Part 507 - HEALTH SUPERVISION AND MEDICAL CARE FOR CHILDREN

Doc Status: 
Complete
Statutory Authority: 
Social Services Law, Sections 20, 34, 350, 364, 365-a, 462

Section 507.1 - General responsibilities for health supervision and

Section 507.1 General responsibilities for health supervision and medical care for children. (a) It is the responsibility of the local social services district to provide for comprehensive medical services for children in foster care and to assure the availability and encourage the utilization of such services for children receiving services under a public assistance program. This responsibility will be jointly shared by the medical assistance unit and the children's services and public assistance staffs.

(b) Administratively, the provision of medical care for children must be carried out in accordance with other provisions of this Subchapter and section 43.6 of this Title.

(c) For children in foster care, health supervision is a continuing responsibility of the children's services caseworker and medical assistance staff of the local social services district. Such responsibility includes:

(1) procuring, recording and maintaining information regarding the health history, current health status, and health care needs of the children in care;

(2) arranging for periodic medical and dental examinations according to the following schedule:

(i) for children aged 0-1 years: at 2-4 weeks; 2-3 months; 4-5 months; 6-7 months; 9-10 months;

(ii) for children aged 1-6 years: at 12-13 months; 14-15 months; 16-19 months; 23-25 months; 3 years; 4 years; 5 years; and

(iii) for children aged 6-21 years: at 6 years; 8-9 years; 10-11 years; 12-13 years; 14-15 years; 16-17 years; 18-19 years; 20 years;

(3) arranging for periodic medical and dental examinations that must follow current recommended medical practice and be consistent with the needs of the child as determined by the child's physician. Every examination must include the following as appropriate by age:

(i) a comprehensive health and developmental history;

(ii) a comprehensive unclothed physical examination;

(iii) an assessment of immunization status and provision of immunizations as necessary;

(iv) an appropriate vision assessment;

(v) an appropriate hearing assessment;

(vi) laboratory tests as appropriate for specific age groups or because the child presents a history or symptoms indicating such tests are necessary;

(vii) dental care screening and/or referral. All children up to age three should have their mouths examined at each medical examination and where appropriate should be referred for dental care. All children three years of age or over must have a dental examination by a dentist annually and must be provided with any dental care as needed; and

(viii) 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;

(4) for a child who is eligible for medical assistance, notifying the foster parent(s), or the institution, group residence, group home, or agency boarding home where the child is residing, in writing within 60 days of acceptance of the child into foster care of the availability of child/teen health plan services (C/THP) and providing upon request the names and locations of providers offering examinations, diagnosis and treatment to children eligible for C/THP. All families eligible for C/THP services must also be informed at least annually of the availability of such services in accordance with section 508.4 of this Title;

(5) informing foster parents that assistance is available in scheduling appointments with and providing transportation to providers of medical care on behalf of their foster children if such assistance is requested;

(6) consulting with physicians, dentists, psychologists and other professional staff, as appropriate, regarding the significance of information and findings;

(7) determining actions to be taken to carry out treatment recommendations;

(8) in accordance with section 463.2 of this Title, advising in writing each foster parent providing care to an adolescent who is 12 years of age or over of the availability for such child of social, educational and medical family planning services;

(9) providing or arranging, in accordance with section 463.2 of this Title, requested family planning services within 30 days of such request; and

(10) when a child-caring agency is authorized by a local social services district to offer family planning services to a foster child who is 12 years of age or over in accordance with section 463.2 of this Title, monitoring the provision of information and services and assuring that reports and data on such services are included in the uniform case record.

(d) For a child receiving services under a public assistance program, the local social services district is responsible for making available prompt and adequate medical and dental examinations and treatment in accordance with Part 508 of this Title, and in educating the parent(s), guardian or other relative caring for the child on the necessity for health supervision of the child.

(e) Records. (1) For a child placed in foster care, Form DSS-711, Child's Medical Record, or an appropriate physician's medical record form must be used to report the results of the initial physical examination and also must be maintained as a continuous and permanent medical history of the child. For a child placed in the care of a voluntary agency for whom the local social services district has responsibility, the voluntary agency must maintain a continuous and permanent medical and dental history and the local social services district must maintain a copy of such history in its files.

