5101:2-42-66.1 Comprehensive health care for children in placement.

Effective Date: February 1, 2003.

Most current prior effective date: October 1, 1997.

(A)      The PCSA, PCPA or PNA shall be responsible for the supervision of comprehensive health care including a physical health examination, developmental and psychological assessments, for each child in its care or custody and placed in substitute care.


(B)      For every child placed in substitute care the PCSA, PCPA or PNA shall attempt to determine if the parent(s), guardian, or custodian has health care insurance coverage available to the child. If such insurance coverage is available, the PCSA, PCPA or PNA shall attempt to make use of this resource, as appropriate, to help meet the child's health care needs.


(C)      As soon as possible following the child's placement in substitute care, the PCSA or PCPA that has custody of a child shall assess the child's eligibility for medicaid, Title IV-E, and supplemental security income, or other assistance programs that might provide financial assistance to help meet the child's health care needs. No later than thirty days after the date of substitute care placement, unless an application for Title IV-E has been submitted, the PCSA or PCPA shall apply for medicaid on behalf of the child.


(D)      When the PCSA or PCPA petitions for custody, it shall also request financial support for comprehensive health care, if applicable.


(E)      When a child has been determined medicaid eligible, the PCSA, PCPA or PNA shall coordinate with the CDHS healthchek coordinator to ensure the provision of comprehensive health care.


(F)      The PCSA, PCPA or PNA shall be responsible for completing the ODHS 3528 JFS 03528 "Healthchek Participation Agreement" on behalf of the medicaid eligible child and serve as a liaison with the CDHS healthchek coordinator, medical providers, custodial parents, and substitute caregiver.


(G)      The PCSA, PCPA or PNA may authorize the substitute caregiver to serve as a liaison with the CDHS healthchek coordinator to schedule screenings and arrange transportation.


(H)      No later than five working days after a child's placement, not counting the day placement occurred, the PCSA, PCPA or PNA shall secure a placement medical screening of the child in order to prevent possible transmission of common childhood communicable diseases and identify any symptoms of illness, injury, or maltreatment. Each child shall be checked by a licensed physician, advanced practice nurse, registered nurse, licensed practical nurse, or physician's assistant. If a child is moved from one placement setting to another placement setting, medical care shall be provided following the time frames established by the original placement, unless medical care is needed at an earlier date.


(I)      The PCSA, PCPA or PNA shall arrange for and secure comprehensive health care for each child no later than sixty days after the child's placement into substitute care. The PCSA, PCPA or PNA shall secure an annual physical reexamination no later than thirty days from the anniversary date of the child's last comprehensive physical examination. For a child who is not medicaid eligible, the physical examination shall be completed by a licensed physician.


(J)      A healthchek screening examination or its equivalent constitutes comprehensive health care for all children in placement unless identified otherwise in this rule. A healthchek screening examination includes those components listed in rule 5101:3-14-03 of the Administrative Code, including all of the following:


(1)      Comprehensive physical examination;


(2)      Health and developmental histories;


(3)      Nutrition, vision, hearing, developmental, psychological, and dental assessments;


(4)      Lab tests;


(5)      Immunizations if needed; and


(6)      Health education.


(K)      The PCSA, PCPA, or PNA shall attempt to arrange for health care from the child's existing and previous medical providers.


(L)      When a child has been determined medicaid eligible and the PCSA, PCPA, or PNA is unable to secure comprehensive health care by a medicaid provider within the timeframe specified in paragraph (I) of this rule, the PCSA, PCPA, or PNA shall remain responsible for securing comprehensive health care through an alternative provider and document why an alternative provider was used in the case record.


(M)      The PCSA, PCPA or PNA shall arrange for and secure appropriate immunizations for each child entering substitute care. If a child's record of previous immunizations is unavailable at the time of the comprehensive physical exam, and it is reasonable to assume that the child has received immunizations, the PCSA, PCPA or PNA may postpone immunizing the child until a record of the child's immunizations is available for review.


(N)      For a child who is not medicaid eligible, the PCSA, PCPA or PNA shall arrange for and secure an initial vision assessment no later than sixty days after the child's placement into substitute care. The PCSA, PCPA or PNA shall secure treatment whenever a condition of visual impairment indicates a need for treatment. All treatment shall be performed by a licensed optometrist or ophthalmologist.


(O)      For a child who is not medicaid eligible, the PCSA, PCPA, or PNA shall arrange for and secure an initial hearing assessment no later than sixty days after the child's placement into substitute care. The PCSA, PCPA, or PNA shall secure reexaminations whenever a condition of hearing impairment indicates a need for treatment. All treatment shall be performed by a physician or licensed audiologist.


(P)      For a child who is not medicaid eligible, the PCSA. PCPA. or PNA shall arrange for and secure an initial dental assessment for a child over three years of age no later than one hundred and eighty days after the child's placement into substitute care. The PCSA. PCPA. or PNA shall secure annual dental reexaminations no later than thirty days from the anniversary date of the child's last dental examination.Treatment shall be provided whenever a dental condition indicates a need for treatment. All dental treatment shall be performed by a licensed dentist.


(Q)      All infants age two and under shall receive required pediatric care as prescribed by a licensed physician according to the schedule recommended by the American academy of pediatrics.


(R)      The PCSA, PCPA, or PNA shall refer all infants and toddlers age three and under to the county early intervention program when a screening or assessment indicates the child has or is at risk for a developmental disability or delay.


(S)      When follow-up care or treatment for the child is indicated as a result of diagnostic findings or for continued treatment need, such care must be initiated within sixty days of the examination.


(T)      The PCSA, PCPA, or PNA responsibility for providing health care pursuant to this rule is waived when a child leaves the placement within the sixty-day timeframe pursuant to paragraph (I) of this rule.


(U)      When a newborn child is placed in care directly from the hospital, paragraphs (H), (I), (N), (O) and (P) do not apply.


(V)      When the PCSA, PCPA, or PNA determines that a child has received a comprehensive health care screening or examination within three months prior to placement in substitute care, the PCSA, PCPA or PNA is waived from compliance with paragraphs (H) and (I) of this rule. Results of the comprehensive health care screening or examination shall be obtained by the PCSA, PCPA, or PNA and filed in the case record.


(W)      The PCSA, PCPA, or PNA shall work actively to involve the parent, guardian, or custodian in the planning and delivery of physical health examination, developmental and psychological assessments for children in temporary custody.


(X)      Health information about a child in the care or custody of a PCSA, PCPA, or PNA shall be documented in the child's case record pursuant to rule 5101:2-42-662 of the Administrative Code.


Effective: 02/01/2003

R.C. 119.032 review dates: 10/02/2002 and 02/01/2008

Certification: CERTIFIED ELECTRONICALLY

Date: 12/16/2002

Promulgated Under: 119.03

Statutory Authority: 5103.03, 5153.16

Rule Amplifies: 5103.03, 5153.16

Prior Effective Dates: 9/28/87(Emer.), 12/27/87, 1/1/89, 1/1/90, 5/1/93, 9/1/93, 10/1/97