N.H. Admin. Code § He-P 816.16

Current through Register No. 45, November 7, 2024

Section He-P 816.16 - Student Services

(a) Prior to providing services at the EHC, the EHC shall:

(1) Provide, in writing, to the student, or guardian if applicable, the EHC's policies on student rights and responsibilities and its complaint procedure and rules;

(2) Obtain written confirmation acknowledging receipt and understanding of the policies in (a) (1) above;

(3) Collect and record, in the student's record, the following information:

a. Student's name, home address, home telephone number, and date of birth;

b. Name, address, and telephone number of an emergency contact; and

c. Student's insurance information, if applicable for billing purposes; and

(4) For students in grades K-12, confirm, by reviewing received documentation, that the student has had a physical examination prior to or within 90 days following the start of classes that includes:

a. Diagnosis, if applicable;

b. Medical history;

c. Medical findings, including the presence or absence of communicable diseases;

d. Identification of all current medications;

e. Allergies;

f. Dietary needs, if applicable; and

g. A completed immunization record, as required by He-P 301.

(b) The EHC shall develop a policy, in coordination with the educational institution of which it is a part, with regard to TB testing of students from areas designated as a high risk area by the United States Centers for Disease Control and Infection (CDC), including, at a minimum, the following:

(1) The EHC shall require that any student from an area designated as a high risk area by the CDC shall have a TB test, Mantoux method, or other method approved by the CDC, prior to the start of classes; and

(2) The frequency and timeframe of required TB testing of students who travel to and return from a high risk area.

(c) Any student with a positive TB test shall be tracked as directed by the department's bureau of disease control.

(d) If the EHC is an integrated service provider such as providing education, counseling, or dietary services in addition to nursing, and an RN is not available by telephone, radio, or pager to respond within 15 minutes, the EHC may continue to provide the integrated services if it has a written plan in place to refer students for emergency care and the integrated service providers have documented annual training to exercise the plan.

(e) Notwithstanding (d) above, an EHC may offer counseling and education services during off-hours or when it is closed due to the unavailability of an RN.

(f) When an RN has assessed a student and determined that the student needs periodic medical care, nursing observation, or monitoring, the RN shall:

(1) Document the findings of a nursing assessment, including, but not limited to, the following, as applicable:

a. Obtaining a history regarding what brought the student to the EHC;

b. An assessment of the student's pain level;

c. The student's vital signs;

d. The student's physical, cognitive, and behavioral status; and

e. How the student is adapting psychologically to their social environment; and

(2) Determine if the student should remain in his or her dormitory room, be monitored at the EHC, or be admitted to the EHC if the EHC has licensed beds.

(g) When an RN has assessed a student and determined that the student requires continuous nursing observation, monitoring, and/or medical care, the RN shall:

(1) Admit the student to the EHC if the EHC has licensed beds, and maintain awake nursing personnel for as long as the student requires continuous nursing observation, monitoring, and/or medical care; or

(2) Transfer the student to a facility licensed to provide the necessary student services.

(h) For any student that is admitted to a bed in the EHC, the RN shall complete the following written documents:

(1) A nursing assessment, as specified in (f) (1) above;

(2) Daily progress notes, if applicable; and

(3) A discharge summary and discharge instructions, if applicable.

(i) In the event of a medical emergency concerning a student, the nurse in charge shall promptly notify the administrator, or his or her designee, and the medical director of the event and document all information involving the emergency and notifications in the student record.

(j) Physical or chemical restraints shall be prohibited except as allowed by RSA 151:21, IX.

(k) Immediately after the use of physical or chemical restraints, the EHC shall make the following notifications:

(1) To the student's guardian, if any, as soon as is practicable and in no case longer than 24 hours; and

(2) To the department's health facilities licensing unit within 48 hours by fax, at (603) 271-5574, or by electronic means.

(l) The EHC shall:

(1) Have policies and procedures on:

a. What type of physical or chemical restraint can be used;

b. When physical or chemical restraint can be used; and

c. What professional personnel may authorize the use of restraints; and

(2) Provide personnel authorized by (1) c. above with education and training on the limitations and the correct use of restraints.

(m) The use of mechanical restraints shall be prohibited.

(n) For each student accepted for care and services at the EHC, a current and accurate record shall be maintained and include, at a minimum:

(1) All orders from a licensed practitioner, including the date and signature of the licensed practitioner;

(2) Results of any laboratory tests, X-rays or consultations performed at the EHC;

(3) All admission notes;

(4) All assessments;

(5) All care and services provided at the EHC including the:

a. Date and time of the care or service;

b. Description of the care or service;

c. Daily progress notes, if applicable;

d. Student's response to the care and services provided; and

e. Signature and title of the person providing the care or service;

(6) All medication records required by He-P 816.17(ah) ;

(7) Documentation of nurse delegation, if applicable;

(8) If services are provided at the EHC by individuals not employed by the licensee, documentation that includes the name of the agency providing the services, the date services were provided, the name of the person providing services, and a brief summary of the services provided;

(9) Documentation of reportable incidents involving the student, including the information required by He-P 816.14(r) ; and

(10) Documentation of the refusal of a student to follow the prescribed orders of the licensed practitioner, including the date and time the licensed practitioner was notified of the refusal.

(o) Student records shall be safeguarded against loss, damage, or unauthorized use by being stored in locked containers, cabinets, rooms, or closets, except when being used by the EHC's personnel.

(p) Student records and information shall be kept confidential and only provided in accordance with law.

(q) The licensee shall develop and implement written policy and procedures that specify the method by which release of information from a student's record shall occur.

(r) Records shall be retained for a minimum of 4 years.

(s) The licensee shall arrange for storage of, and access to, student records as required by (r) above in the event the EHC ceases operation.

(t) If anyone other than a licensed provider, RN, or LPN trained in phlebotomy collects human specimens from students for laboratory testing, the EHC shall also be licensed as a collection station in accordance with He-P 817.

(u) If the EHC tests human specimens it shall be licensed as a laboratory in accordance with He-P 808, and, if in possession of a laboratory license under He-P 808, it shall not be required to have the collection station license referenced in (t) above.

(v) Not withstanding (u) above, the EHC may perform the following Clinical Laboratory Improvement Amendments (CLIA) waived tests, as per 42 CFR Part 493.15, without having a NH state laboratory or collecting station license, required by He-P 808 and He-P 817, respectively:

(1) Rapid strep testing;

(2) Urine dip-stick testing;

(3) Finger stick glucose testing;

(4) Rapid flu testing;

(5) Rapid HIV testing; and

(6) Urine pregnancy testing.

(w) The performance of CLIA moderate or high complexity testing including microscopic testing such as potassium hydroxide or wet prep analysis requires that the EHC also be licensed as a laboratory under He-P 808.

(x) The EHC shall hold the appropriate CLIA certificate to perform any laboratory tests.

N.H. Admin. Code § He-P 816.16

#9193, eff 6-26-08; ss by #9565, eff 10-16-09

Amended by Volume XXXVII Number 23, Filed June 8, 2017, Proposed by #12197, Effective 6/2/2017, Expires 6/2/2027.