Early Intensive Development and Behavioral Intervention Manual

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Early Intensive Development and Behavioral Intervention Manual

EIDBI Benefit Policy Manual Resources Health and safety standards

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Health and safety standards

Page posted: 6/18/15		Page reviewed: 2/21/17	Page updated: 10/30/20
Overview	These health and safety standards provide guidelines for EIDBI provider agencies to help them safely and effectively provide EIDBI services. This page includes information about health and safety standards for: · Physical space and equipment · Emergency preparedness · Food and water provision · Medical requirements · Toileting and sanitation · Service animals. While EIDBI provider agencies are not legally required to follow these health and safety standards, DHS strongly recommends them as best practice. These standards are comparable to the requirements licensed settings must meet, as defined in Minn. Stat. §245D.06 and Minn. R. 9503.0140.
Physical space and equipment	If the EIDBI provider agency is located in an area of the state that: · Adheres to the Minnesota State Building Code, it must comply with the standards specified in the code · Does not adhere to the Minnesota State Building Code, it must comply with all applicable local building ordinances. In addition, the provider agency should follow these physical space and equipment standards. Indoor and outdoor spaces All indoor and outdoor areas used by people should be clean and free from: · Crumbling plaster · Debris · Holes in the walls, floors and ceilings · Litter · Loose, flaking, peeling or chipped paint and/or wallpaper. All outdoor spaces, if owned or leased by the provider agency and used by people, should be: · Enclosed if adjacent to a body of water, railroads, traffic, machinery or other environmental hazards (Note: This does not apply to public parks or playgrounds) · Free of litter, toxic materials, water hazards, machinery, animal waste and sewage contaminants. Hazardous areas and objects The following areas and objects should be inaccessible to people who receive services: · Bodies of water (e.g., ponds, pools, lakes), unless staff are supervising people directly · Electrical outlets, exposed electrical cords and other electrical objects · Hazardous objects (e.g., sharp objects, medicines, plastic bags, household supplies, poisonous plants, chemicals) · Kitchens, stairs and other hazardous areas, unless staff are supervising people directly · Radiators, fireplaces, hot pipes and other hot surfaces. Equipment, furniture and toys All equipment, furniture and toys at the provider agency should be: · Cleaned and disinfected daily and when mouthed or soiled · Durable and structurally stable, following assembly and installation · Free of sharp edges, dangerous protrusions, openings or angles that could crush or trap part of a child's body · Kept in locations that are accessible to a person who receives services (unless this is contrary to their individual treatment plan) · Lead-free · Made of a material that can be cleaned and disinfected easily. Rugs should have a non-skid backing or be firmly fastened to the floor. They should be free from tears, curled or frayed edges and hazardous wrinkles. Environmental adaptations The provider agency should make reasonable environmental adaptations to meet the specific needs of each person who receives services. Personal storage space The provider agency should provide an accessible, separate, personal storage space for each person who receives services. Room temperature The provider agency should keep indoor areas used by people who receive services between 68 and 85 degrees Fahrenheit.
Emergency preparedness	The provider agency should follow these emergency preparedness standards. Training All staff should be trained in emergency, accident and evacuation procedures. Equipment The provider agency should have the following equipment on site: · Battery-operated flashlight · Battery-operated portable radio · Fire extinguisher and instructions for its use that are accessible to all staff · First aid kit that contains sterile bandages, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer and adhesive tape · First aid kit manual that is accessible to all staff · Additional first aid kit and manual for staff to take with people who receive services if they travel off site · Landline telephone that is accessible to all staff. Fire and fire extinguisher inspection The provider agency should have a fire marshal inspection on file before it enrolls with Minnesota Health Care Programs (MHCP) as an EIDBI provider agency. If DHS has reasonable cause to believe a potential hazard exists, DHS may request another inspection and written report by a fire marshal, building official or health authority. A qualified inspector must service all fire extinguishers annually. The name of the inspector and date of the inspection should be written on a tag attached to the extinguisher. Emergency information The provider agency should identify and visibly post the following information on site: 1. A list of staff responsible for each area of the facility in case of an emergency 2. Evacuation routes from the facility 3. Instructions on how to close off a fire 4. List of emergency numbers posted next to the telephone for: · Emergency medical and dental care · Local fire department · Police department · Emergency transportation · State health authority · Poison control center 5. Primary and secondary exits from the facility 6. Tornado shelter area 7. Written emergency and accident procedures.
