1. (1) Each child placed in foster care must be assessed for risk factors related to HIV infection in accordance with section 441.22(b) of this Title as follows:

   1. (i) Each child entering foster care on or after September 1, 1995, must be assessed for risk factors related to HIV infection within five business days of entry into care if it is determined within five business days of entry into care that there is no possibility that the child has capacity to consent to HIV-related testing, or within 30 business days of entry into care if it is determined within five business days of entry into care that there may be a possibility that the child has capacity to consent to HIV-related testing.
   2. (ii) Each child who entered foster care prior to September 1, 1995, must be assessed for risk factors related to HIV infection within 60 business days of the next periodic medical examination required for the child according to the schedule for periodic medical examinations provided in section 441.22(f) of this Title or within 60 business days of the child's next service plan review date, whichever occurs sooner.
   3. (iii) In addition, each service plan review of a child and each periodic medical examination of a child required pursuant to section 441.22(f) of this Title that occurs after the initial assessment of the child for risk factors related to HIV infection must include an assessment of whether HIV-related testing of the child is recommended based on the child's medical history and any available information regarding the child obtained since the initial assessment of the child, the prior service plan review of the child or the prior periodic medical examination of the child, as applicable.

2. (2) If the child is determined through the required assessment to have one or more risk factors for HIV infection or if the child's medical provider recommends the HIV-related testing of the child, designated agency staff must initiate the process to arrange for the HIV-related testing of the child in accordance with section 441.22(b) of this Title including obtaining the necessary written informed consent for such testing.

   (b)

3. (1) Initial medical examination. Within 30 days of admission into foster care, each child must be given an initial comprehensive medical examination. When records are available to document that such an examination has been completed within 90 days prior to admission into care, and the authorized agency has obtained such records and determines that the child's health status does not warrant a second comprehensive examination within 30 days after admission into foster care, the local social services district may waive the initial medical examination required by this paragraph.

4. (2) When an initial medical examination is required, the initial medical examination must be comprehensive in accordance with standards of the American Academy of Pediatrics, taking into account the age, environmental background and development of the child. Such an examination must include the following: Laboratory tests may include complete blood count, urinalysis, tuberculin skin test, X-rays, HIV-related test, where performed in a manner consistent with article 27-F of the Public Health Law, and lead, sickle cell, and venereal disease screening at the direction of a physician when indicated on the basis of the child's age, medical history, environmental background and physical/developmental condition.

   1. (i) a comprehensive health and developmental history;
   2. (ii) a comprehensive unclothed physical examination;
   3. (iii) an assessment of the child's immunization status and the provision of immunizations as necessary;
   4. (iv) an appropriate vision assessment;
   5. (v) an appropriate hearing assessment;
   6. (vi) appropriate laboratory tests;
   7. (vii) a dental screening; and
   8. (viii) an observation for child abuse and maltreatment which, if suspected, must be reported to the State Central Register of Child Abuse and Maltreatment as mandated by section 413 of the Social Services Law.

5. (3) The comprehensive initial examination described in paragraph (1) of this subdivision must be completed within 30 days:

   1. (i) after a child is accepted into foster care, unless records are available to document that such an examination has been completed within 90 days prior to admission into care and the initial medical examination is waived by the authorized agency; or

   2. (ii) after a foster child returns to foster care if more than 90 days have passed and the child:

      1. (a) was discharged from care, either on a trial basis or on a permanent basis; or
      2. (b) was absent from care without leave.

6. (4) The initial medical examination described in paragraph (1) of this subdivision may be completed at the discretion of the authorized agency when:

   1. (i) there are concerns about a foster child's health condition when such child returns to care within 90 days after:

      1. (a) being discharged from care, either on a trial basis or permanent basis; or
      2. (b) being absent from care without leave; or

   2. (ii) a child is transferred to the care of another agency, and the receiving agency determines that a comprehensive medical examination may be necessary to assist in the formulation of the child's service plan.

      (c) Discharge to another planned living arrangement with a permanency resource.

      Prior to the child's discharge from foster care according to a permanency planning goal of discharge to another planned living arrangement with a permanency resource, such child must have a comprehensive medical examination in accordance with sections 441.22 of this Title, and 507.1 of this Part, unless the child has undergone such an examination within one year prior to the date of discharge.

      (d) Adoption.

7. (1) When a child in foster care is freed for adoption or has a permanency planning goal of adoption, a comprehensive medical examination in accordance with sections 441.22 of this Title and 507.1 of this Part must be completed prior to adoptive placement unless the child has undergone such an examination within six months prior to the adoptive placement.
8. (2) Consideration must be given to the desirability of psychiatric or psychological evaluation or consultation for a child in foster care prior to adoptive placement, and when deemed advisable, such evaluation or consultation shall be carried out and included in the comprehensive health history of the child.

(a) Assessment of each child in foster care for risk factors related to HIV infection.