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5101:2-5-37 Additional
Requirements For an Agency That Acts as a Representative of ODJFS in
Recommending Medically Fragile Foster Homes For Certification.
Effective Date: January 1, 2003.
IN ADDITION TO THE REQUIREMENTS FOUND IN RULES 5101:2-5-02 TO 5101:2-5-35 OF
THE ADMINISTRATIVE CODE, AN AGENCY THAT ACTS AS A REPRESENTATIVE
OF THE OHIO DEPARTMENT OF JOB AND FAMILY SERVICES IN RECOMMENDING
MEDICALLY FRAGILE FOSTER HOMES FOR CERTIFICATION SHALL MEET THE FOLLOWING
REQUIREMENTS:
(A) BEGINNING TWENTY-SEVEN MONTHS
AFTER THE EFFECTIVE DATE OF THIS RULE, NO MEDICALLY FRAGILE CHILD SHALL BE
PLACED IN A FOSTER HOME UNLESS THE FOSTER CAREGIVER(S) HAS BEEN CERTIFIED TO
OPERATE A MEDICALLY FRAGILE FOSTER HOME PURSUANT TO THIS RULE AND RULE
5101:2-7-17 OF THE ADMINISTRATIVE CODE.
(B) A TREATMENT TEAM SHALL BE ASSIGNED TO
EACH MEDICALLY FRAGILE CHILD PLACED IN A MEDICALLY FRAGILE FOSTER HOME. A
PHYSICIAN, LICENSED NURSE PRACTITIONER OR A REGISTERED NURSE SHALL SUPERVISE THE
MEDICAL ASPECTS OF THE CHILD'S SERVICE PLAN.
(C) AN INITIAL SERVICE PLAN SHALL BE
COMPLETED BY THE TREATMENT TEAM FOR EACH MEDICALLY FRAGILE CHILD PLACED IN A
MEDICALLY FRAGILE FOSTER HOME NO LATER THAN THIRTY DAYS AFTER PLACEMENT. THE
SERVICE PLAN SHALL BE REVIEWED AND REVISED, IF NECESSARY, AT LEAST ONCE EVERY
SIXTY DAYS THEREAFTER. SERVICE PLAN APPROVAL AND ANY REVISIONS SHALL BE
COMPLETED BY THE INDIVIDUAL ASSIGNED UNDER PARAGRAPH (B) OF THIS RULE WHO
IS OVERSEEING THE MEDICAL ASPECTS OF THE CHILD'S SERVICE PLAN AND APPROVED BY
THE TREATMENT TEAM LEADER'S SUPERVISOR. ALL TREATMENT TEAM MEMBERS SHALL BE
NOTIFIED IN ADVANCE OF EACH TREATMENT TEAM MEETING AND INVITED TO PARTICIPATE.
DOCUMENTATION OF THE INVITATIONS SHALL BE MAINTAINED IN THE CHILD'S RECORD.
(D) THE SERVICE PLAN FOR A MEDICALLY
FRAGILE CHILD PLACED IN A MEDICALLY FRAGILE FOSTER HOME SHALL INCLUDE:
(1) A NURSING TREATMENT PLAN SIGNED BY A
LICENSED PHYSICIAN. THE NURSING TREATMENT PLAN SHALL LIST ANY SPECIAL
INSTRUCTIONS FOR THE CARE OF THE CHILD, THE CHILD'S MEDICATIONS INCLUDING
INSTRUCTIONS FOR ADMINISTERING THE MEDICATIONS AND POTENTIAL SIDE EFFECTS, AND
THE CHILD'S NURSING NEEDS. THE NURSING TREATMENT PLAN SHALL BE REVIEWED AND
APPROVED NO LESS OFTEN THAN EVERY SIXTY DAYS.
(2) TREATMENT GOALS, CLINICAL AND/OR
REHABILITATIVE SERVICES AND OTHER NECESSARY INTERVENTIONS FOR THE CHILD AND
HIS FAMILY.
(3) THE METHOD BY WHICH THE GOALS, AND
REHABILITATIVE SERVICES, AND OTHER NECESSARY INTERVENTIONS WILL BE ATTAINED
AND PROGRESS EVALUATED.
(4) THE PROJECTED LENGTH OF THE CHILD'S STAY
IN THE FOSTER HOME.
