New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-C - Commissioner, Department of Health and Human Services
Chapter He-C 4000 - CHILD CARE LICENSING RULES
Part He-C 4001 - NH RESIDENTIAL CHILD CARE LICENSING RULES
Section He-C 4001.12 - Communicable Disease Issues and Health Requirements for Residents and Other Children

Universal Citation: NH Admin Rules He-C 4001.12

Current through Register No. 40, October 3, 2024

(a) Parental authorization for medical treatment shall be on the premises for each resident upon his or her first day of residence in the program, except for residents in short term placement, and available in accordance with He-C 4001.10(n).

(b) Physical examinations shall be completed for children admitted to the program as residents and children who reside on the premises of the program.

(c) A child health form or an equivalent record of physical examination documenting that a physical examination was completed within the past 12 months shall be on file for each child, as specified in (b) above, within 30 days of the date any child begins residing on the premises of the program.

(d) When a child has not had a physical examination as required in (c) above, the program shall schedule an appointment for a future physical exam within 10 business days of the date the child begins residing at the program.

(e) The child health form or equivalent record of physical examination required under (c) above shall include at least the following:

(1) The name and date of birth of the child or resident;

(2) The date of the exam;

(3) Diagnoses, if any, and a description of any health condition that might affect the child or resident's participation in the program;

(4) Documentation of immunizations, including dates immunized;

(5) A history of illness and hospitalizations;

(6) Reports of any screening or assessment;

(7) Notations about the child or resident's physical, mental, and social development;

(8) A list of current medications, both prescribed and over the counter;

(9) Any known allergies;

(10) Dietary needs, including special diets; and

(11) The signature of a licensed health care practitioner and the date signed.

(f) Physical examinations as required under (b) above shall be completed:

(1) At least every 12 months for each child younger than 6 years of age, with a 60-day grace period to allow the program to obtain the updated physical examination record; and

(2) At least every 24 months for each child 6 years of age or older, with a 60-day grace period to allow the program to obtain the updated physical examination record.

(g) Each resident shall have a dental examination based upon a schedule, which shall:

(1) Take into account the needs of the resident as determined by a licensed dentist; and

(2) Provide for each resident to have a dental examination at intervals of 6 to 12 months.

(h) If the program is unsuccessful in obtaining dental examinations in accordance with (g)(2) above, it shall document good faith efforts to schedule an exam.

(i) A written record documenting the date of the dental exam and treatment needed or provided, shall be maintained on the premises of the program in each resident's permanent record.

(j) Other medical exams and evaluations shall be completed for each resident as necessary to meet his or her medical needs.

(k) When a resident is believed to have a reportable communicable disease which was not diagnosed by a physician or other health care provider, the program director or designee shall report the known or suspected communicable disease to the department's bureau of communicable disease control in accordance with RSA 141-C:7 and He-P 301.

(l) The only exception to (k) above shall be for HIV infection, specifically, the identity of any individual with HIV infection shall be held confidential in accordance with RSA 141-F:8.

(m) SCPs shall provide services in a residential setting, including access to nursing or medical care, for all children placed in the program diagnosed as having functional limitations and are dependent upon or require medical technology to maintain or improve independence and health.

(n) SCPs shall provide for the complex health needs of residents whom are medical technology dependent:

(1) In a manner that affords the least intrusive intervention available to ensure his or her safety, the safety of others, and that promotes healthy growth and development;

(2) By providing services and an environment that meets each resident's needs; and

(3) By training direct care staff in the use and care of the specific medical technology device or devices that residents in their care are dependent upon.

(o) Training shall include:

(1) How to recognize symptoms that may indicate a decline in the resident's health;

(2) Seizures and seizure disorders;

(3) G/J tube use and care;

(4) Tracheostomy care;

(5) C-pap and Bi-pap care; and

(6) Any intervention or procedure that will heighten direct care staff's attention to the health and well-being of residents, such as topics on medical changes that require immediate notification for nursing assessment.

(p) All training and education required in (n) and (o) above shall be performed by the appropriate medical professional with the requisite education and licensure to perform such training or utilize outside resources if an appropriate medical professional is not available.

(q) At the time of admission of a resident with special health care needs or who is medical technology dependent, the licensee shall obtain written and signed orders from a licensed practitioner for medications, treatment, and special diet as applicable.

(r) No resident shall be admitted until the appropriate training in (n) and (o) above has been completed.

#2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-06

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14

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