(1) Licensees must obtain immediate medical care for a medical emergency, per WAC 110-145-2930.

(2) Obtaining health history information. Licensees must attempt to obtain all information relevant to children's or youth's emergent medical needs upon admission:

(a) This information must include:

(i) Allergies;

(ii) Physical or mental health conditions, including injuries;

(iii) Dental or optometry conditions;

(iv) Medications they are currently taking; and

(v) Other treatments they are receiving; and

(b) Licensees may gather this information from:

(i) Observation;

(ii) The child or youth;

(iii) The child's or youth's health record; or

(iv) The child's or youth's representatives.

(3) If the child or youth has immediate physical, mental health, dental, or optometry needs, the licensees must arrange for care as necessary.

(4) Licensees must follow the schedule outlined by DOH for routine dental exams for children and youth in care.

(5) Initial health screens. Licensees must take children or youth to a licensed health care provider for an initial health screen, except for interim facilities:

(a) When the children or youth enter out-of-home care for the first time or it is their first placement other than having been in interim facilities; and

(b) As soon as possible, but no later than 14 calendar days after entering the licensee's care; or

(c) Unless the child or youth:

(i) Came to the facility from a hospital or pediatric interim care;

(ii) Is receiving services through a child or youth advocacy center or sexual assault clinic;

(iii) Has had an EPSDT exam in the last 30 calendar days;

(iv) Receives an EPSDT exam within the first 14 calendar days of entering the licensee's care; or

(v) Entered DDCS services as a community child or youth with an out-of-home services agreement.

(6) Licensees must:

(a) Verify the initial health screen is conducted by the children's or youth's established licensed health care providers if possible; or

(b) Work with the children's or youth's representatives if it is not possible to see their established licensed health care providers.

(7) EPSDTs. Licensees must, except for interim facilities:

(a) Take children and youth to a licensed health care provider for an EPSDT exam within the first 30 calendar days of entering the licensee's care, unless they have had an EPSDT exam in the last 30 calendar days;

(b) Obtain a copy of documentation of the EPSDT exam;

(c) Verify the EPSDT documentation:

(i) Is signed by the licensed health care provider; and

(ii) Identifies any:

(A) Chronic medical issues;

(B) Immediate health concerns; and

(C) Follow-up actions or appointments needed;

(d) Notify the child's or youth's representatives of the date of the scheduled exam if an appointment with a licensed health care provider is not available within the required time frames in this section; and

(e) Follow the schedule outlined by a licensed health care provider for subsequent periodic EPSDT exams.