(5) THE CRITERIA TO BE MET FOR THE CHILD'S
REUNIFICATION WITH HIS PARENT(S)/FAMILY OR GUARDIAN OR THE PROJECTED
POST-TREATMENT SETTING INTO WHICH THE CHILD WILL BE PLACED UPON ATTAINMENT OF
THE TREATMENT GOALS.
(6) AFTERCARE SERVICES TO BE PROVIDED OR
ARRANGED.
(7) HOW THE CHILD'S PERMANENCY PLAN FOR FAMILY
REUNIFICATION, ADOPTION, INDEPENDENT LIVING OR OTHER PERMANENT LIVING
ARRANGEMENT, AS SPECIFIED IN THE CUSTODIAL AGENCY'S CASE PLAN, WILL BE
ATTAINED.
(E) AN INDIVIDUAL PLAN FOR RESPITE
CARE SHALL BE DEVELOPED FOR EACH MEDICALLY FRAGILE CHILD PLACED IN A MEDICALLY
FRAGILE FOSTER HOME. THE USE OF RESPITE CARE SHALL COMPLY WITH THE AGENCY'S
RESPITE CARE POLICY PREPARED PURSUANT TO RULE 5101:2-5-13 OF THE ADMINISTRATIVE
CODE. A COPY OF THE INDIVIDUAL PLAN FOR RESPITE CARE FOR EACH MEDICALLY
FRAGILE CHILD PLACED IN A MEDICALLY FRAGILE FOSTER HOME SHALL BE INCLUDED IN THE
CHILD'S CASE RECORD.
(F) THE AGENCY SHALL ENSURE THAT A MEMBER
OF THE AGENCY'S PROFESSIONAL STAFF SHALL BE ON-CALL FOR MEDICALLY FRAGILE FOSTER
CAREGIVERS AND EACH MEDICALLY FRAGILE CHILD PLACED IN A MEDICALLY FRAGILE FOSTER
HOME ON A TWENTY-FOUR HOUR, SEVEN DAY A WEEK BASIS.
(G) THE AGENCY SHALL ENSURE THAT
MEDICALLY FRAGILE FOSTER CAREGIVERS ARE PROVIDED WITH A MANUAL CONTAINING ALL
POLICIES, PROCEDURES AND OTHER INFORMATION RELATED TO THE PROGRAM NOT LATER THAN
THE DATE THE INDIVIDUAL BECOMES CERTIFIED AS A MEDICALLY FRAGILE FOSTER
CAREGIVER.
(H) THE AGENCY SHALL COORDINATE WITH THE
AGENCY HOLDING CUSTODY OF A MEDICALLY FRAGILE CHILD OR THE CHILD'S PARENT OR
GUARDIAN FOR THE PROVISION OF ALL REHABILITATIVE SERVICES AND OTHER NECESSARY
INTERVENTIONS CONTAINED IN THE CHILD'S SERVICE PLAN AND ANY REVISIONS THERETO.
THE AGENCY SHALL ALSO IMPLEMENT THOSE ASPECTS OF THE CHILD'S SERVICE PLAN THAT
ARE ITS RESPONSIBILITY.
(I) THE AGENCY SHALL ENSURE THAT A
DISCHARGE SUMMARY IS PREPARED PURSUANT TO RULE 5101:2-5-17 OF THE ADMINISTRATIVE
CODE FOR EACH CHILD DISCHARGED FROM A MEDICALLY FRAGILE FOSTER HOME. THIS
PARAGRAPH DOES NOT APPLY TO A CHILD WHO HAS BEEN ENROLLED IN THE PROGRAM ONLY
FOR RESPITE SERVICES.
(J) AT THE TIME OF A CHILD'S PLACEMENT IN
A MEDICALLY FRAGILE FOSTER HOME AND WHENEVER ADDITIONAL INFORMATION BECOMES
AVAILABLE, THE AGENCY SHALL DISCLOSE TO THE MEDICALLY FRAGILE FOSTER CAREGIVER
ALL INFORMATION AVAILABLE TO THE AGENCY ABOUT THE CHILD AND HIS FAMILY PURSUANT
TO RULE 5101:2-42-90 OF THE ADMINISTRATIVE CODE. IN ADDITION, THE
CAREGIVER SHALL BE PROVIDED WRITTEN STEP-BY-STEP INSTRUCTIONS FOR EACH SKILLED
PROCEDURE REQUIRED TO BE PERFORMED FOR EACH MEDICALLY FRAGILE CHILD PLACED IN
THE HOME. DOCUMENTATION OF THE RECEIPT OF THIS INFORMATION SHALL BE MAINTAINED
IN THE CAREGIVER'S RECORD AND IN THE CHILD'S RECORD.
