Ohio's Families and Children Rule Review Site

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

To make a new comment, highlight an unhightlighted area of text related to your comment with your cursor. To join the discussion on a previously highlighted text segment, click the "View Discussion" link on the appropriate sidebar link.

If you are on a mobile, tablet or other device not compatible with the text selection function, you can copy the text below and paste it here.

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 Agree10I 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 Agree11I 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 Agree2I 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 Agree2I 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 Agree2I 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 Agree0I 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 Agree0I 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 Agree0I 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.
0I Agree0I 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.