CALIFORNIA CODE OF REGULATIONS - State of California

Page 565
TITLE 15. DIVISION 4 — DEPARTMENT OF THE YOUTH AUTHORITY § 4734
Division 4. Department of the Youth Authority
Chapter 3. Institutions and Camps Services
Subchapter 3.
Article 1.
Services to Wards
Medical and Dental Services
§ 4730. Medical and Dental Treatment.
Medical and dental treatment shall be provided Youth Authority
wards according to the following guidelines:
(a) Emergencies, acute illnesses, and traumatic conditions of
recent origin shall be treated promptly.
(b) Emergent conditions shall be treated when such treatment is
indicated for the welfare of the individual in order to preserve health,
prevent permanent disability, or prevent permanent impairment of the
health and welfare of the ward. In borderline cases, health care
decisions shall be based upon the judgment of the physician or the
dentist acting in accordance with the guidelines for the Utilization
Review Committee.
(c) Ongoing medical treatment which is necessary for the
maintenance of health, including the treatment of chronic conditions
such as diabetes mellitus or epilepsy, shall be provided.
(d) Significant functional defects, which would include those
incurred prior to Youth Authority commitment or while in a Youth
Authority facility, may be corrected if:
(1) There is marked functional disability, or
(2) The delay in the correction of such a disability would result in
further loss of function or health impairment.
(e) A ward requiring extensive or long–term medical, surgical, or
psychiatric treatment shall, when possible, be considered for return to
the committing county or home environment for such care.
(f) Correction of cosmetic defects shall not be provided except
where there is marked clinical evidence and expectation that the
ward’s physical and psychological state may be greatly benefited by
the correction of such cosmetic defect.
NOTE: Authority cited: Section 1712, Welfare and Institutions Code.
Reference: Sections 1001, 1002, 1004, 1752, 1755.3 and 1755.5, Welfare
and Institutions Code.
§ 4731. Treatment Centers.
NOTE: Authority cited: Sections 1001, 1002, 1004, 1711.3 and 1751,
Welfare and Institutions Code. Reference: Sections 1002, 1711.3,
1752, 1755.3 and 1755.5, Welfare and Institutions Code.
§ 4732. Medical and Dental Examination.
(a) A ward shall receive a complete baseline health evaluation,
including a dental examination, and the physician shall record in the
ward’s medical record the following:
(1) The ward’s complete medical history.
(2) Medical findings.
(3) Treatment recommendations.
(b) (Reserved)
(c) A physical examination for a parole violator returned to a
reception center and clinic:
(1) Shall consist of an interval history and physical examination
when the previous medical record is available and when, in the
judgment of the chief medical officer, the previous information is
sufficient.
(2) Shall consist of a complete history, physical examination and
laboratory tests when the medical record is not available.
(d) A ward scheduled for transfer to a camp shall be examined to
determine fitness and shall receive priority for the necessary dental
and/or medical treatment to prepare the ward for camp clearance. The
ward may be held for completion of such treatment before being
transferred to a camp.
(e) A ward returning to a facility after furlough or escape shall not
be permitted to come in contact with other wards until he or she has
been examined for infectious diseases and cleared by medical staff.
(f) A ward shall have a physical examination prior to being
assigned to work as a food handler or in food service areas.
(g) A ward shall receive a physical examination, and the medical
and dental staff shall review his or her medical and dental records
upon notification of a projected date for release to parole. When a
ward with a disability, illness, or condition requiring continuous
medical treatment and medication is released to parole, the chief
medical officer shall approve the provision of a 30 day supply of the
required medication. For those wards prescribed psychotropic
medications that could pose a serious health risk if taken in a suicide
attempt, the chief medical officer shall approve the provision of a
three (3) day supply of medication and a 15 day prescription. This
section does not authorize the dispensing of Drug Enforcement
Administration regulated medication or other drugs of high abuse
potential unless withdrawal could create side effects.
NOTE: Authority cited: Section 1712, Welfare and Institutions Code.
Reference: Sections 1001, 1002, 1004, 1752 and 1755.3, Welfare and
Institutions Code.
§ 4733. Consent for Medical or Dental Treatment.
(a) Consent shall be obtained for all medical or dental treatment.
Treatment and procedures which are complex, as identified by the
physician or dentist, and psychotropic medication require informed
consent. Informed consent is defined as consent which is obtained
without duress or coercion and which clearly and explicitly manifests
consent to the proposed medication, treatment or procedure in
writing.
(b) A ward 18 years of age or older, or a ward who has emancipated
minor status, who is competent to make an informed decision, may
give his or her own consent for medical or dental treatment.
(c) A ward 18 years of age or older or a ward who has emancipated
minor status, who is not competent to give informed consent, is a
ward, who in the professional opinion of a physician or psychiatrist,
is considered incompetent to refuse psychiatric treatment or
psychotropic medication, or lacks the capacity to refuse medical or
dental treatment, or medication. This includes a ward who lacks the
ability to knowingly and intelligently act upon the medical
information provided.
(d) For a ward under 18 years of age, who legally cannot give
informed consent, medical or dental treatment shall be given as
follows:
(1) Primary care treatment may be approved by the superintendent
in the event that a parent or guardian cannot be located.
(2) Complex treatment, as identified by the physician or dentist, or
psychotropic medication for wards under 18 require informed consent
from a parent or guardian.
NOTE: Authority cited: Section 1712, Welfare and Institutions Code.
Reference: Sections 1001, 1002, 1004, 1752 and 1755.3, Welfare and
Institutions Code.
§ 4734. Refusal of Medical or Dental Treatment.
(a) A ward, or a parent or guardian if the ward is under 18 years of
age, may refuse medical, surgical, mental and/or dental treatment,
including the administration of medication; and if the treatment is
accepted, may revoke that acceptance at any time in the future.
However, necessary medical or dental treatment may be administered
to a ward, either an adult or a minor, without consent, or in the absence
of a parent or guardian’s consent and against his or her will and in
accordance with Section 4735. Involuntary psychotropic medication
may be administered in accordance with Article 1.5, Section 4747.
(b) The Youth Authority physician or dentist shall explain the
consequences of the refusal to the ward or a parent or guardian if the
ward is under 18 and record the refusal in the medical record,
including a statement of the possible consequences if the medical,
surgical, mental and/or dental treatment is not administered.
NOTE: Authority cited: Section 1712, Welfare and Institutions Code.
Reference: Sections 1001, 1002, 1004, 1752 and 1755.3, Welfare and
Institutions Code.