Government of New York
NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICESHOW TO FILL OUTThe Health Care Plan for Legally-Exempt Group Child Care ProgramWho must complete the health care plan?Those legally-exempt group child care programs (LEGCCP) that wish to be eligible to receive an enhanced rate from their local district by meeting the Enhanced Rate-Health requirements AND/ORThose LEGCCP that wish to be authorized by the New York State (NYS) Office of Children and Family Services (OCFS) to administer medication other than:over-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellent (TO/S/R’s); AND/ORemergency medications: epinephrine auto-injectors, diphenhydramine in combination with the auto-injector, asthma inhalers, and nebulizers to children in their care receiving child care subsidy.Which LEGCCP do not need to complete the health care plan?Any LEGCCP that will not give children any medicine other than:over-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellent (TO/S/R’s); ANDchild-specific emergency medications: asthma inhalers, nebulizers, epinephrine auto-injectors, and diphenhydramine in combination with the auto-injector.Any LEGCCP that does NOT wish to apply for an enhanced rate from its local district. How do I get my program’s Health Care Plan approved?LEGCCP that elect to administer medications other than topical ointments, sunscreen and topically applied insect repellent, or emergency medications (epinephrine auto-injectors, diphenhydramine in combination with the auto-injector, asthma inhalers, and nebulizers) must have one or more designated, qualified medication administrant; have their health care plan reviewed and approved by a qualified health care consultant (HCC), as explained in these instructions; and, following the approval by the HCC, submit the Health Care Plan for Legally-Exempt Group Child Care Program to the Enrollment Agency for review.LEGCCPs that do not wish to administer medications other than topical ointments, sunscreen and topically applied insect repellent, or emergency medications (epinephrine auto-injectors, diphenhydramine in combination with the auto-injector, asthma inhalers, and nebulizers) but want to apply for the enhanced rate must submit their completed health care plan to their local enrollment agency for review and approval. Is the program required to give the child’s parent a copy of the health care planIf a program is administering medications, the plan must be on site and available upon demand by a parent, and the program is required to notify parents of its policies and procedures at enrollment and when substantive changes are made. What sections of the health care plan need to be filled out?Complete all the appropriate sections that apply to the program and its decision on administering medications. Enhanced Rate Only (No medications)Sections 1-6; 11 and 13Over-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellantSections 1-7; 11 and 13Child-specific epinephrine auto-injectors, diphenhydramine in combination with the epinephrine auto-injector, asthma inhalers and nebulizersSections 1-6; 8; 11 and 13Prescription and Over-the-counter medications not included above (MUST HAVE Health Care Consultant Approval)Sections 1-6; 9; 11-13Stock MedicationsSections 1-6; 10-11; 13NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICEShow to fill out the health care plan for legally-exempt group child care programSECTION 1: Program InformationAll programs must complete this section.Provide all the information about the program requested.Please note that Health Care Plan Legally-Exempt Group Program is site (place) specific. If you give child care at different places, then you must complete a Health Care Plan for Legally-Exempt Group Program and an enrollment form for each location. SECTION 2: IMMUNIZATIONSThe program must follow the OCFS regulations regarding children’s immunizations and the maintenance of immunization records. SECTION 3: DAILY HEALTH CHECKSDaily health checks must be conducted daily for each child upon their arrival to program. A daily health check is an assessment of a child’s overall all health each day done through observations and interactions with the child, and when applicable, a conversation with the parent/caretaker. Check the box that indicates the procedure the program will use for conducting these daily health checks. If the program chooses to use a procedure that is different from that which is found in Appendix A, explain the procedure in the space provided, attaching additional pages as needed. Check the box that indicates the form the program will use to document the completion of this mandatory requirement. If the program chooses to use a form other than that of the OCFS-LDSS-7026-1, Attendance Sheet for Enrolled Legally-Exempt Child Care Program, a copy of the form must be attached for review and approval. D. The program must document any signs of illness, communicable disease, injury and/or suspected abuse/neglect for each child. Check the box/boxes that show where the program will keep this documentation. E. The program must have a procedure in place for caring for children who develop symptoms of illness while in care. Check the box/boxes that reflect the procedure the program will follow. SECTION 4: EMERGENCY PROCEDURESThe program should maintain emergency information for every child enrolled. Check the box that indicates the form(s) the program will use to record the emergency contact information for each child, if any. Check the box that indicates the location(s) where this emergency contact information will be kept, if any. The program must have policies and procedures in place regarding how professional assistance will be obtained in emergency situations. SECTION 5: FIRST AID KITOCFS regulations require that the program maintain a well-stocked first aid kit that is accessible for