Food and water	Most provider agencies require the person’s parent/primary caregiver to provide meals, snacks and drinks (other than water) for the person. If the provider agency, rather than the family, provides food for the person, it should meet the following food and water requirements. Menus and food preparation If the provider agency prepares and supplies food for people who receive services, it should ensure: · Menus comply with the nutritional requirements of the United States Department of Agriculture, Food and Nutrition Service, 7 C.F.R. §226.20 · Procedures for preparing, handling and serving food and washing food, utensils and equipment comply with the requirements for food and beverage establishments in Minn. R. 4626. If a food service provider other than the provider agency provides food, it should ensure the food is prepared in compliance with Minn. R. 4626. Dietary needs The person (or their parent/primary caregiver) determines their diet. If the person has special dietary needs identified by their medical provider or parent/primary caregiver and the provider agency provides food, the agency should serve food that meets the person’s needs. If the special dietary items are not part of the provider agency’s food menu, however, the agency can require the person or their legal guardian to provide them. The provider agency should: · Document the person’s special dietary needs and the duration of those needs in the person’s health record · Inform all staff who provide services to the person of their special dietary needs. Food allergy If the person has food allergies, the provider agency should: · Inform all staff who provide services to the person of their food allergies · Make information about the person’s food allergies available in food preparation and serving areas. Meals and snacks availability The provider agency should either provide the following or ensure they are available to the person: · One snack if the person receives services at the agency for more than two hours but less than five hours · Either one meal and two snacks, or two meals and one snack if the person receives services at the agency for five or more hours. An EIDBI staff member should sit with and oversee the person during meal and snack times. Food storage The provider agency should refrigerate all perishable foods, including food the person or their parent/primary caregiver supplies. The temperature of the refrigerator should be 40 degrees Fahrenheit or less. Sanitation The provider agency should: · Use sanitary procedures to prepare, handle and store all food and drinks and clean dishes and utensils provided to the person by the agency · Wash surfaces used for meals (e.g., tables, highchair trays) with soap and water before and after each use. Water The provider agency should: · Have a safe water supply · Have drinking water available to people who receive services throughout its hours of operation · Offer drinking water to people who receive services at frequent intervals. If a provider agency uses water from a privately owned well that is not governed by Minn. R. 4720, it should have a Minnesota Department of Health-certified laboratory test the water for coliform bacteria and nitrates. The agency should keep the test results in its administrative record.
Medical	The provider agency should follow these medical standards. Information The provider agency should have the following information in the health service record that is on file for each person: · The person’s physical and medical status · Emergency contact. This information should be: · Available to staff · Current when the person begins to receive EIDBI services (i.e., last updated no more than 12 months before the service start date) and updated annually thereafter. Sickness If a person who receives services becomes sick at a provider agency, the agency should immediately: · Notify the person’s parent/primary caregiver · Provide a space for them as they wait for transportation home. This space should: · Be separate from areas used by other people who receive services · Have a cot or bed and a blanket for the sick person · Be supervised by a staff member when a sick person is in the space. Reports If an incident occurs while a person is receiving services, the agency staff member who was responsible for the person at the time of the incident should complete a report. For more information, see the incident reports section on EIDBI – Health service records. Contagious disease or condition If a medical or dental provider diagnoses a person who receives services with any of the following diseases or conditions, the person’s parent/primary caregiver should inform the provider agency within 24 hours (not including weekends and holidays): · A