(A)The public children services agency (PCSA) or private child placing agency (PCPA) shall coordinate comprehensive health care for each child in its care or custody who is placedenters into substitute care or has a placement change. In coordinating comprehensive health care, the PCSA or PCPA shall attempt to arrange for health care from the child's existing and previous medical providers as well as involve the parent, guardian, or custodian in the planning and delivery of health care services.

(B)If applicable, when petitioning for custody, the PCSA or PCPA shall determine whether the parent, guardian or custodian has health care insurance and / or financial resources to provide comprehensive health care.

(1)If insurance or financial resources are available, the PCSA or PCPA shall request financial support.

(2)If insurance or financial resources are not available, the PCSA or PCPA shall assess the child's eligibility for medicaid, Title IV-E, supplemental security income (SSI), or other assistance programs. Unless an application for Title IV-E has been submitted, the PCSA, the PCPA shall apply for medicaid on behalf of the child no later than thirty days after the date of the child's placement into substitute care.

(C)The PCSA or PCPA shall arrange for a medical screening within seventy-two hours of each child entering into substitute care or when a child's placement changes, No later than five working days after the date of the child's most recent placement setting, unless medical care is needed sooner, the PCSA or PCPA shall secure a medical screening to prevent possible transmission of common childhood communicable diseases and to identify any symptoms of illness, injury, or maltreatment. A screening is not required for newborn children directly placed into substitute care from the hospital. The medical screening shall be conducted by one of the following:

(1)A licensed physician.

(2)An advanced practice nurse.

(3)A registered nurse.

(4)A licensed practical nurse.

(5)A physician's assistant.

(D)The PCSA or PCPA shall arrange for the following health care for a child who is in substitute care, the agency shall ensure:

(1)A comprehensive physical exam for children age three or over, including a review of physical, mental, developmental, vision and dental health is completed within thirty days after a child enters into substitute care. A comprehensive physical exam is not required if a comprehensive physical exam of the child has been conducted within six months prior to the child's entry into substitute care and a copy of the exam is filed in the child's case record. The agency shall ensure an annual comprehensive physical exam is completed no later than thirty days after the anniversary date of the child's last physical, which shall include a vision and hearing screening. No later than sixty days after the child's placement into substitute care the agency is to obtain a comprehensive physical exam which will include a vision and hearing screening. The agency shall secure an annual comprehensive physical exam no later than thirty days after the anniversary date of the child's last physical which shall include a vision and hearing screening.

(2)Additional visits, as appropriate, during the first sixty to ninety days of the child entering substitute care to:

(a)Assess the child in the process of transition.

(b)Monitor the adjustment to care.

(c)Identify evolving needs and;

(d)Continue information gathering.

(2)(3)   A child under the age three or under receives required pediatric care, which includes medical, developmental, mental, dental, vision and hearing as prescribed by a licensed physician pursuant to rule 5160-14-035160-1-14 of the Administrative Code and the Bright Futures guidelines (rev. 2/2017). The guidelines can be reviewed at http://www.aap.org.

(3)(4)   A child age three or under is referred to the county "Help Me Grow Program" when a screening or assessment indicates the child has or is at risk of a developmental disability or delay.

(5)Every child entering substitute care shall receive immunizations appropriate to age and health history. If a child's record of previous immunizations is unavailable at the time of the comprehensive physical exam, and it is reasonable to assume that the child has received immunizations, immunizations may be postponed until an immunization record is available for review.

(6)A dental examination is to be completed for a child three years of ageand older no later than six months after the child's placement into substitute care. The agency shall ensure a follow-up dental examination is completed every six months from the date of the last dental examination with a thirty day grace period for scheduling purposes.

(7)Treatment for any diagnosed medical or psychological need is initiated within sixty days of the diagnosis, unless treatment is required sooner.