emergency treatment. List ALL the location(s) where the first aid kit(s) will be stored. The first aid kit(s) must be kept stocked to treat a broad range of injuries and situations. OCFS provides a list of supplies that may be included in the program’s first aid kits. Please check off which supplies your program includes in the first aid kit(s). In the box beneath the list, write in any additional supplies the program will keep in the first aid kit(s). Programs may elect to keep the following items in the first aid kit: Non-child-specific over-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellantNon-child-specific over-the-counter medication Child-specific emergency medicationNon-child specific stock emergency medications (epinephrine auto-injectors) Choose which of the above options the program will keep in the first aid kit(s). List the specific names of the applicable contents in the spaces provided. The program must have a procedure for monitoring and replenishing the first aid kit(s). Place a checkmark in each box that reflects ALL the instances when program staff will check and replenish the supplies within the kit. NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICEShow to fill out the health care plan for legally-exempt group child care programSECTION 6: HEALTH CARE PROCEDURES AND ADMINISTRATION MEDICATIONChild HealthThe program may choose to identify the wellness level(s) of children that it will care for: well children, mildly ill children and/or moderately ill children. Place check marks in the boxes to show the categories of children the program cares for. B. Infection Control The program should check off if they have infection control procedures in place relating to each item listed in this section. The program may follow the protocols provided by OCFS. They may also create their own to use instead of or in addition to the OCFS protocols. Check the box indicating if the program uses any of the procedures for each applicable method of reducing the risk of infection. If the program chooses to also use a procedure in addition to the attached OCFS protocols, a copy of the procedure must be attached for approval.C. Staff Health PoliciesThe program must ensure staff meet all medical requirements per regulation.The program may check a box to state if the program does or does not have criteria in place for staff/volunteers to return to the program after contagious disease and/or serious illness. D. Program Policy on the Administration of Medication to Children in CareThe program must have a policy regarding the administration of medication to children in its care, including whether it will administer medication(s) and if so, the extent to which the program will administer medication. The program must notify all parents of the program’s policies pertaining to the administration of medication. The program may choose to administer the followingOver-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellant Child-specific epinephrine auto-injectors, diphenhydramine in combination with the auto-injector, asthma inhalers, and nebulizers Prescription medication and over-the-counter medication not included above. Non-child Specific stock epinephrine autoinjectors Check the box(es) that accurately reflect(s) the program’s decision on the administration of medication. If the program has opted NOT to administer any type of medications, explain in the space provided how the needs of any child who requires medication not administered by the program during program hours will be met.Who May Administer Medication The parent, or a person who is a relative, at least 18 years of age, who is within the third degree of consanguinity of the parents or step-parents of the child, even if the parent is an employee or volunteer at the program, may administer medication ONLY to the child he/she is related to while the child is attending the program, even if the program is not approved to administer medication.F. Documenting Medication Administration by Parent and RelativeThe administration of medication by parent or relative must be documented as stated in the health care plan. G. School Age Children Exemptions for Carrying and Administering MedicationThe program must follow the specified instructions when a school-age child will be carrying and using an inhaler or epinephrine autoinjector device while in care. H. Forms and PermissionPrograms which administer medication must document medication usage, any observed side effects and consent. When medication is given to a child, the dosage, time administered, and any observed side effects must be documented. The program may use the specified OCFS form as indicated in the chart or an approved equivalent. If the program uses its own form then the program must check the box to indicate such and it must be attached for approval. NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICEShow to fill out the health care plan for legally-exempt group child care programSection 7: PROGRAMS THAT WILL ADMINISTER OVER-THE-COUNTER TOPICAL OINTMENTS, LOTIONS AND CREAMS, SPRAYS, INCLUDING SUNSCREEN PRODUCTS AND TOPICALLY APPLIED INSECT REPELLANTTopical Ointments, Lotions, and Creams, Sprays, Including Sunscreen Products, and Topically Applied Insect RepellantThe program must have parental permission to apply any over-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellant (TO/S/R). All TO/S/R must be stored in a clean area that is inaccessible to children. Write in the space provided the place(s) in which these supplies will be stored. All over-the-counter TO/S/R applied to a child during program hours must be documented. The program must use either the OCFS-LDSS-7004, Log of Medication Administration or an approved form. Check the box(es) that accurately indicates the form the program will use to document these applications. If the program chooses to use its own