OKDHS.org - OAC 340:75-6-88. Medical services to children in custody

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340:75-6-88. Medical services to children in custody

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Revised 6-1-07

(a) Medical services for child in custody in out-of-home care. The Child Welfare (CW) worker is responsible for ensuring, in coordination with the parent(s), when applicable, and placement provider, that a child in out‑of‑home care timely receives all needed routine and specialized medical care, including medical, dental, visual, and counseling needs. • 1

(1) The worker's and placement provider's responsibilities for the child's services include:
- (A) Early Periodic, Screening, Diagnosis and Treatment (EPSDT) screening according to the schedule of frequency or at a minimum an annual physical exam. In addition, the Oklahoma Department of Human Services (OKDHS) provides as soon as practicable after the filing of the petition an initial health screening for each child placed in OKDHS emergency custody, to identify any health problems that require immediate treatment, diagnose infections and communicable diseases, and evaluate injuries or other signs of abuse or neglect. The law requires OKDHS to provide medical care as necessary to preserve the child's health and protect the health of others in contact with the child; [10 O.S. § 7004-1.1] • 2
- (B) yearly mental health or developmental screening. The first screening is conducted no later than 90 days after the child's removal from the home;
- (C) yearly dental exam for children over three years of age. Children under the age of three years receive dental services as needed;
- (D) immunizations initiated and kept current;
- (E) visual and hearing evaluation exams and corrective lenses or hearing aides, if indicated;
- (F) outpatient or inpatient behavioral mental health treatment, when appropriate;
- (G) physician's services, if the child is sick. This service is not considered a physical exam; and
- (H) follow-up and referral services as recommended by a qualified professional.
(2) If requested by a placement provider, OKDHS provides examinations or tests regarding HIV on the child based on the Centers for Disease Control guidelines for time and frequency of testing. [10 O.S. § 7003-5.4] • 2

(b) Medical services for child in custody in parent(s)' home. A child in OKDHS custody and living in the parent(s)' home may continue to be eligible to receive financial assistance from the Oklahoma Health Care Authority for necessary medical services. The parent(s) of a child in temporary OKDHS custody who is living in his or her own home has the primary responsibility to provide and arrange for the medical needs of the child. • 2

(c) Notification of injury to the child -88that requires medical examination or treatment. When medical attention for accidental or non-accidental injury is sought or required for a child in the legal custody of OKDHS in out-of-home placement, OKDHS notifies the:

(1) court of jurisdiction;
(2) child's parent(s);
(3) parent(s)' attorney;
(4) child's attorney;
(5) district attorney; and
(6) court-appointed special advocate. • 3

INSTRUCTIONS TO STAFF 340:75-6-88

Revised 6-1-07

1. Initial health and developmental screening. The Child Welfare (CW) worker ensures the child's initial health and developmental screening is completed no later than 30 days after the child's placement in Oklahoma Department of Human Services (OKDHS) custody. When a child is placed in foster care, the medical examination is scheduled within ten days after placement. If the child is younger than three years of age, the CW worker:

(1) refers the child to SoonerStart via Form 04MP021E, Child Welfare SoonerStart Referral, no later than 15 working days after the child's initial placement in out-of-home care, excluding shelter and emergency foster care;

(2) notifies the parent(s) and placement provider of the referral to SoonerStart;

(3) informs the placement provider that cooperation is required with SoonerStart in the provision of any service recommended for the child;

(4) updates KIDS Contacts screen with purpose type – SoonerStart Referral;

(5) notifies SoonerStart of any change in placement of the child by providing copy of Form 04KI025E, Change in Placement Notification, within two working days if the screening, evaluation, or both, has not been completed by SoonerStart;

(6) discusses with the parent(s), within 15 working days of receipt, the information provided by SoonerStart;

(7) documents SoonerStart information in KIDS Medical screen;

(8) includes SoonerStart information in KIDS Family and Child Strengths and Needs Assessment screens;

(9) files SoonerStart information in the child's paper case record; and

(10) when notified by SoonerStart of the placement provider's lack of cooperation or follow through with recommendations, completes Form 04AF022E, Report of Violation of Rules in an OKDHS Resource Home.

2. (a) Early Periodic, Screening, Diagnosis and Treatment (EPSDT) schedule.

(1) The schedule of frequency for EPSDT provides for:

(A) six health screenings during the child's first year of life;

(B) two screenings in the child's second year of life;

(C) one screening yearly for the child age two through five years; and

(D) one screening every other year for the child age six through 20 years.

(2) Eligible children may receive dental screening services once every 12 months.

(3) More frequent screening services are allowed when a medical condition is suspected.

(b) Documentation of medical services. The CW worker and placement provider ensure the continuity of medical services and records while a child is in out-of-home care.

(1) These records are made:

(A) part of the child's paper case record and Life Book; and

(B) available to the parent(s), any subsequent provider, and youth leaving care for independent living.

(2) The CW worker updates the:

(A) appropriate KIDS screens no later than 30 days after each child's appointment for medical, dental, or psychological services;

(B) child's immunization and prescriptions records and KIDS Service Log; and

(C) KIDS AFCARS screens when the child receives a specific diagnosis by the physician or therapist.

(c) Medical consent. Refer to OAC 340:75-13-65 regarding consent for medical services.

(d) HIV-related services. Refer to OAC 340:75-1-115 for testing related to Human Immunodeficiency Virus (HIV).

(e) Healthcare for child in parent(s)' home. Refer to OAC 340:75-13-62 for medical coverage when the child resides with the parent(s).

3. Notification of medical injury or treatment.

(1) Form 04MP027E, Notice of Injury to Child Requiring Medical Examination or Treatment, is completed by the CW county of placement worker when a child in OKDHS custody requires medical treatment as a result of an accidental or non-accidental injury and to advise the parties of the:

(A) nature of the injury;

(B) date of occurrence; and

(C) medical care provided or planned to meet the child's needs.

(2) All injuries, other than normal minor childhood scrapes and bruises, such as small bruises to the knee or shin, are made known to CW staff.

(3) Any injury to the child, even when accidental, is immediately reported per OAC 340:75-3-6, when the injury involves the face, head, neck, stomach, or genitals, burns, broken bones, deep bruises or wounds, or any type of injury requiring medical attention.

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