a) Medical and Health Services

1. 1) Protocol for youth to report illnesses and injuries.
2. 2) Treatment of ailments.
3. 3) Prescription and administration of medications and special diets.
4. 4) Arrangements for hospitalization.
5. 5) Liaison with community medical facilities and resources, including providers for emergency medical care.
6. 6) Environmental health inspections and procedures.
7. 7) Supervision of special treatment programs, as for drug addicts, alcoholics, etc.
8. 8) Maintenance of accurate medical records for each youth.
9. 9) Maintenance of detailed records log of medical supplies, particularly of narcotics, barbiturates, amphetamines, and other dangerous drugs.
10. 10) Vaccinations.

All facilities shall employ a competent medical doctor, physician assistant, nurse practitioner, or registered nurse to ensure that the following are available:

b) Physician and Dental Services

1. 1) General medical physician services shall be provided in accordance with one or more of the following procedures:

   1. A) On salary, in accordance with locally established personnel pay plan;
   2. B) A contract with a local physician or clinic for full-time coverage at specific hours and for emergencies;
   3. C) A contract with a local physician to conduct sick call, to be on call for emergencies and to examine newly admitted youth;
   4. D) Arrangements with a nearby hospital to provide all needed medical services; and
   5. E) Services rendered, without cost, by another agency or department or with costs prorated.
2. 2) Access to psychiatric and/or psychological services shall be provided in individual cases as needed.

A medical doctor shall be available to attend the medical needs of youth. Arrangements shall be made for a dentist to provide emergency dental care.

c) Medical Examination Room

A medical examining room shall be located close to or be part of the admissions area.

d) Medical Examination

1. 1) Newly admitted youth suspected of having any type of communicable disease shall be isolated and an immediate referral shall be made to the facility physician for possible transfer to a medical facility, unless the admitting facility can safely and effectively segregate and maintain a medically prescribed course of treatment.
2. 2) All youth confined for more than seven days shall be given a medical screening by a medical doctor, registered nurse or physician assistant.

All youth admitted to detention shall undergo a physical examination as prescribed in Section 2602.50(h).

e) Sick Call

1. 1) The names of youth reporting to sick call shall be recorded in the medical log.
2. 2) Youth with emergency complaints shall receive attention as quickly as possible, regardless of the sick call schedule.
3. 3) Nonmedical detention staff may issue any form of over-the-counter medication, providing the facility physician gives prior written approval to the facility for the issue.

A schedule and procedure shall be established for daily sick call.

f) Record or Log

A record shall be maintained as part of the youth's personal file of all treatment (including special diet) and medication prescribed, including the date and hour the treatment and medication is administered. A record shall be maintained of over-the-counter medication (i.e., aspirin, cough medicine, etc.) issued by detention staff. A youth's treatment and medication program shall be a part of the summary to the probation officer.

g) Medical Security

1. 1) When a physician or other medical personnel attends patients at the facility, a staff member shall be present to assure an orderly process.
2. 2) Drugs, including over-the-counter medication and other abusable medical supplies, shall be secured and accessible only to designated staff.
3. 3) Youth shall receive one dose of medication at a time and shall be required to ingest medication in the presence of a medical staff member or detention staff member.

Security of supplies must be maintained at all times.

h) First Aid Training

One person on duty, per shift, shall have basic first aid and cardiopulmonary resuscitation (CPR) training.

i) First Aid Supplies

Those facilities not having a dispensary shall maintain a stock of first aid supplies for the treatment of cuts, bruises, sprains and other minor injuries. First aid supplies must be secured and not accessible to youth.

j) Parental Notification

Recommendations of the facility physician shall be reported to parents or guardians, in writing, through the probation officer. Parents or guardians, the probation officer, and the court shall be immediately notified of a youth's serious illness or accident.

k) Recommendations

1. 1) Medication to be ingested should, whenever possible, be in liquid form.
2. 2) Conditions requiring immediate attention by a physician include, but are not limited to: head injuries, coma, broken bones, open wounds, history of diabetes, epilepsy, tuberculosis, venereal disease, fever or bleeding.

3. 3) The Department of Public Health may be requested to assist detention facilities by:

   1. A) Providing immunizations;
   2. B) Investigating epidemics, contagious diseases, food poisoning and providing environmental inspections; and
   3. C) Providing health education literature, lectures and staff in-service training consultation.

4. 4) The Department of Human Services may be requested to assist detention facilities. Since youth may be emotionally disturbed, pre-psychotic, or psychotic but in a temporary state of remission, the Department of Human Services may provide:

   1. A) Mental health staff members for detention facilities;
   2. B) Hospitalization of psychotic youth;
   3. C) In-patient and out-patient treatment of discharged youth;
   4. D) Mental health education; and
   5. E) Diagnostic examinations for reports and commitments.
5. 5) Existing facilities should provide a private area for a medical examining room.
6. 6) Detention personnel should receive instruction for emergency care of epileptics during seizures. Specialized care for epileptics will be determined by the detention physician.
7. 7) Diabetics and epileptics should be closely supervised as they may fail to follow their diet, react to an overdose of medication or, conversely, ignore necessary medication. Diabetics and epileptics should be regularly seen by the facility physician.