Section 449.75 - Regulations(a) Standards.--Pursuant to the intention of the General Assembly to provide safe and sanitary facilities and healthful programs, the department may adopt and publish rules and regulations to implement the provisions of this act, which shall include reasonable and fair standards. Any conflict between these standards and those that may be set forth in local, county or city ordinances shall be resolved in favor of those having Statewide effect. Such standards shall, at a minimum, include:(1) Adoption and implementation of policies and procedures which assure the health and safety of children.(2) The maintenance of pediatric extended care centers based upon the size of the structure and number of children, relating to plumbing, heating, lighting, ventilation and other building conditions, including adequate space, which will ensure the health, safety, comfort and protection from fire of the children served.(3) The appropriate provisions of the "Life Safety Code" (NFPA-101), the National Fire Protection Association requirements and State building code requirements. This paragraph applies to renovation and remodeling of a PECC.(4) The number and qualifications of all personnel who have responsibility for the care of the children served.(5) All sanitary conditions within the pediatric extended care center and its surroundings, including water supply, sewage disposal, food handling and general hygiene, and maintenance thereof, which will ensure the health and comfort of children served.(6) Supportive, contracted, other operational and transportation services. Staff providing transportation services shall not be counted in direct caregiving staff ratio under this paragraph.(7) Maintenance of appropriate medical records, data and information relative to the children and programs. Such records shall be maintained in the facility for inspection by the department.(b) Requirements.--(1) For emergency transportation, arrangements shall be made with the county emergency transportation services. The PECC shall assure that any child being placed in an ambulance for transport for emergency services is accompanied by a direct caregiver of the PECC who is familiar with the child's treatment plan. The direct caregiver shall stay with the child until the parent or legal guardian arrives to relieve the direct caregiver of the PECC.(2) The department shall require that the PECC has employed an administrator whose qualifications are that of a physician who has a current, active, unrestricted license in this Commonwealth, a certified registered nurse practitioner licensed to practice in this Commonwealth, a licensed nursing home administrator, personal care home administrator, a child day-care administrator or a registered nurse with five years of documented experience in pediatric medicine. The administrator shall be responsible for the operation of the PECC.(3) The PECC shall employ or contract with a medical director. The medical director's qualifications are that of a physician who has a current, active, unrestricted license in this Commonwealth with pediatric specialty board certification or other postgraduate preparation acceptable to the department or a certified registered nurse practitioner licensed to practice in this Commonwealth with five years of documented experience in pediatric medicine. The medical director shall be responsible for the basic and supportive services, including medical, pharmaceutical and nursing services provided by the PECC.(4) A minimum of one supervisor shall be employed for every six children. The supervisor may have direct caregiving responsibilities and may be counted in the one direct caregiving staff to every three children ratio. The supervisor shall comply with all health care professional licensing statutes and regulations promulgated by the appropriate licensing boards. A supervisor shall hold a valid professional license issued by the State Board of Medicine, State Board of Nursing, State Board of Occupational Therapy Education and Licensure, State Board of Osteopathic Medicine, State Board of Pharmacy, State Board of Physical Therapy, State Board of Podiatry or State Board of Examiners in Speech-Language and Hearing.(5) A minimum of one direct caregiving staff shall be available for every three children at all times, including the transportation of the child for services not provided in the PECC but provided to the child while under the care of the PECC. Direct caregiving staff must be a licensed practical nurse, a registered nurse, a physical therapist, an occupational therapist, a speech-language pathologist or an individual who has a high school diploma or its equivalent and at least one year of documented and supervised experience in a health care or child-care setting. Additional staff may provide other support services. Basic and supportive services provided at a PECC shall comply with all health care professional licensing statutes and any regulations promulgated by the appropriate licensing boards.(6) Each child shall have an individualized care plan which is designed by the attending physician, the PECC treatment team, a parent or legal guardian and, when appropriate, the child. The care plan shall be reviewed at least monthly and revised as the child's care needs change. Staffing shall be adequate to provide for the needs of each child as identified on the child's care plan. For any child enrolled in the early intervention program or the local school district's program under the Individuals with Disabilities Education Act (Public Law 91-230, 20 U.S.C.§ 1400 et seq.), the PECC shall do all of the following:
(i) In the development of the care plan, consider the components of the individualized family services plan for children under four years of age or the individualized education plan for children under 21 years of age. The PECC shall not duplicate services already provided through the early intervention program or the local school district.(ii) Make available upon request by the early intervention program or the local school district any records necessary to develop, review or revise an individualized family services plan or individualized education plan under Federal law.(7) The PECC shall have a documented orientation program which assures that employees and contract staff are adequately trained to provide services to children.(8) The PECC shall have a documented staff development program that assures that employees and contract staff are adequately trained to provide services to children.(9) The PECC shall have a documented preventative maintenance program with specific emphasis on assuring that all durable medical equipment is functioning correctly and safely so as to assure the health and safety of the children.(10) The PECC shall have appropriate emergency services readily available. These services may include an emergency drug kit, a crash cart with a defibrillator appropriate for children and any other emergency services as appropriate based on the needs of the children served in the PECC.(11) The PECC shall have arrangements with a licensed pharmacist to provide consultation services for children enrolled in the PECC.(12) The director of the PECC shall assure that the governing body has developed, approved and implemented policies and procedures regarding the operation of the PECC. At a minimum, the PECC shall have policies and procedures on the prevention, reporting and investigation of abuse, delivery of medical and therapeutic services, control and delivery of pharmaceutical service and prevention of incidents and accidents.(13) The PECC shall have a written disaster plan which, at a minimum, addresses natural disasters, financial disasters, weather emergencies and bomb threats. A fire drill shall be conducted at least once every two months. A disaster drill shall be practiced every month, and a full evacuation shall occur at least once every six months.(14) The PECC shall report any unusual incidents immediately to the department. Unusual incidents include a death, abuse or suspected abuse, rape, transfer to a hospital as a result of injury or accident, child abduction or child released to wrong family, fire on the premises, a need to implement a disaster plan or receipt of a strike notice, medical errors resulting in injury or harm to the child or any knowledge of an unlicensed practice of a regulated profession.(15) The PECC shall maintain a log of all incidents and accidents. At a minimum, the log shall include the date the incident occurred, a description of the incident, the name of the child involved in the incident and the name of the employee involved in the incident. A system shall be developed, documented and implemented to demonstrate evidence that the incident or accident has been thoroughly investigated and that any corrective action to avoid the incident or accident in the future has been implemented.(16) A PECC may not serve a child for more than 12 hours within a 24-hour period.(17) A PECC may only provide services to medically or technologically dependent children.(18) If, upon application to a PECC, the PECC has no evidence of an application to the early intervention program or the local school district, the PECC shall make a referral for the family to the early intervention program or the local school district, appropriate for the child's residence.(19) The operator and all employees and contract staff of the PECC shall comply with 23 Pa.C.S.§ 6344 (relating to information relating to prospective child-care personnel).(20) The PECC shall annually disclose to the department and to the public the names of persons owning 5% or more of the PECC as well as the PECC's officers and board members.(21) All of the standards set forth in this section shall apply at all times that the PECC is open and operating.Amended by P.L. 993 2012 No. 111, § 2, eff. 7/5/2012.1999, Nov. 24, P.L. 884, No. 54, §15, imd. effective. Affected 2007, July 25, P.L. 402, No. 56, § 8(10), effective in 90 days [Oct. 23, 2007].