form it must be attached for approval. The program may choose to apply over-the-counter TO/S/R that is supplied by the parent, part of the program’s stock supply or both. Check the box(es) that accurately indicate if the program will apply over-the-counter TO/S/R that is supplied by the parent and/or if they will maintain a stock of over-the-counter TO/S/R to be available for use on children whose parents have given permission. The program may include a written procedure describing how the program will protect/handle/care for children for which they do not have parental permissions for TO/S/R, such as sunscreen or insect repellant. Section 8: PROGRAMS THAT WILL ADMINISTER CHILD-SPECIFIC EMERGENCY MEDICATIONS: EPINEPHRINE AUTO INJECTORS, DIPHENHYDRAMINE IN COMBINATION WITH THE EPINEPHRINE AUTO-INJECTOR, ASTHMA INHALERS, AND NEBULIZERSEmergency medications include the administration of child-specific epinephrine auto-injectors, diphenhydramine in combination with the epinephrine auto-injector, asthma inhalers and nebulizers. The program must obtain the appropriate permissions and instructions on the use and administration of the emergency medications. The program must adhere to the policies stated in this section. In the space provided, explain where the program will store these devices and medications. Section 9: ADMINISTERING MEDICATION (PRESCRIPTION AND OVER-THE-COUNTER MEDICATIONS THAT REQUIRE HEALTH CARE CONSULTANT APPROVAL)ONLY programs that choose to administer prescription and over-the-counter medications in addition to those listed in Section 7 and 8 must fill out this section. A. Qualifications of the Medication Administrant OCFS requires that the program designate at least one person, who is legally permitted, to administer medication to children in care, to act as a medication administrant. If the program has more than one medication administrant, please copy and complete this section for each person.For each designated person, complete the following information:Name: Give full nameRole: State their role at the program (director, caregiving staff, etc.)Basic Requirements: Show that the person(s) designated meets the basic requirements for age and literacy by checking the boxes next to each requirement.Qualifications:The person administering medication may have completed the required OCFS training requirements or may be a medical professional. (Choose either a. or b., to show how this person is qualified to administer medication.) NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICEShow to fill out the health care plan for legally-exempt group child care programChoice a: Certified to Administer Medication-The person designated to give medicine meets OCFS training requirements. Choose this if the person has completed the three required trainings: Cardio-pulmonary Resuscitation (CPR), First Aid, and Medication Administration Training (MAT). Check off the box in front of the training course to show that it has been completed.Fill in the certification date for each training. This is the date the designated person completed training. It is found on the training completion certificate. Fill in the expiration date for each training. This is the date that the training certificate expires. For example, the MAT certificate will expire three years after the certification date. An expired certificate is not valid. Please Note: You must make sure the person giving medicine gets re-certified, in each area, before the certificates expire. You must update this part of the plan with the new information, by attaching a page. You must keep the original training certificates and re-certifications for MAT, CPR and First Aid, on-site and accessible at inspection, to prove the qualifications of the person designated to give medicine. Choice b: Authorized-The person designated to give medicine is a trained medical professional with a license issued by NYS Department of Education or certification issued by the NYS Department of Health.Specified trained medical professionals are not required to attend the MAT, first aid or CPR trainings. Choose this option if the person designated to give medicine has:a current, professional license under NYS Education Law in the profession of:practical nurse, physician, physician’s assistant, nurse practitioner, orregistered nurse.OR has a current certification from the NYS Department of Health as an:Advanced Emergency Medical Technician.The medical license/certification must be issued by NYS and must be current. The designated person may not administer medicine if the professional license or certification is expired. Provide the requested information. Type of license or certificate: This is the person’s professional occupation, as found on the license. License or certificate number: This is the individual’s license/certificate number as is found on the license/certificate.Expiration Date: This is the date that the license or certificate expires and is found on the license. If the license/certification has expired, then it is considered invalid.Attach a copy of the medical license or certification to the Health Care Plan for Legally-Exempt Group Program You can confirm that a medical license is valid by contacting the NYS Education Department, Office of the Professions. Telephone: (518) 474-3817Internet Site: Address: New York State Education Department, Office of Professions State Education Building 89 Washington Avenue, Albany, NY 12234 You can confirm that a certificate for an advanced EMT is valid by completing the Verification of NYS Certification form (available at ) and emailing it to mailto:emsverifications@health..NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICEShow to fill out the health care plan for legally-exempt group child care programB. Administering Medication State whether a medication administrant will be on site at all times. Explain in the