Health, Health Systems Improvement, Licensing

Rule R432-101

Specialty Hospital - Psychiatric

Notice of Proposed Rule

(Amendment)

DAR File No.: 34318
Filed: 12/20/2010 09:05:49 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

In Section R432-101-17, the change increases public awareness of out-of-state adjudicated delinquent juveniles admitted to licensed psychiatric hospitals in Utah. Some communities in the state are concerned about patients in these facilities and want to ensure that they are appropriately monitored. This amendment was recommended by the Health Facilities Committee and approved on 11/17/2010. This committee has representation from a broad cross section of the entities affected by this rule. In Section R432-101-12, the changes clarify and align the tuberculosis testing requirements for licensed health care facilities in Utah. The clarifications are in accordance with current law and will be consistent with all health facility rules. This amendment was approved by the Health Facilities Committee on 11/17/2010. This committee has representation from a broad cross section of the entities affected by this rule.

Summary of the rule or change:

In Section R432-101-17, this amendment will add a requirement in the admission criteria of the psychiatric hospital for all out-of-state adjudicated delinquent juveniles to be processed and monitored through the appropriate interstate compact. In Section R432-101-12, this amendment will require employee tuberculosis testing to be completed within two weeks of hire, after suspected exposure or development of symptoms.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

These rule amendments will have no effect on state budgets since there will be no change in current practice.

local governments:

These rule amendments will have no effect on local government budgets since there will be no change in current practice.

small businesses:

These rule amendments will have no effect on small businesses since there will be no change in current practice.

persons other than small businesses, businesses, or local governmental entities:

These rule amendments will have no effect on persons since there will be no change in current practice.

Compliance costs for affected persons:

These rule amendments will have no effect on persons since there will be no change in current practice.

Comments by the department head on the fiscal impact the rule may have on businesses:

The public will be protected as a result of these rule changes and the fiscal impact is expected to be minimal but will be carefully evaluated based on public comment.

David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Systems Improvement, Licensing
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at jhoffman@utah.gov
• Carmen Richins at the above address, by phone at 801-538-9087, by FAX at 801-538-6024, or by Internet E-mail at carmenrichins@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

02/14/2011

This rule may become effective on:

02/21/2011

Authorized by:

David Sundwall, Executive Director

R432. Health, Health Systems Improvement, Licensing.

R432-101. Specialty Hospital - Psychiatric.

R432-101-12. Infection Control.

(1) The facility shall have a written plan to effectively prevent, identify, report, evaluate and control infections.

(2) The plan shall include a method to collect and monitor data and carry out necessary follow-up actions.

(3) Infection control actions shall be documented consistent with the requirements of the plan and in accordance with Department requirements and standards of medical practice.

(4) In-service education and training of employees shall be provided to all service and program components of the hospital.

(5) The infection control plan shall be reviewed and revised as necessary, but at least annually.

(6) The hospital shall implement an employee health surveillance program and infection control policy which meets the requirements of R432-100-10 and the following:

(a) complete at the time a person is hired, an employee health inventory that includes the following:

(i) conditions that may predispose the employee to acquiring or transmitting infectious diseases;

(ii) conditions that may prevent the employee from satisfactorily performing assigned duties.

(b) develop employee health screening and immunization components of personnel health programs in accordance with Rule R386-702, concerning communicable diseases;

(c) [conduct] employee skin testing by the Mantoux Method or other FDA approved in-vitro serologic test and follow up for tuberculosis shall be done in accordance with R388-804, Special [concerning m]Measures for the C[c]ontrol of T[t]uberculosis .[:]

(i) The licensee shall ensure that all employees are skin test ed[ing] for tuberculosis within two weeks of: [must be conducted on each employee annually and after suspected exposure to a resident with active tuberculosis;]

(A) initial hiring

(B) suspected exposure to a person with active tuberculosis; and

(C) development of symptoms of tuberculosis.

(ii) all employees with known positive reaction to skin tests are exempt from skin testing.

(d) report all infections and communicable diseases reportable by law to the local health department in accordance with Section R386-702-2, concerning reportable diseases; and

(e) comply with the Occupational Safety and Health Administration's Bloodborne Pathogen Standard.

 

R432-101-17. Admission and Discharge.

(1) The hospital shall develop written admission, exclusion and discharge policies consistent with the Plan for Patient Care Services and the Utilization Review plan. These policies shall be available to the public upon request.

(2) The hospital shall make available to the public and each potential patient information regarding the various services provided, methods and therapies used by the hospital, and associated costs of such services.

(3) Admission criteria shall be clearly stated in writing in hospital policies.

(a) The facility shall assess and screen all potential patients prior to admission and admit a patient only if it determines that the facility is the least restrictive setting appropriate for their needs. The pre-screening process shall include an evaluation of the patient's past criminal and violent behavior.

(b) Patients shall be admitted for treatment and care only if the hospital is properly licensed for the treatment required and has the staff and resources to meet the medical, physical, and emotional needs of the patient.

(c) Patients shall be admitted by, and remain under the care of, a member of the medical staff. There shall be a written order for admission and care of the patient at the time of admission. A documented telephone order is acceptable.

(d) There shall be procedures to govern the referral of ineligible patients to alternate sources of treatment where possible.

(e) Involuntary commitment must be in accordance with Section 62A-12-234.

(f) All out of state adjudicated delinquent juveniles admitted to the hospital shall be processed and monitored through the appropriate Interstate Compact.

(4) The patient shall be discharged when the hospital is no longer able to meet the patient's identified needs, when care can be delivered in a less restrictive setting, or when the patient no longer needs care.

(a) There shall be an order for patient discharge by a member of the medical staff except as indicated in R432-101-17(4)(b) below.

(b) In cases of discharge against medical advice, AMA, the attending physician or qualified designee shall be contacted and the response documented in the patient record.

(c) Discharge planning shall be coordinated with the patient, family, and other parties or agencies who are able to meet the patient's needs.

(d) Upon discharge of a patient, all money and valuables of that patient which have been entrusted to the hospital shall be surrendered to the patient in exchange for a signed receipt.

 

KEY: health facilities

Date of Enactment or Last Substantive Amendment: [May 1, 1997]2011

Notice of Continuation: December 13, 2010

Authorizing, and Implemented or Interpreted Law: 26-21-2.1; 26-21-5; 26-21-6; 26-21-20