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For Staff


Health Services Manual


Admission Process


  • Q: How is the Facility Entry Physical Health Screening different than the Comprehensive Physical Assessment?
    A: Each youth receives a Facility Entry Physical Health Screening by a staff member (health care or non-health care) admitting the youth to a detention center or residential commitment program. The purpose of this screening is to ensure that the youth does not have any health conditions that would require emergency services. This screening does not take the place of the Comprehensive Physical Assessment or other required evaluations. Facility Entry Physical Health Screenings performed by non-healthcare staff are reviewed by the facility nurse on the next nursing shift.
    The Comprehensive Physical Assessment is the standardized physical assessment of a youth, conducted by a Physician, an Advanced Registered Nurse Practitioner or Physician Assistant at Departmentally specified intervals.
  • Q: When a youth has a positive PPD/TST and exhibits no signs and symptoms of TB, is it a requirement that the youth be placed in isolation?
    A: No. A youth who has symptoms suggestive of TB disease and has a positive PPD/TST shall immediately receive a medical evaluation and shall be placed in isolation or an Airborne Infection Isolation Room until active TB disease has been ruled out. The licensed nurse must provide the youth and staff a NIOSH approved disposable particulate TB respiratory mask. The nurse shall be responsible for fit testing the youth and staff to assure the proper sizing of the respiratory mask.

Consent & Authority for Evaluation and Treatment


  • Q: What is the difference between parental consent and parental notification?
    A: The Authority for Evaluation and Treatment (AET, HS Form 002) is the Department’s general parental consent form authorizing specific medical care and treatment for youth in the custody of the Department. For the purpose of the AET document, departmental custody includes those DJJ facilities where youth are housed 24 hours per day, such as, Detention Centers and Residential Commitment Programs. The AET provides limited authority for youth in DJJ facility-based non-residential programs. There are certain types of care that requires additional written consent that is not addressed in the Authority for Evaluation and Treatment.


    Parental notification refers to notifying parents of specific events that have occurred related to the youth’s health care. This notification may be provided verbally, or by telephone followed by notification in writing. Written notification is required for any additional health-related care not addressed in the signed Authority for Evaluation and Treatment. This is accomplished by sending the parent the necessary standardized Parental Notification of Health Related Care (HS Forms 020, 021, 022) for any additional health-related care not addressed in the signed Authority for Evaluation and Treatment.
  • Q: Is each detention and residential facility required to obtain a new parental consent for the Authority for Evaluation and Treatment form?
    A: No. The Authority for Evaluation and Treatment (AET) is valid for as long as the youth is under any type of supervision, custody or other form of legal control by the Department; or for one year after it was signed by the parent/legal guardian, whichever comes later, or until the youth’s 18th birthday. Legal control includes probation and conditional release.
  • Q: When a youth turns 18 years old, does the youth then sign his/her own Authority for Evaluation and Treatment form?
    A: No. Once a youth turns 18, an AET is not valid because the youth is legally considered an adult. The youth must provide consent at the point of care for all medical services, as with any other adult. The youth’s parent or guardian may not be contacted for consent or notification of medical services unless the youth gives consent to do so.
  • Q: Is parental notification required for a pregnant female receiving prenatal services if the youth requests that the parent not be notified?
    A: No. Consent or notification of the parent or guardian for a youth’s prenatal services is not required; however, the youth should be encouraged to allow for parental notification when prenatal care issues arise. Because of the Department’s unique responsibility for the health and safety of the youth and unborn child, if the youth refuses to notify her parents, the facility superintendent, program director, or designee shall consult with the regional general counsel’s office if the situation is serious.
  • Q: Is parental notification required every time we give a youth a Tylenol or a band-aid? What about other Over-the-Counter medications?
    A: No. Parental consent to provide a youth Acetaminophen (Tylenol), Ibuprofen (Motrin), anti-indigestion medications (e.g., Pepto Bismol), antacids (i.e., Milk of Magnesia, Maalox), Triple Antibiotic Ointment, and Diphenhydramine (e.g., Benadryl) is obtained when the parent signs the Authority for Evaluation and Treatment (AET).  Additional Over-the-Counter medications require a separate Parental Notification or consent.