space provided how a child’s medication needs will be met if a medication administrant is not on site. C. Parental/Caretaker Permission and Health Care Provider Instructions Required Before Administering MedicationThe program must obtain the required parental/caretaker’s permission and the health care provider instructions before giving medicine. The two OCFS forms, the OCFS-7002, Written Medication Consent Form and the OCFS-7003, Verbal Medication Consent Form, must be used to record the parent’s/caretaker’s permission and the health care provider’s instructions. D. Administering Medication with Verbal Permissions and Instructions The program must follow this specific protocol to administer medication with verbal permission. E. Keeping Track of Medicine Dosages and TimeThe program must follow the policies and procedures for keeping track of dosages and times. Written instructions from the licensed authorized prescriber are required for any changes to dosage, time or frequency of administration of the medication. Any other changes require a new prescription. In question 6, the program must have a method in place to alert the person designated to give medicine when the health care provider instructions for giving a medicine does not match the instructions on the label. In the space provided, the program must describe your method for doing this. For example, you could attach a red dot sticker to the medicine container whenever the health care provider has issued instructions that are different from those on the container. The red dot would signal to the person designated to give medicine that the instructions have changed. The designated person would then refer to the child’s chart for the current medicine administration instructions.F. Storage and Disposal of Medications including Controlled SubstancesThis section discusses the program’s procedures for storage and disposal of medication. In the space provided, please explain all the places medication will be stored. Please also check off the applicable times in which a program will check for out-of-date or leftover medications. Section 10: STOCK MEDICATION PROCEDURESThis section is to be completed only by those programs that wish to have a supply of stock medications for the program’s use. As a rule, only non-prescription medicines can be stock medications. However, the program may choose to stock non-patient specific epinephrine auto-injectors (such as EpiPen). To do so, the program MUST also comply with Appendix H: Procedures for Programs that Will Administer Stock Non-Patient Specific Epinephrine Auto-Injectors. The program will only be allowed to use stock medicine if the health care consultant indicates approval of these procedures on the approval page. Check the box(es) of the medications which the program wishes to stock.Section 11: STATEMENTSConfidentiality StatementThe program must comply with confidentiality requirements. Information about any child in the program is confidential and will not be given to anyone other than OCFS, its designees or other persons authorized by law.Americans with Disabilities Act (ADA) StatementThe program must comply with all the provisions of the Americans with Disabilities Act. Enrolled Legally-Exempt Group Program StatementThis section restates a few key points of the Health Care Plan for Legally-Exempt Group Program. Read this section and complete the information requested at the bottom.By signing this section, the program agrees to follow the health care plan as written and all regulations applicable to legally-exempt group programsSection 12: CHANGES TO THE HEALTH CARE PLAN FOR ADMINISTRATION OF MEDICATION This section describes the procedures a program needs to agree to follow in regard to any changes (updates, renewals, amendments and/or revocations) for programs that administer medication. Check the boxes stating whether the program agrees to follow the describes policies and procedures. NEW YORK STATEOFFICE OF CHILDREN AND FAMILY SERVICEShow to fill out the health care plan for legally-exempt group child care programSection 13: APPROVALS A. Health Care Consultant Approval Health care consultant (HCC) means a physician, physician assistant, nurse practitioner or registered nurse who possesses a valid New York State License in his or her field. Such consultant may include a health care professional who is an employee of a local Health Department. The HCC may not serve in the employment of the LEGCCP in any other role.Approval by a HCC is required when the program is choosing to administer medications other than over-the-counter topical ointments, and creams, lotions and creams, sprays, including sunscreen products and topically applied insect repellant, and/or, epinephrine auto-injectors, diphenhydramine in combination with the auto-injectors, asthma inhalers, and nebulizers and/or stock medications.The HCC is responsible for visiting the child care program, reviewing the health care plan and, upon verification that it meets OCFS requirements approving the health care plan. As part of the review and approval process, the HCC mustreview the qualifications of the designated medication administrantverify medication administrant are qualified to give medication to children in the program’s care, and confirm the program has developed a safe and reasonable plan to give medication. The approval of the HCC is valid for up to two years or whenever the policies, procedures need to change.The HCC must completely fill out the approval section. All information must be legible and the license number must be verifiable through the NYS Office of the Professions. Enrollment Agency ApprovalApproval by the enrollment agency is required when● the health care plan has not been approved by a HCC and a program wishes to apply for the enhanced rate. ................
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