Section 51242.1 - EPSDT Supplemental Services Provider -Pediatric Day Health Care Facility(a) A pediatric day health care facility, as defined in Section 51184(k)(2), seeking to provide pediatric day health care EPSDT services shall be considered to be an EPSDT supplemental services provider and shall comply with the provisions specified in this section and in Section 51242, except the provisions of subsections (a), (c) and (e). In addition, the pediatric day health care facility shall maintain documentation available for Department review substantiating compliance with all of the provisions of this section.(b) The pediatric day health care facility shall provide the required EPSDT services specified in Section 1760.6 of the Health and Safety Code, with the exception of Section 1760.6(b)(5).(c) The pediatric day health care facility shall comply with the personnel requirements specified in Section 1267.13 of the Health and Safety Code. Such personnel, as required to provide the services pursuant to paragraph (b) of this section, shall be: (1) Licensed, certified or credentialed health professionals acting within their scope of practice who meet the experience requirements specified in this section; and(2) Present in the facility in sufficient numbers, as determined under the patient classification system defined in Title 22, California Code of Regulations, Section 70053.2, during all hours of facility operation to provide services as prescribed by the attending physician and documented in the individual plan of treatment and to address projected admissions, terminations and emergencies.(d) In complying with the provisions of paragraph (c) of this section, the following requirements shall apply: (1) Registered nurse personnel shall upon hire provide to the employer evidence of all of the following: (A) Current California licensure as a registered nurse, and a minimum of two years of experience within the last five years which includes the provision of nursing services to children with the types of medical conditions for which the facility provides care. For those registered nurses serving in a supervisory capacity, such experience shall include nursing supervision; and(B) Within one year of his or her date of hire, proof of completion of at least thirty (30) continuing education units specific to the physical and psychosocial assessment of, and provision of nursing services to, children with the types of medical conditions for which the facility provides care.(2) Licensed nurse personnel, other than registered nurses, shall provide to the employer evidence, upon hire, of a minimum of six months' experience within the past two years providing care to children with the types of medical conditions for which the facility provides care; or an acquired competency, to be documented in the licensed nurse's personnel records, including:(A) Proof of completion, within one year of his/her date of hire, of at least 15 continuing education units specific to the provision of care to children with the types of medical conditions for which the facility provides care, and(B) Proof of completion, within two months of employment, of at least 40 hours of direct employee specific preceptorship, provided by a registered nurse meeting the qualifications specified in subsection (1). For purposes of this section "preceptorship" means the pairing of the newly hired nurse with a registered nurse who has met the experience and education qualifications specified in subsection (1), for the purpose of promoting the clinical competency of the newly hired nurse in providing nursing services to the types of patients for whom the facility provides care. Such a preceptorship may be provided during the licensed nurses' normal working tour of duty.(3) If the facility provides care to a child who is dependent on mechanical ventilation, the facility shall employ a licensed respiratory care practitioner, or a licensed nurse with documented education, preparation and expertise specific to the assessment and treatment of the ventilator dependent child. Such personnel shall be present in the facility during all hours in which the ventilator dependent child is present in the facility.(4) If the facility utilizes nonlicensed nursing personnel pursuant to Section 1337 of the Health and Safety Code, such personnel shall, upon hire, provide evidence of a minimum of six months' experience within the past year providing care to children with the types of medical conditions for which the facility provides care.(5) All medical personnel shall: (A) Have upon hire, and subsequently maintain, pediatric cardiopulmonary resuscitation certification, or(B) Prior to the completion of the orientation period described in Title 22, California Code of Regulations, Section 72517(d), obtain, and subsequently maintain, pediatric cardiopulmonary resuscitation certification.(e) The facility shall collaborate with and involve the child's parent, foster parent or legal guardian in the decision making process for all care planning and provision of interventions and treatment at the facility and in the child's home. Such collaboration shall be provided by the director or personnel delegated by the director, and shall involve, at a minimum:(1) A conference with the child's parent, foster parent or legal guardian to be held quarterly, or more frequently as indicated by the needs of the child or parent, foster parent or legal guardian, to provide, at a minimum: (A) A written status report on the plan of treatment of the child at the facility.