(8)Pursuant to section 2152.72 of the Revised Code, if a child has been adjudicated delinquent for any crimes listed in section 2152.72 of the Revised Code, the agency shall ensure a psychological examination of the child is completed within sixty days of the child's entry into substitute care. A psychological examination of the child is not required if a psychological examination of the child has been conducted within twelve months prior to the child's entry into substitute care and a copy is filed in the child's case record. Prior to any subsequent placements, the agency shall ensure a new psychological examination is completed unless either of the following apply:

(a)A psychological examination of the child has been conducted within twelve months prior to the child's placement.

(b)A psychological examination of the child has been conducted within twenty-four months prior to the date of the adoptive placement when the foster caregiver seeks to adopt the foster child.

(4)A psychological examination for a child adjudicated delinquent is conducted within sixty days of the child's entry into substitute care unless a psychological examination was conducted within twelve months prior to the date the child was placed in substitute care and a copy is filed in the child's case record. If no psychological examination of the child is available, an examination to detect mental and emotional disorders shall be performed by:

(a)A licensed independent social worker.

(b)A licensed social worker.

(c)A licensed professional clinical counselor.

(d)A licensed professional counselor.

(5)The arrangement for and secure appropriate immunizations. If a child's record of previous immunizatinos is unavailable at the time of the comprehensive physical exam, and it is reasonable to assume that the child has received immunizations, immunizations may be postponed until an immunization record is available for review.

(6)Treatment for any diagnosed medical or psychological need is initiated within sixty days of the diagnosis, unless treatment is required sooner.

(7)To document health information about the child in the child's case record within the state automated child welfare system (SACWIS) pursuant to rule 5101:2-42-66.2 of the Administrative Code for the PCSA. The PCPA shall document health information about the child in the child's case record.

(8)A dental exam for a child over three years of age no later than six months after the child's placement into substitute care. The agency shall secure annual dental re-examination no later than thirty days after the anniversary date of the child's last dental examination.

(E)A comprehensive health care screening or exam is not required when:

(1)A child has received a comprehensive physcial exam within three months prior to placement in substitute care and the results of the comprehensive physical exam are obtained by the PCSA or PCPA and maintained in the case record.

(2)The newborn is placed directly from the hospital.

(F)(E)  For a medicaid eligible child, the PCSA or PCPA shall:

(1)Coordinate with the county department of job and family services (CDJFS) healthchek coordinator to secure a healthchek screening exam. The agency may authorize the substitute caregiver, managed care coordinator, medical providers and custodial parents to serve as a liaisonwork with the CDJFS healthchek coordinator to schedule appointments and arrange transportation to those appointments.

(2)Complete the JFSODM 03528 "Healthcheck and Pregnancy Related Services Information SheetHealthchek and Pregnancy Related Services Information Sheet" (rev. 3/2014)(rev. 3/2018) and return the form to the CDJFS healthchek coordinator within the following timelines:.

(a)Within sixty days of the child's entry into substitute care or move to a subsequent placement.

(b)Annually based on the date the previous ODM 03528 form was completed and returned to the CDJFS healthchek coordinator.

(3)Inform the substitute caregiver(s) about healthcheck services within sixty days of placement into the caregiver's home by reviewing the ODM 03528 with the substitute caregiver and providing the caregiver a copy of the form.

(G)(F)  Comprehensive health care pursuant to paragraph (D) of this rule is not required if the child's placement episode is less than sixty days; however the PCSA or PCPA, shall coordinate health care whenever the child has a condition which indicates a need for treatment during the placement episode.

Effective: 5/1/2019

Five Year Review (FYR) Dates: 1/7/2019 and 05/01/2024

Certification: CERTIFIED ELECTRONICALLY

Date: 03/14/2019

Promulgated Under: 119.03

Statutory Authority: 5153.166, 5103.03

Rule Amplifies: 5103.03, 5153.166

Prior Effective Dates: 09/28/1987 (Emer.), 12/27/1987, 01/01/1989, 01/01/1990, 05/01/1993, 09/01/1993, 10/01/1997, 02/01/2003, 10/09/2006, 11/09/2009, 08/11/2014