contagious, reportable disease specified in Minn. R. 4605.7040 · Chicken pox · Impetigo · Lice · Ringworm · Scabies. The provider agency should include a requirement in its policies that when a person who receives services is diagnosed with one of the above diseases or conditions, the provider agency should notify the: · Legal guardians of all other people who receive services and were exposed to the disease or condition on the same day the agency receives notification from the sick person’s legal guardian · Health authority within 24 hours from when the agency receives notification from the sick person’s legal guardian. Medication If the provider agency administers either prescription or non-prescription medication to a person who receives services, it should: · Have written permission from the person’s legal guardian · Keep all medication in its original container · Label each person’s medication with their name · Only give a medication to the person whose name is on the label · Follow written instructions from either the medication’s manufacturer or a medical provider who is legally authorized to prescribe medications (Note: The person’s name and instructions on the label are considered instructions) · Not administer a medication after its expiration date · Store all medications according to the directions on the original container and in a place inaccessible to people who receive services · Return unused portions to the person’s legal guardian or destroy them. Examples of non-prescription medications that require a legal guardian’s permission to administer include: · Diapering products · Sunscreen lotions · Insect repellents. Each time prescribed medication is given to a person, the provider agency should document the following in the person’s health record: · Person’s name · Medication name or prescription number · Date and time · Dosage amount · Name and signature of the staff member who dispensed it.
Toileting and sanitation	The provider agency should provide: · Toilet paper · Liquid hand soap · Facial tissues · Single-use paper towels or warm-air hand dryers · Private toileting or diapering space for people who are school age and for younger children when the need for this adaptation is written in their individual treatment plan. Toilets for toddlers and preschoolers To meet the needs of toddlers and preschoolers, the provider agency may use a: · Step stool and child-size toilet seat cover to access a regular-size toilet · Child-size toilet · Toilet training chair. Specialized toiletry items If a person needs specialized toiletry items, their legal guardian should provide them. If the legal guardian does provide specialized toiletry items, the provider agency should make instructions for using these items available to all staff who work with the person. Diaper changing The provider agency should change diapers in a diaper changing area or in the bathroom. The diaper changing area should: · Be separate from areas used for food storage, food preparation and eating · Have a hand sink with hot and cold running water within three feet of it · Have a smooth, nonabsorbent surface and floor covering · Have a sanitary container for soiled and wet diapers · Include posted diaper-changing procedures. Hand washing Staff should monitor and assist a person who needs help with hand washing. A person should wash their hands or be assisted with washing their hands with soap and water: · After their diaper is changed · After they use a toilet or toilet training chair · Before they eat a meal or snack. Staff should wash their hands with soap and water: · After they change a child’s diaper · After they assist a person with toileting or eating · After they use toilet facilities · Before they handle food, eat or assist a person with eating. For additional resources and guidelines, reference: · Center for Disease Control and Prevention guidelines for health-care settings (PDF) · Minnesota Department of Health guidelines for hand hygiene · World Health Organization guide for health care professionals (PDF). Hand sinks and steps The provider agency should not use a common basin or hand sink filled with standing water. The provider agency should have hand sinks available in the toilet area. Hand sinks in the toilet area should not: · Be used for custodial work or food preparation. · Exceed 120 degrees Fahrenheit for hot water temperature. The provider agency may use sturdy and washable portable steps to meet hand-washing needs of toddlers and preschoolers. Cleaning The provider agency should: · Clean toilet facilities daily · Empty, wash (with soap and water) and disinfect toilet training chairs after each use · Wash (with soap and water) and disinfect toilets and toilet seats daily and whenever soiled.
Service animals	If service animals or therapy animals are present at the provider agency, the agency should notify people’s legal guardians that an animal is present. To learn more, see U.S. Department of Justice – Frequently asked questions about service animals and the Americans with Disabilities Act (ADA).
Additional resources	EIDBI – Resources EIDBI – Rights and responsibilities

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