Ohio's Families and Children Rule Review Site

5101:2-42-66.1 Comprehensive health care for children in placement

This rule is no longer open for comment. However, here you can view an archived, read-only version of the rule and any associated comments.

Please Note: This rule is under review for 30 days for a five year rule review. This rule regards voluntary custody, independent living and health checks for children in agency custody. The review will concentrate on clarifying areas of the rules for a clearer understanding for the PCSA/PCPA.

(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 placed into substitute care. 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, 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) 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. 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) 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) A child age three or under receives required pediatric care as prescribed by a licensed physician pursuant to rule 5160-14-03 of the Administrative Code.

(3) 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.

(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) 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 liaison with the CDJFS healthchek coordinator to schedule and arrange transportation.

(2) Complete the JFS 03528 "Healthcheck and Pregnancy Related Services Information Sheet" (rev. 3/2014) and return the form to the CDJFS healthchek coordinator.

(G) 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: 08/11/2014
R.C. 119.032 review dates: 04/30/2014 and 08/01/2019
Promulgated Under: 119.03
Statutory Authority: 5103.03, 5153.166
Rule Amplifies: 5103.03, 5153.166
Prior Effective Dates: 9/28/87 (Emer.), 12/27/87, 1/1/89, 1/1/90, 5/1/93, 9/1/93, 10/1/97, 2/1/03, 10/9/06, 11/09/09.
0I Agree13I Disagree
(A) The public children services agency (PCSA) or private child placing age...
Shawn Pedani
02-09-2018 (4:10pm)
Should it say that PCSA's shall coordinate with PNA's for providing comprehensive health care for child in its custody? I work at a PNA (Christian Children's Home of Ohio) in our foster care department. Reading this rule, it's unclear who is responsible for coordination of health care. It appears to be that the PCSA's are responsible. None of the county contracts address this (except Cuyahoga) - as they are all state, master contracts. Cuyahoga just talks about the initial. Yet, all the counties want us to make sure we are providing a physical and forms to document doctor and dentists appts. Thank you!
Show related text
In regards to: (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 placed into substitute care
0I Agree15I Disagree
A psychological examination for a child adjudicated delinquent is conducted...
Jusitn Gall
02-15-2018 (1:14pm)
A mental health diagnostic assessment to determine if a psychological examination is necessary for a child adjudicated delinquent within sixty days of the child’s entry into substitute care. **It has become increasingly more difficult to secure the completion of a psychological examination due to availability of psychologist to complete the examination in addition to the time necessary to complete the evaluation. A diagnostic assessment should give the necessary information to identify necessary service provisions for a child in addition to allowing for the recommendation of a full psychological.
Show related text
In regards to: 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.
0I Agree5I Disagree
A psychological examination for a child adjudicated delinquent is conducted...
Jeff Felton
02-22-2018 (11:05am)
The term "psychological examination" implies an evaluation performed by a licensed psychologist. The term "mental health assessment", "mental health screening" would appear more appropriate and not tie the evaluation/assessment to a particular discipline
Show related text
In regards to: 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.
0I Agree5I Disagree
(C) No later than five working days after the date of the child's most rece...
Jeff Felton
02-22-2018 (11:07am)
The cost of these services must be born by the MCO and not the PSCA.
Show related text
In regards to: (C) 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. 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) 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.
0I Agree5I Disagree
(3) A child age three or under is referred to the county "Help Me Grow Prog...
Patricia Harrelson
02-22-2018 (4:19pm)
Is this program still called Help Me Grow?
Show related text
In regards to: (3) 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.
0I Agree3I Disagree
The public children services agency (PCSA) or private child placing agency ...
Belinda Peugh
02-23-2018 (11:51am)
While this requirement made sense in a Medicaid fee for service environment, it does not now. Practically, this is currently being done IN PARTNERSHIP with the Medicaid Managed Care Plans. The MCPs have the lead role in assuring access to care. This is an important statement of state policy and might be worth reviewing with ODM.
Show related text
In regards to: 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 placed into substitute care. 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.
0I Agree3I Disagree
No later than sixty days after the child's placement into substitute care t...
Belinda Peugh
02-23-2018 (11:51am)
MCP should assist the PCSAs to determine whether these types of exams have been performed in past 3 months, and if so, help get records to PCSA so care is not duplicated.
Show related text
In regards to: 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.
0I Agree3I Disagree
A psychological examination for a child adjudicated delinquent is conducted...
Belinda Peugh
02-23-2018 (11:53am)
This section needs to be updated to meet the current standard of care. “Psychological examination” is not appropriate, and a “behavioral health screening” may be better. This should not just apply to adjudicated delinquents but could be required for ALL children when entering custody of PCSA. Screening could include: trauma, depression, ADHD, PTSD, SUD, other ACES/trauma related issues. If screening indicates need for further evaluation and care, PCSA and MCP will work together to assure access to this within 60 days. Further, the list of people who can perform the screening should be expanded to include school personnel, PCSA staff, medical professionals, many other types of clinicians.
Show related text
