1. (1) Medical issues that require immediate attention shall be determined by the DHA or physician designee.
2. (2) Any complaint of severe pain, including dental pain, shall be treated as an emergency with immediate referral to the onsite nursing staff, APRN, PA or Physician.
3. (3) Non-licensed staff shall immediately report any youth who appears incapacitated to their supervisor and the onsite health care staff.
4. (4) If a program utilizes a Licensed Practical Nurse (LPN) without the presence of a Registered Nurse onsite, then the LPN shall review all episodic or emergency cases daily, which is defined as seven days a week, including Holidays, (either electronically, telephonically or in person) with either the Registered Nurse or a higher licensure level health care staff.
5. (5) When licensed health care professional staff is not onsite, a designated non-licensed staff person shall contact the on-call licensed health care professional and/or access off-site services promptly.
6. (6) All staff members shall have access to contact Emergency Medical Services (EMS) by calling “911” immediately under any circumstances that require immediate medical attention or evaluation.
7. (7) Episodic care provided by a non-licensed staff person, or that requires off site care, must have a follow-up evaluation/assessment by a licensed health care professional the next time this person is on-site.
8. (8) The Designated Health Authority or physician designee shall be notified when a youth requires emergency transfer off-site for evaluation, treatment and/or hospitalization. The DHA/Designee shall perform a physician evaluation and review of records at the first available opportunity.
9. (9) Non-licensed staff members who provide first aid and/or emergency care are authorized to provide care only within their training and maintain required certifications as per Chapter 63H-3, F.A.C.
10. (10) First aid supplies shall be kept and maintained onsite as determined by the Designated Health Authority. First aid kits for vehicles shall be stored in a cool environment to protect contents from heat exposure and checked out prior to use of the vehicle to transport youth.
11. (11) All licensed health care professionals shall maintain, at a minimum, current certification in Basic Cardiopulmonary Resuscitation (with AED training, as applicable).
12. (12) Training records and proof of staff certifications shall be maintained per Chapter 63H-3, F.A.C.
13. (13) Emergency drills, both announced or unannounced, shall be conducted for each shift, on a quarterly basis at a minimum, and simulate an episodic care event that calls for immediate need of First Aid or administration of CPR techniques and the initiation of the emergency procedures to follow when a life-threatening emergency does occur. Documentation of these drills shall also be maintained per facility. CPR and AED techniques shall be demonstrated at least annually. All staff from all shifts with direct contact on a day-to-day basis must participate in at least one emergency drill annually which demonstrates CPR/AED.
14. (14) A list of emergency telephone numbers and cell-phone numbers must be posted or located accessible to all staff, on all shifts and be inaccessible to youth.
15. (15) Episodic care subsequent to a Protective Action Response (PAR) shall be conducted pursuant to 63H-3, F.A.C.
16. (16) All episodic care provided by licesnes healthcare staff shall be documented in SOAP format in the chronological progress notes in the Individual Health Care Record. Episodic care provided by non-licensed staff may be recorded on the Report of Onsite Health Care by Non-Health Care Staff Form (HS 049).
17. (17) All episodic care provided shall be documented on the Episodic (First Aid/Emergency) Care Log (HS 009, February 2024) The Episodic (First Aid/Emergency) Care Log is incorporated into this rule and is available electronically at HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-17509"http://www.flrules.org/Gateway/reference.asp?No=Ref-17509. The facility may utilize a form of their choice if the form includes all information required on the Episodic (First Aid/Emergency) Care Log that is incorporated by reference into Chapter 63M-2, F.A.C.
18. (18) Routine or emergency care conducted off-site shall be documented on the Summary of Off-Site Care form (HS 033, October 2006), and filed in the Individual Health Care Record, in reverse chronological order along with any records from the off-site provider and uploaded to the department’s EMR/EHR where applicable.
19. (19) The staff member who notifies the Designated Health Authority of the episodic event shall document the notification in the chronological progress notes.

20. (20) PAR/RI Medical Review documentation is as follows:

    1. (a) The Post-PAR/RI Medical Review shall be documented on a progress note in the youth’s Individual Health Care Record.
    2. (b) If an off-site medical review is conducted, the relevant sections of the youth’s Individual Health Care Record and Medication Administration Record shall accompany the youth to the review as well as a Summary of Off-Site Care form indicating the type of examination needed. After the off-site medical review, the documents will then be placed in reverse chronological order in the designated section of the youth’s Individual Health Care Record.
    3. (c) The facility Superintendent or Program Director shall have access to the medical Post-PAR/RI documentation for review.

Rulemaking Authority 985.64(2) FS. Law Implemented 985.64(2), 985.145, 985.18 FS. History–New 3-16-14, Amended 2-5-25.