Sick Call


  • Q: What is the difference between Sick Call and Episodic Care?
    A: Sick Call is the component of health care that responds to a youth’s complaints of illness or injury of a non-emergent nature but which requires a professional nursing assessment and possibly, a nursing or medical intervention.  Sick Call is conducted when a licensed nurse is on-site, and should be conducted on a regularly-scheduled basis.  Episodic care is the health care component intended to provide medical services in response to unexpected illnesses, accidents or conditions that require immediate attention or an immediate professional assessment to determine their severity. Any Sick call complaint that has been evaluated to require an immediate response shall not wait until the next scheduled Sick Call. A youth experiencing a health-related condition or complaint that is considered an emergency must receive immediate medical attention and is not part of the sick call process.
  • Q: Does a youth have to submit a sick call request each time he or she requires over-the-counter medications for minor health complaints?
    A: No. A process must be in place for all youth to have timely access to sick call care and treatment. The process by which youth indicate their respective need for Sick Call may vary as long as access is not denied. However, a youth must be provided a Sick Call Request form and a pencil when requesting to see a nurse or physician.

Medications


  • Q: How do we dispose of unused medications?
    A: If the pharmacy vendor your facility utilizes offers a Reverse Distributor service, this is the preferred method of medication disposal.  For facilities that have a Modified Class IIB Institutional Pharmacy Permit, the method of disposal should be by Reverse Distributor or as determined by your facility’s Consultant Pharmacist and medical staff.  For facilities that do not have the Modified Class IIB Institutional Pharmacy Permit, the method of disposal should be via flushing or the sewer system.  In the case of controlled medications (e.g. Narcotics), this must be done by a three-party witness, and must be destroyed beyond reclamation, per FAC 64B16, by a Pharmacist, Nursing Supervisor, and administrator or designee, and should be done via sewer. Disposal by placing in cat litter and disposing in the trash is not recommended because medications are to be destroyed beyond reclamation to avoid any possible diversion of medications in the correctional setting.
  • Q: Does a youth have the right to refuse medication?
    A: Yes. The forced (involuntary) administration of medication is not permitted under any circumstances. Each facility must develop a Medication Refusal form or utilize the Department’s Right to Refuse Care form. This form should be completed each time a youth refuses care.
  • Q: Can a non-licensed staff member provide medication to a youth?
    A: If no licensed nurses are on-site to administer oral prescription medications or Over-the-Counter medications, then non-licensed direct care staff assist youth with the self-administration of their medications. All non-licensed direct care staff that have this responsibility are required by the department to have the appropriate training, conducted by a Registered Nurse or higher licensure level, and verified as competent to provide medications to youth who are administering their own medications.  All facilities must have operating procedures in place that include the training of non-licensed staff whose responsibilities include these duties.

Health Care Forms


  • Q: How are the Health Services forms accessed?
    A: All Health Services forms may be accessed through the Forms Library.  For facilities with JJIS access, the Health Services forms are also accessible in the JJIS database.

Health Care Record


  • Q: Does the Individual Health Care Record have to be standardized?
    A: Yes. The Individual Health Care Record is the youth-specific unified, organized collection of health records (i.e. histories, assessments, treatments, diagnostic tests, reports of consultations, etc.), which relate to a youth’s medical, mental/behavioral, and dental health. It is essential that a comprehensive, organized and accurate Individual Health Care Record is developed and maintained for each youth to facilitate effective communication among the various health care providers who treat each individual youth.
  • Q: Are non-licensed staff members permitted to make entries in the individual health care record?
    A: Yes. All on-site medical health care encounters, including those performed by licensed health care professionals, health care para-professionals, and other trained facility staff shall be documented in the chronological progress notes in chronological order (with exceptions as noted in Chapter 15). Any person, licensed or non-licensed, administering medication and/or treatment to a youth must document on the Medication and Treatment Record (MAR) any medications, physical or dental health treatment provided pursuant to physician’s orders. Any medications administered outside of scheduled sick call shall be documented accordingly on the MAR as well.
  • Q: Can duplicate copies of a document be destroyed?
    A: If duplicate identical copies of a document (i.e., the Health Related History or Comprehensive Physical Assessment) exist in a youth’s Individual Health Care Record; the replicates may be shredded as long as they contain the exact same information as the copy that remains in the youth’s record.
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