In regards to: 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.
1I Agree2I Disagree
To document health information about the child in the child's case record w...
Belinda Peugh
02-23-2018 (11:54am)
We are hoping that the MCPs could have rights to document this directly in SACWIS.
Show related text
In regards to: 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.
0I Agree2I Disagree
(A) The public children services agency (PCSA) or private child placing age...
PCSAO
03-02-2018 (3:59pm)
While this requirement made sense in a Medicaid fee for service environment, it does not now that all children in custody (with very few exceptions) are required to have a Medicaid Managed Care Plan (MCP). Practically, the act of coordinating comprehensive health care for each child now must be done IN PARTNERSHIP with the MCP and with paid placement providers, and the MCPs have the LEAD role in assuring access to care. This is an important statement of state policy and might be worth reviewing with the Department of Medicaid.
Show related text
In regards to: (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 placed into substitute care. 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.
0I Agree2I Disagree
(C) No later than five working days after the date of the child's most rece...
PCSAO
03-02-2018 (4:01pm)
It must be clear that Medicaid MCPs have a lead role in assuring access to the five-day screen as requested by the PCSA.
Show related text
In regards to: (C) 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. 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.
0I Agree2I Disagree
(C)
PCSAO
03-02-2018 (4:09pm)
Before (c): Within 14 days of when an MCP becomes aware of a child in custody's enrollment into their managed care plan, the MCP must provide all available information to the PCSA regarding Medicaid-reimbursed health care services that have been delivered to the child within the past 6 months. The PCSA should be given information about providers, services, medication filled, vaccination-related claims, and any other relevant information the MCP has about the child's health. This will help to prevent duplication of services and determine un-met needs. Additionally, within 14 days of becoming aware of the enrollment, the MCP should begin working with the PCSA to begin coordinating care and access to services for the child.
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In regards to: (C)
0I Agree2I Disagree
(D) The PCSA or PCPA shall arrange for the following health care for a chil...
PCSAO
03-02-2018 (4:10pm)
Per comment placed before (C) above, within 2 weeks of becoming aware of the child's enrollment into the MCP, the MCP should assist the PCSAs to determine whether these types of exams have been performed in past 3 months, and if so, help get records of these screens to the PCSA so care is not duplicated.
Show related text
In regards to: (D) The PCSA or PCPA shall arrange for the following health care for a child who is in substitute care, the agency shall ensure:
0I Agree2I Disagree
(4) A psychological examination for a child adjudicated delinquent is condu...
PCSAO
03-02-2018 (4:14pm)
This section should be deleted, as access to behavioral health screening is achieved for all children (not just those adjudicated delinquent) through EPSDT requirements / bright futures screenings.
Show related text
In regards to: (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.
0I Agree2I Disagree
(5) The arrangement for and secure appropriate immunizations. If a child's ...
PCSAO
03-02-2018 (4:15pm)
Per comment placed before (C) above, within 2 weeks of becoming aware of the child's enrollment into the MCP, the MCP should assist the PCSAs with obtaining an immunization history.
Show related text
In regards to: (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.
0I Agree2I Disagree
(6) Treatment for any diagnosed medical or psychological need is initiated ...
PCSAO
03-02-2018 (4:18pm)
The MCP should be responsible for securing access for needed services within this time frame. The MCP should work with the PCSA to meet this responsibility.
Show related text
In regards to: (6) Treatment for any diagnosed medical or psychological need is initiated within sixty days of the diagnosis,unless treatment is required sooner.
0I Agree2I Disagree
(7) To document health information about the child in the child's case reco...
PCSAO
03-02-2018 (4:20pm)
MCPs should be able to document available health history directly in SACWIS, just as PCPAs can.
Show related text
In regards to: (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.
0I Agree2I Disagree
(8) A dental exam for a child over three years of age no later than six mon...
PCSAO
03-02-2018 (4:20pm)
The MCP should be responsible for securing access for needed services within this time frame. The MCP should work with the PCSA to meet this responsibility.
Show related text
In regards to: (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.
0I Agree2I Disagree
(E) A comprehensive health care screening or exam is not required when:
PCSAO
03-02-2018 (4:21pm)
Add (3) information is obtained from the MCP indicating a screen or exam is not warranted.
Show related text
In regards to: (E) A comprehensive health care screening or exam is not required when:
0I Agree2I Disagree
(F) For a medicaid eligible child, the PCSA or PCPA shall: (1) Coordinate ...
PCSAO
03-02-2018 (4:23pm)
In practice, coordination with the JFS may not happen and should not be a requirement. The MCP has responsibility for assuring completion of all Healthchek activities, not the PCSA.
Show related text
In regards to: (F) 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 liaison with the CDJFS healthchek coordinator to schedule and arrange transportation.
0I Agree2I Disagree
(2) Complete the JFS 03528 "Healthcheck and Pregnancy Related Services Info...
PCSAO
03-02-2018 (4:24pm)
This for may not be needed, and/or it should be revised in light of MCP involvement.
Show related text
In regards to: (2) Complete the JFS 03528 "Healthcheck and Pregnancy Related Services Information Sheet" (rev. 3/2014) and return the form to the CDJFS healthchek coordinator.
0I Agree2I Disagree
however the PCSA or PCPA, shall coordinate health care whenever the child h...
PCSAO
03-02-2018 (4:26pm)
As in other areas, the MCP should be should be responsible to secure access for needed services for all children in custody. The MCP should coordinate access to this care with the PCSA.
Show related text
In regards to: 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.