(K) THE AGENCY SHALL ASSURE THAT ALL
PROFESSIONAL TREATMENT STAFF REQUIRED TO BE LICENSED SHALL BE APPROPRIATELY
LICENSED. PROFESSIONAL TREATMENT STAFF SHALL DEMONSTRATE TO THE EMPLOYING OR
CONTRACTING AGENCY THAT THE TRAINING REQUIRED FOR PROFESSIONAL LICENSURE SHALL
BE IN TOPICS APPROPRIATE TO MEDICALLY FRAGILE FOSTER CARE.
(L) ALL PROFESSIONAL TREATMENT STAFF
SHALL BE APPROPRIATELY LICENSED AND SHALL ANNUALLY COMPLETE AT LEAST FIFTEEN
HOURS OF TRAINING IN SPECIFIC ISSUES ADDRESSING THE NEEDS OF MEDICALLY FRAGILE
CHILDREN AND THE MISSION OF THE AGENCY.
(M) THE AGENCY SHALL ENSURE THAT ALL
PROFESSIONAL TREATMENT STAFF ARE PROVIDED WITH A MANUAL OF ALL POLICIES AND
PROCEDURES RELEVANT TO THE PROGRAM AT THE BEGINNING OF THEIR EMPLOYMENT WITH THE
AGENCY.
(N) THE AGENCY SHALL NOT PROHIBIT
MEDICALLY FRAGILE FOSTER CAREGIVERS FROM PARTICIPATION IN ANY FORMAL OR INFORMAL
SUPPORT GROUPS ORGANIZED FOR THE PURPOSE OF SUPPORTING FOSTER CAREGIVERS.
(O)(1) WITH THE EXCEPTION OF THE
PROVISIONS OF PARAGRAPH (O)(2) OF THIS RULE, A MEDICALLY FRAGILE FOSTER
CAREGIVER MAY PROVIDE FOSTER CARE FOR NOT MORE THAN FIVE FOSTER CHILDREN, TWO OF
WHOM MAY HAVE INTENSIVE NEEDS AS DESCRIBED IN RULE 5101:2-47-18 OF THE ADMINISTRATIVE
CODE REQUIRING THEIR PLACEMENT IN A MEDICALLY FRAGILE FOSTER HOME. ANY
EXCEPTION TO THE NUMBER OF MEDICALLY FRAGILE FOSTER CHILDREN PLACED IN THE HOME
SHALL BE ONLY WITH SPECIFIC JUSTIFICATION IN ACCORDANCE WITH THE AGENCY'S POLICY
FOR MATCHING MEDICALLY FRAGILE FOSTER CHILDREN AND CAREGIVERS DEVELOPED PURSUANT
TO RULE 5101:2-5-13 OF THE ADMINISTRATIVE CODE. SUCH
JUSTIFICATION, WHICH MAY INCLUDE THE NEED TO PLACE A SIBLING GROUP, OR THE
ABILITIES OF A PARTICULAR CAREGIVER(S) IN RELATION TO THE INTENSIVE NEEDS OF A
PARTICULAR CHILD, SHALL BE DOCUMENTED IN THE CHILD'S CASE RECORD AND IN THE
FOSTER HOME RECORD. IF MORE THAN TWO MEDICALLY FRAGILE CHILDREN ARE PLACED IN A
MEDICALLY FRAGILE FOSTER HOME, ALL AGENCIES HOLDING CUSTODY OF ANY OTHER
CHILDREN PLACED IN THE HOME SHALL BE NOTIFIED BY THE AGENCY RECOMMENDING
CERTIFICATION OF THE HOME WITHIN SEVENTY-TWO HOURS OF THE ADDITIONAL CHILD'S
PLACEMENT.
