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5101:2-39-082 "Child's
education and health information" form.
(A) The PCSA shall complete the ODHS
1443 ODJFS 01443 "Child's Education and Health
Information" form, or the PCSA's form used in lieu of the ODHS
1443 ODJFS 01443 form, when a child is placed in a
substitute care setting, or at the time the case plan document is completed
pursuant to rule 5101:2-39-081 of the Administrative Code, whichever occurs
first.
(B) The PCSA shall complete the ODHS
1443 ODJFS 01443 "Child's Education and Health
Information" form, or the PCSA's form used in lieu of the ODHS
1443 ODJFS 01443 form, when any of the following occur:
(1) A semiannual administrative review is
conducted pursuant to rule 5101:2-42-43 of the Administrative Code; or
(2) Any time there is a placement change; or
(3) Any time there is a change in any of the
health or education information required on the ODHS
1443 ODJFS 01443 form.
(C) The ODHS
1443 ODJFS 01443, or the form the PCSA uses in lieu of
the ODHS 1443 ODJFS 01443,
shall contain information regarding a child's medical history including, but not
limited to, the following:
(1) Names and addresses of the child's health
care provider(s);
(2) Child's known medical problems;
(3) Child's medications;
(4) A record of the child's immunizations; and
(5) Any other pertinent health information
concerning the child such as:
(a) Child's medication allergies and any
other known allergies;
(b) Childhood illnesses;
(c) Child's last physical and dental exams.
(D) The ODHS
1443 ODJFS 01443, or the form the PCSA is utilizing in
lieu of the ODHS 1443 ODJFS
01443, shall contain information regarding a child's educational background
including, but not limited to, the following:
(1) Names and addresses of the child's
educational provider(s);
(2) Child's grade level performance;
(3) Child's school records, including, but not
limited to:
(a) Child's grade level;
(b) Disciplinary issues, and
(c) Attendance.
(4) Any other pertinent educational
information concerning the child such as:
(a) Special education requirements; and
(b) Any developmental delays or learning
disabilities.
(E) If there are circumstances in which the
health and education records are unavailable or inaccessible, the PCSA shall
provide written documentation on the ODHS 1443
ODJFS 01443 or the PCSA's form being used in lieu of the ODHS
1443 ODJFS 01443 describing the reasons why this
information is unavailable or inaccessible and the steps being taken by the PCSA
to obtain such information.
(F) The PCSA shall provide the custodian, parent
or guardian and the substitute caregiver with a copy of the completed ODHS
1443 ODJFS 01443 or the PCSA's form being used in lieu of
the ODHS 1443 ODJFS 01443
form and all subsequent updates of the form at the time the case plan document
is completed, pursuant to rule 5101:2-39-081 of the Administrative Code, or at
least within seven calendar days after the PCSA has received the information and
completed the ODHS 1443 ODJFS
01443 form.
(G) If the PCSA determines that sharing the
identifying information contained on the ODHS
1443 ODJFS 01443 form or the PCSA's form being used in
lieu of the ODHS 1443 ODJFS
01443 may result in adverse or negative consequences to the child, the PCSA
may delete any information that identifies the current school of attendance or
the medical provider from the copy of the ODHS
1443 ODJFS 01443 form which is provided to the custodial
parent or guardian. A statement providing full explanation of the reasons for
not sharing this information shall be contained in the PCSA case record prepared
pursuant to rule 5101:2-39-02 of the Administrative Code.
(H) The PCSA shall attach the ODHS
1443 ODJFS 01443 form or the PCSA's form being used in
lieu of the ODHS 1443 ODJFS
01443 form to the agency's copy of the ODHS
1443 ODJFS 01444 "Family RISK
ASSESSMENT DECISION MAKING Model, Part II: Case
Plan" prepared pursuant to rule 5101:2-39-081 of the Administrative Code.
Submittal of a completed ODHS 1443
ODJFS 01443 form for court approval or journalization is not an ODHS
1443 ODJFS requirement.
(I) The PCSA may use the health care information
obtained pursuant to rules 5101:2-42-661 and 5101:2-42-662 of the Administrative
Code as a source to complete the ODHS 1443
ODJFS 01443 or the PCSA's form being used in lieu of the ODHS
1443 ODJFS 01443.
Effective Date: 4/1/2001
Review Date:
Certification: Jo Ann Davidson
Date
Promulgated Under: Revised Code Chapter 119.
Statutory Authority: Revised Code Sections 2151.412, 2151.421, 5103.03,
5153.16.
Rule Amplifies: Revised Code Sections 2151.412, 2151.421, 5103.03, 5153.16.
Prior Effective Dates: 7/1/92, 5/1/93, 10/1/97.
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