(2) Form DSS-704, Medical Report on Mother and Infant, must be used to record the child's birth history, as available from the appropriate hospital, for each preschool child placed in foster care, either in the direct care of the local social services district or in the care of voluntary agencies. Such form must be included in the uniform case record as part of the continuous medical history for the child.

(3) Form DSS-3306, Progress Notes, must be maintained in the uniform case record by the agency providing care to the child and must include a summary of activities related to medical and dental appointments, examinations and services, including records of referrals as specified in section 428.5 of this Title.

(4) For children receiving public assistance, all medical reports from physicians or other sources must be maintained in the case record so that a continuous medical history may be available at all times.

 

Doc Status: 
Complete

Section 507.2 - Special assessments, examinations and tests required for children

507.2 Special assessments, examinations and tests required for children in foster care.

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

(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:

(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.

(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.

(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) 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) (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.

(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:

(i) a comprehensive health and developmental history;

(ii) a comprehensive unclothed physical examination;

(iii) an assessment of the child's immunization status and the provision of immunizations as necessary;

(iv) an appropriate vision assessment;

(v) an appropriate hearing assessment;

(vi) appropriate laboratory tests;

(vii) a dental screening; and

(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.

Laboratory tests may include complete blood count, urinalysis, tuberculin skin test, X-rays, HIV related tests, 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.

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

(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

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

(a) was discharged from care, either on a trial basis or on a permanent basis; or

(b) was absent from care without leave.

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

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

(a) being discharged from care, either on a trial basis or permanent basis; or

(b) being absent from care without leave; or

(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. (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.

(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.

Doc Status: 
Complete
Effective Date: 
Thursday, December 29, 2005

Section 507.3 - Payment for health supervision and care.

507.3 Payment for health supervision and care. (a) Medical services.

(1) Fee schedules. The fee schedules of the department shall prevail for purposes of reimbursement in accord with the policies of the department.

(2) Pediatric care. When children are placed under the care of a qualified pediatrician for child health supervision and regular medical care, that pediatrician shall be considered to be the personal physician to that child. His fees shall be governed by the fee schedule.

 

Doc Status: 
Complete

Section 507.4 - Medical rehabilitation and mental health.

507.4 Medical rehabilitation and mental health. (a) Medical rehabilitation. Children with handicapping physical defects, including physically handicapping malocclusion, the nature of which may make them eligible for care under the physically handicapped children's program of the State Department of Health shall be referred promptly to the local medical rehabilitation director for determination of medical eligibility for such program. If a child is determined to be medically eligible therefor, the local social services official shall determine financial eligibility for medical assistance. If the case is determined to be fully eligible financially for medical assistance, the medical services shall be authorized by the local social services official and payments for such services shall be made in full from medical assistance funds. If, however, the social services official determines that the case is not fully eligible financially and that the child's parents are required to contribute toward the cost of his care under medical assistance eligibility standards, the case shall be referred for payment for that care to the physically handicapped children's program.

(b) Mental health. Utilization of available child guidance or mental health clinics, or other suitable resources, shall be arranged as indicated for children with evidence of emotional disturbance or behavior disorder.

 

Doc Status: 
Complete

Section 507.5 - Emergency medical treatment for children in foster care.

507.5 Emergency medical treatment for children in foster care. Social services officials shall establish a procedure under which an immediate determination as to permission for emergency medical treatment will be sought from the person having custody of a child for each child for whom a district provides or purchases foster care; immediate determinations will be sought when emergency medical treatment is necessary and the provider of medical services requires a consent. Each local social services department shall assure that:

(a) procedures are developed and implemented for receiving requests for consent, and obtaining prompt consent, at any hour of the day or night;

(b) foster parents are fully informed of those procedures at the time of placement; and

(c) consents are promptly made available to the provider.

 

Doc Status: 
Complete