Section 214-RICR-60-00-1.10 - Clinical ServicesA. Providers of health, dental and behavioral health care are prepared and credentialed in conformance with the licensing and certification requirements of the RI Department of Health, RI Department of Children, Youth, and Families and/or the Department of Elementary and Secondary Education. 1. Final judgments regarding medical care for residents are made by a physician or nurse practitioner and regarding dental care by a dentist.a. Credentialed health care providers, including but not limited to registered nurses, nurse practitioners, physician assistants, registered dental hygienists and certified dental assistants, practice within the parameters defined by the RI Department of Health (RIDOH).b. Standing medical orders are written by physicians or nurse practitioners, are reviewed regularly and are revised as necessary.2. Residents have daily access to medically necessary health, dental and behavioral health services and 24-hour access to emergency health, dental and behavioral health services. a. Pharmaceuticals are managed, prescribed and administered by qualified personnel pursuant to an appropriate examination of the resident.b. For residents requiring a special health program or close medical supervision, an individualized plan is developed.B. In the event of serious illness, injury or death, the resident's parents or legal guardians are notified as soon as possible. In addition, staff notify the Superintendent in compliance with § 1.18 of this Part.C. The content, quality and periodicity of health, behavioral health and dental care conforms to the relevant standards of the Rhode Island Department of Health, the American Psychiatric Association, the American Academy of Pediatrics, the American Dental Association and the U.S. Centers for Disease Control. 1. Interventions are individualized for each resident and calibrated to the seriousness and urgency of the presenting need.2. Each resident is provided an explanation of interventions consistent with his or her cognitive and developmental capacity, language barriers or disabilities.3. To ensure medical confidentiality, interventions are delivered in private.a. Any exception to the medical confidentiality of a resident requires the finding by the Superintendent or designee that the safety or security of the resident or staff requires staff supervision.b. When the safety or security requires the presence of staff during a routine or scheduled physical examination or intervention, supervision is provided by staff of the same sex as the resident. (1) In the case of a transgendered or intersex identified youth, the youth may identify the preferred gender of the supervising staff.D. Staff secure appropriate consent before providing treatment to detained or adjudicated residents provided however that a resident may receive medically necessary emergency medical treatment before such consent is given.1. The consent of the resident's parent or legal guardian is required for residents under the age of 18 with the exception for the treatment of sexually transmitted infections or for the treatment of substance abuse.2. If medically necessary emergency medical treatment is provided before parents/legal guardians sign the Consent for Medical Treatment or Authorization for Medication Forms, parents are notified as soon as possible.3. If consent cannot be secured, treatment is rendered if the resident's condition poses an imminent danger to him/herself or others. In some cases, such as, when treatment is refused on personal or religious beliefs, a court order may be sought.E. Any resident grievance related to health care is deemed a potential emergency and managed in conformance with § 1.16 of this Part: "Resident Grievance Procedure".F. Medical, dental and behavioral health screening begins at intake to the RITS.G. Medically trained personnel monitor and respond to residents' health needs daily.1. In no circumstance is resident access to medical care denied by staff.2. Review of results of medical or dental examinations, tests or the identification of problems is performed by a physician, nurse practitioner, dental hygienist, or dentist.H. The Clinical Director, in collaboration with the Medical Director, annually reviews and approves protocols for the management of serious and infectious diseases. The RITS adheres to the recommendations of the RIDOH and the U.S. Centers for Disease Control.I. Health, behavioral health and dental records are managed in a manner compatible with the confidential relationship between a resident and his/her doctor as well as the security of the facility.J. Health Education is provided to residents. In addition, staff provide individualized information on sound health and hygiene practices related to each resident's needs during the provision of health, behavioral health and dental care.K. Resident participation in medical, cosmetic or pharmaceutical experimentation is prohibited because residents confined in a juvenile correctional facility are incapable of volunteering as a human subject without hope of reward and, therefore, cannot do so on the basis of fully informed consent. A resident may participate in a clinical trial of a medical treatment specific to his/her individual treatment needs if the:1. treatment is medically necessary; and2. fully informed consent has been secured from the resident or parent in conformance with § 1.10(D) of this Part above;3. prior, written permission of the Superintendent has been secured; and4. clinical trial is conducted by appropriately credentialed providers in accredited facilities accredited pursuant to documented Internal Review Board's approval.214 R.I. Code R. 214-RICR-60-00-1.10