(B) Information on the interventions and treatments specified in the child's plan of treatment.(2) A written report of the day's events provided to the parent, foster parent or legal guardian at the conclusion of each day of attendance specifying information including but not limited to: (A) Treatments provided and when they were provided.(B) Medications administered, including amount, time and route of dosage.(C) Nutritional intake, including amount, time and route of intake.(D) Developmental activities.(E) Contact with the attending physician.(f) The facility shall work in conjunction with the Regional Center, as defined in Title 17, Section 54302(a)(49), or the Local Education Agency Provider, as defined in Title 22, Section 51190.2, in the development and implementation of an age appropriate Individualized Family Service Plan (IFSP), Individualized Education Plan (IEP) and/or Individualized Health and Support Plan (IHSP) as specified in Government Code Section 95020, for each child. The facility shall incorporate those identified activities in the IFSP, IEP, and/or IHSP as appropriate, into the individual plan of treatment. To facilitate continuity of services, the facility shall obtain instruction for its personnel from the Regional Center or Local Education Agency Provider in performing activities identified in the IFSP, IEP, and/or IHSP.(g) During any work shift, personnel employed by the facility shall not be simultaneously assigned duties at a licensed health care facility, including but not limited to, a skilled nursing facility or a congregate living health facility as defined in Division 2, Chapter 2, commencing with Section 1250 of the Health and Safety Code.(h) The facility shall accept and retain only those beneficiaries for whom it can provide adequate, safe, therapeutic and effective care as determined by the attending physician and documented in the child's individualized plan of treatment.(i) Pharmaceutical services, as required by paragraph (b) of this section, shall be: (1) Supplied to the licensed nursing personnel of the facility by the child's parent, foster parent or legal guardian in the original dispensing container which specifies administration instructions, except when a verbal order is obtained from the attending physician and the medication is delivered to the facility by a pharmacy. In such a case, the facility shall provide the container with the new medication to the child's parent, foster parent or legal guardian the same day the medication was delivered to the facility. Administered only upon written and signed orders of the child's attending physician.(2) All physician orders shall be current and maintained in the child's medical record at the facility. Verbal orders from the attending physician for services to be rendered at the facility may be received and recorded by licensed nursing personnel in the child's medical record at the facility and shall be signed by the attending physician within thirty (30) working days.(3) Administered by facility personnel acting within the scope of their practice.(j) Nutrition services, as required by paragraph (b) of this section, shall include a minimum of one meal per day, between meal nourishment, and consultation services by the facility's dietitian. Therapeutic diets, as defined in Title 22, Section 72115, and between meal nourishment shall be provided and served as prescribed by the attending physician. The child's parent, foster parent or legal guardian shall supply the facility with baby food, baby formula, enteral formula, and any other food or snack items not included in the facility's fixed meal menu. The administration of all food shall be supervised by licensed or certified personnel functioning within their scope of practice and documented in the plan of treatment.(k) Each pediatric day health care facility shall provide readily available emergency health services as follows:(1) The facility shall obtain a written agreement from the child's parent, foster parent or legal guardian granting the facility permission to transfer the child to a hospital or other health facility in case of an emergency.(2) The facility shall maintain written agreements for the provision of emergency medical care which shall include: (A) An on-call physician.(B) Hospital or emergency room care.(C) Medical transportation.(3) First aid services shall be available at the facility. All personnel shall receive in-service training in first aid. Training in cardiopulmonary resuscitation shall be in accordance with Sections 51242.1(d)(5)(A) and (B).Cal. Code Regs. Tit. 22, § 51242.1
1. New section filed 11-10-99 as an emergency; operative 11-10-99 (Register 99, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-9-2000 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 11-10-99 order, including amendment of subsections (d)(1)(A) and (d)(2), new subsections (d)(2)(A)-(B) and amendment of subsections (i)(2) and (j), transmitted to OAL 3-8-2000 and filed 4-19-2000 (Register 2000, No. 16). Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Section 14132.10, Welfare and Institutions Code.
1. New section filed 11-10-99 as an emergency; operative 11-10-99 (Register 99, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-9-2000 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 11-10-99 order, including amendment of subsections (d)(1)(A) and (d)(2), new subsections (d)(2)(A)-(B) and amendment of subsections (i)(2) and (j), transmitted to OAL 3-8-2000 and filed 4-19-2000 (Register 2000, No. 16).