10A NCAC 70K .0204       PROGRAM OF CARE

(a)  The program of care shall be suited to the needs of adolescent and adult women experiencing an unplanned pregnancy.  There shall be opportunity provided for private time, for family contacts, and for group fellowship.

(b)  The residents shall be free from duress to make their own decisions about releasing or keeping their babies.

(c)  The residents shall be provided confidentiality concerning their situations and protection from harm insofar as possible.

(d)  Educational opportunities shall be provided or arranged by the residential maternity home in accordance with the needs of individual residents and resources available in the community.  For those residents who are required to attend school under the compulsory school attendance laws of North Carolina, the maternity home shall arrange for attendance in a public or a nonpublic school which is operated in accordance with the laws of North Carolina.  If a school or educational program is maintained and operated by the maternity home which residents attend in lieu of attending public schools, the maternity home shall comply with the North Carolina General Statutes governing nonpublic schools. Opportunity shall be offered to residents who wish to participate in educational courses available in the community.

(e)  Health education including information about pregnancy, delivery, and family planning services shall be provided residents.  Information about the care of infants shall be made available to the residents who want this information.

(f)  Recreational activities shall be provided which meet the needs of residents.  Suitable space shall be provided at the maternity home for both indoor and outdoor activities.  Participation in community activities shall be provided. 

(g)  Work assignments in the maternity home shall be geared to the physical health and emotional well-being of the residents in care. Residents shall be given the opportunity to voluntarily seek paid employment when employment is in accordance with the recommendation of their licensed medical provider and other professional staff of the maternity home.  No resident shall be required to work for the purpose of paying the maternity home for her care.

(h)  The maternity home shall define in writing and make available to applicants and residents those rules and regulations which the residents shall be expected to follow.  These rules and regulations shall respect the personal freedom of the residents.  These rules and regulations shall not infringe on the residents' rights to send and receive uncensored mail and for planned visits with their families and others.  Visitors shall not be allowed to visit minors without prior consent of the parents or guardian, or legal custodian.

(i)  Nutritious, foods shall be provided in the variety and amounts necessary to meet the National Research Council's Recommended Daily Dietary Allowances (USDA Center for Nutrition Policy and Promotion, 1120 20th Street, NW, Suite 200N, Washington, DC  20036).  Special diets shall be planned to meet the modified needs of individual residents as prescribed by a licensed medical provider. Menus shall be planned and written by, or in consultation with, a licensed dietician/nutritionist.  Menus shall be planned and written at least one week in advance.  Snacks shall be recorded on the regular menu.

(j)  Each resident shall be provided prenatal care and general health care by a licensed medical provider which includes:

(1)           a complete medical and obstetrical history and examination before or within one week after admission to the home;

(2)           periodic examinations during pregnancy as outlined by the licensed medical provider;

(3)           dental services as needed; and

(4)           medical services as needed.

(k)  Each resident shall be provided delivery care in a licensed hospital or any facility licensed as a place for delivery of babies.

(l)  All prescription and non prescription medicines shall be stored in a locked cabinet, closet or box not accessible to residents.  The agency shall have written policies and procedures regarding staff administering medications to residents that shall be discussed with each resident and their parents or guardian, or legal custodians (if resident is a minor) prior to or upon placement.  These policies and procedures shall address:

(1)           medication administration;

(2)           medication dispensing;

(3)           packaging, labeling;

(4)           storage and disposal;

(5)           review;

(6)           education and training; and

(7)           documentation, including medication orders, Medication Administration Record (MAR); orders and copies of lab tests; and, if applicable, administration errors and adverse drug reactions.

The residential maternity home shall maintain a MAR for each resident that documents all medications administered. Upon discharge of a resident, the residential maternity home shall return prescription medications to the resident or person or agency legally authorized to remove the minor from residential maternity care.  The residential maternity home shall provide oral or written education to the resident or person or agency legally authorized to remove the minor from residential maternity care regarding the medications.  Unwanted, out-dated, improperly labeled, damaged, adulterated or discontinued prescription medications shall be returned to a pharmacy for disposal.

(m)  The residential maternity home shall ensure that first aid kits are available for immediate use in each living unit, recreation area and in vehicles to transport residents.  A residential maternity home shall obtain a mouthpiece and other precautionary equipment for administering CPR to the residents.

(n)  When residents return to the maternity home, post delivery care shall be available to the residents in accordance with the recommendations of the resident's licensed medical provider and the professional staff of the maternity home.  A resident shall not be required to remain in the maternity home after medical discharge.  Referral to a licensed medical provider or medical clinic or community family planning resource shall be made if requested by the resident.

(o)  A resident and her infant may be considered for aftercare if the resident was in residential care prior to delivery.

(p)  The period of aftercare for the resident and her child shall not exceed 12 consecutive months, during which time a plan for independent living shall be developed with the resident and assistance provided in achieving the goal of the plan within the designated time frame.

(q)  Services provided for the plan of independent living shall include:

(1)           parenting preparation classes;

(2)           stages of growth in infants, children and adolescents;

(3)           day-to-day care of infants, children and adolescents;

(4)           disciplinary techniques for infants, children and adolescents;

(5)           education planning;

(6)           job seeking skills;

(7)           locating housing;

(8)           money management;

(9)           food management;

(10)         child-care;

(11)         health education;

(12)         stress management;

(13)         life skills;

(14)         decision making;

(15)         substance abuse;

(16)         pregnancy prevention; and

(17)         other services based on the needs of the resident.

(r)  A case record shall be maintained at the maternity home for each resident which includes documents concerning all social work, counseling, medical, psychological, and dental services, as well as any other services provided to each resident.

History Note:        Authority G.S. 131D-1; 143B-153;

Eff. February 1, 1986;

Amended Eff. November 1, 2009; October 1, 2008; June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. April 5, 2016.