) past and present treatment or hospitalization for mental disturbance or suicide attempts
2. Observation of:
(i) behavior, which includes state of consciousness, mental status, appearance, conduct, tremors, and sweating
(ii) body deformities, ease of movement, etc.
(iii) condition of skin, including trauma markings, bruises, lesions, jaundice, rashes, and infestations and needle marks or other indications of drug abuse
(j) Program staff are informed of juveniles' special medical needs.
(k) Written Policy, Procedure, and practice provide for medical examination of any employee or juvenile suspected of having a communicable disease.
(l) There is a written plan which provides for twenty-four hour emergency medical, dental, and mental health care availability. It includes arrangements for:
1. on-site emergency first-aid and crisis intervention
2. emergency evacuation of the juvenile from the Facility
3. use of an emergency medical vehicle
4. use of one or more designated hospital emergency rooms or other appropriate health facilities
5. emergency on-call physician, dentist, and mental health professional services when the emergency health facility is not located in a nearby community
6. security procedures providing for the immediate transfer of juveniles when appropriate
(m) Written Policy, Procedure, and practice ensure that all staff either part or full-time, who provide supervision to Youth, are trained and currently certified in CPR and First Aid. This Training should include:
1. recognition of signs and symptoms and knowledge of action required in potential emergency situations
2. administration of First Aid and cardiopulmonary resuscitation (CPR)
3. methods of obtaining assistance
4. signs and symptoms of mental illness, retardation, and chemical dependency
5. Procedures for patient transfer to appropriate medical facilities or Health Care providers
(n) The Facility has available at all times First Aid equipment approved by a recognized Health Authority. The Health Authority may be a physician, health administrator, or organization that has the expertise to determine the potential First Aid needs of the Facility and to evaluate the condition of the First Aid supplies and equipment.
(o) Any person injured in an incident receives immediate medical examination and treatment.
(p) Instructions and assistance in personal hygiene, grooming, and Health Care are provided to all Program participants.
(q) There is a written plan which addresses the management of serious and infectious diseases to include tuberculosis, hepatitis-B, HIV, and AIDS within the facility. This plan should be developed in conjunction with the local health department. It should address control, treatment, and prevention strategies. The plan is to be updated as new information becomes available, and reviewed annually.
(r) All juveniles, juvenile careworkers, and Counseling staff receive Training relevant to communicable diseases and sexually transmitted diseases among at-risk Youth. This Training is developed in conjunction with the local health department.
(s) Written Policy, Procedure, and practice specify methods for monitoring alcohol and drug abuse among juveniles. These policies and procedures are reviewed and approved by an individual or Agency with expertise in this field and are consistent with Program needs.
(t) The Program seeks medical consent authorization from each juvenile's parent, guardian, or Committing Authority as a part of the Admissions process.
(u) Written Policy prohibits the use of juveniles for medical, pharmaceutical or cosmetic experiments. This Policy would not preclude individual treatment of a juvenile based on his/her need for a specific medical procedure that is not generally available.
(v) Written Policy, Procedure, and practice provide for the prompt notification to the juvenile's parent(s)/guardian and referring Agency in case of serious illness, surgery, injury or death. Any death in the Program is reported immediately to the appropriate law enforcement officials.
(w) Each juvenile's file will contain a health record which would consist of, at a minimum:
1. complete receiving screening form
2. all findings, diagnosis, treatments, dispositions
3. medical consent forms
4. place, date, and time of health encounters
5. prescribed medications and records of their administration
(x) For juveniles being transferred to other facilities, copies of the health record and medications are forwarded to the receiving facility prior to or at the time of arrival.(New Rule: Filed December 17, 2004; effective January 21, 2005. Amended by Alabama Administrative Monthly Volume XXXVII, Issue No. 02, November 30, 2018, eff. December 21, 2018.)
Author: Alabama Department of Youth Services, Office of Licensing and Standards
Statutory Authority: Code of Ala. 1975, §§ 44-1-27(a), (b); 44-1-24(4), (6), 38-13-4.
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