(2) A MEDICALLY FRAGILE FOSTER CAREGIVER WHO
IS ALSO AN APPROPRIATELY TRAINED AND LICENSED PROFESSIONAL SUCH AS A
REGISTERED NURSE, SOCIAL WORKER, PROFESSIONAL COUNSELOR, PSYCHOLOGIST OR
TEACHER, OR WHO HAS A MINIMUM OF A BACHELOR'S DEGREE IN A CHILD DEVELOPMENT OR
SOCIAL SERVICES FIELD AND FIVE YEARS OF CHILD CARE EXPERIENCE AND TRAINING
RELATED TO SERVING CHILDREN IN FOSTER CARE, AND WHOSE PRIMARY MEANS OF SUPPORT
IS FROM REIMBURSEMENT AS A MEDICALLY FRAGILE FOSTER CAREGIVER, MAY PROVIDE
CARE FOR NOT MORE THAN FIVE MEDICALLY FRAGILE FOSTER CHILDREN PLACED IN THE
CAREGIVER'S HOME.
(3) CHILDREN PLACED IN A FOSTER HOME ON THE
EFFECTIVE DATE OF THIS RULE SHALL NOT BE MOVED TO ANOTHER PLACEMENT SOLELY TO
MEET THIS REQUIREMENT.
(P) THE AGENCY SHALL ENSURE THAT
PROFESSIONAL TREATMENT STAFF SHALL HAVE CONSULTATION AT LEAST EVERY TWO WEEKS
AND AT LEAST MONTHLY FACE-TO-FACE CONTACT WITH AT LEAST ONE MEMBER OF A
MEDICALLY FRAGILE FOSTER CAREGIVER COUPLE OR CO-PARENTS SERVING AN INTENSIVE
NEEDS CHILD. AT LEAST ONE OF THE FACE-TO-FACE CONTACTS EVERY TWO MONTHS SHALL
TAKE PLACE IN THE MEDICALLY FRAGILE FOSTER HOME.
(Q) THE AGENCY SHALL ENSURE THAT
PROFESSIONAL TREATMENT STAFF SHALL HAVE FACE-TO-FACE MEETINGS WITH EACH
INTENSIVE NEEDS CHILD PLACED IN A MEDICALLY FRAGILE FOSTER HOME AT LEAST EVERY
TWO WEEKS. AT LEAST ONE OF THE FACE-TO-FACE MEETINGS EACH MONTH SHALL TAKE PLACE
IN THE MEDICALLY FRAGILE FOSTER HOME.
(R) FOR EACH MEDICALLY FRAGILE CHILD
PLACED IN A MEDICALLY FRAGILE FOSTER HOME, THE AGENCY SHALL ASSURE THAT THE
MEDICALLY FRAGILE FOSTER CAREGIVERS KEEP A WRITTEN RECORD OF THE CHILD'S
EMOTIONAL RESPONSE TO TREATMENT AND PROGRESS TOWARDS ACHIEVING THE TREATMENT
GOALS IDENTIFIED IN THE CHILD'S SERVICE PLAN. THE WRITTEN RECORD SHALL INCLUDE
SIGNED DOCUMENTS OF TREATMENT PROVIDED BY ANY HEALTH CARE PROFESSIONAL PROVIDING
SERVICES TO THE CHILD, AS WELL AS RECORDS OF ANY HOSPITALIZATIONS AND HOSPITAL
EMERGENCY ROOM OR URGENT MEDICAL CARE VISITS. ALL DOCUMENTATION SHALL BE
MAINTAINED CURRENT AND KEPT IN THE MANNER PRESCRIBED BY THE AGENCY.
(S) THE AGENCY SHALL ASSURE THAT
MEDICALLY FRAGILE FOSTER CAREGIVERS ARE AWARE OF THE POTENTIAL SIDE EFFECTS OF
ANY PRESCRIBED MEDICATION FOR CHILDREN PLACED IN THEIR HOME.
(T) IF A CHILD WITH SPECIAL OR
EXCEPTIONAL NEEDS IS PLACED IN A MEDICALLY FRAGILE FOSTER HOME, THE PROVISIONS
OF RULE 5101:2-5-36 OF THE ADMINISTRATIVE CODE SHALL APPLY FOR
THAT CHILD.
Effective Date: 1/1/03
Review Date:
Certification: Thomas J. Hayes
Date 10/31/02
Promulgated Under: Revised Code Chapter 119.
Statutory Authority: Revised Code Sections 5103.03, 5103.0316
Rule Amplifies: Revised Code Sections 5103.02, 5103.03
Prior Effective Dates:
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