Section 641.80  Access Standards


The Center must establish procedures for the availability of primary care providers and for access to routine, urgent and emergency care, telephone appointments and advice.


a)         Availability of Services


1)         The Center operations must ensure that:


A)        the facility provides 24 hour coverage, 12 months a year;


B)        services are accessible either on-site or through formal referral;


C)        services are convenient to students and include, as necessary, before or after school hours;


D)        working parents, to the maximum extent possible, are accommodated in the health care of their children;


E)        urgent appointments can be handled within the same day and/or the following day;


F)         scheduled appointments do not unnecessarily interrupt the student's classroom time;


G)        services are available in multiple languages as appropriate for the student population;


H)        non-urgent appointments are offered within seven days or through formal referral;


I)         no medical experimentation or invasive research is done on students; and


J)         telephone answering methods are in place to notify students and parents where and how to access 24 hour back-up services when the Center is not open.


2)         The Center, in response to the cultural and language needs of the student body, must ensure that staff are educated in cultural diversity and that interpreting and translation services are provided by staff or interpreters in a manner that ensures confidentiality.


3)         The Center cannot deny access to health care services to students based upon insurance status or ability to pay.


4)         The Center cannot discriminate with regard to race, color, religion, national origin, age, handicap or sex. (See 775 ILCS 5/1-102)


5)         The Center must be accessible to students with disabilities and conform to requirements of the Americans With Disabilities Act (42 USC 12204; 36 CFR 1191).


6)         The Center must provide services to students in a manner that ensures the student's and his/her family's right to privacy.


b)         Physical Plant


1)         The Center must include an adequate waiting and reception area, office space, private examination and treatment rooms, secure medical record area, and pharmaceutical and supply storage area (office, medical, sterile equipment).  The reception area shall include comfortable chairs, educational materials, pamphlets and a bulletin board.  If laboratory procedures are performed, adequate space for necessary lab equipment and supplies must be available.  (See 42 CFR 493.)


A)        Each examining room shall have a screen or door to permit privacy, an examination table with suitable disposable covers, an examination light, a sink equipped for hand washing with paper towel dispenser, waste receptacle, a storage cabinet, a stool and a counter or shelf for writing.


B)        If dental services are provided, each Center shall have at least one dental operatory included as a component of its facility.


C)        The Center shall have the following equipment available:  microscope, sphygmomanometer; stethoscope; measuring tape; reflex hammer; ophthalmoscope; scale; supplies for obtaining wet slide preparations and bacterial smears, specimens, cultures and cytologic studies; and a centrifuge for hematocrit.


D)        Meeting space shall be available within or near the Center.


E)        Adequate space shall be provided for staff personal belongings.


F)         A multi-purpose room shall be available for conferences and health education purposes, including provision for showing visual aids to individuals and/or groups.


2)         The Center must comply with laws and regulations governing health facilities.


A)        The Center staff must have training, supplies and equipment necessary to follow infection control practices as defined by OSHA. (See 29 CFR 1910.1030.)


B)        The Center must comply with laws and regulations regarding reportable disease conditions and employee Centers for Disease Control and Prevention (CDC) health policies.


C)        The Center must comply with CLIA regulations regarding laboratory operations. (See 42 CFR 493.)


3)         The Center must have current fire and building safety certificates and appropriate liability coverage.


4)         The Center must provide adequate space to ensure student confidentiality and privacy during exams and/or counseling sessions.


5)         If the Center is located in a separate building from the school, the entrance must be sheltered from the weather and must meet all physical plant requirements of a Center plus the following:


A)        engineering service and equipment areas shall have sufficient space for boilers, furnaces, mechanical equipment and electrical equipment;


B)        waste processing services shall be provided for the sanitary storage and disposal of waste by incineration, mechanical destruction, compaction, containerization, removal or a combination of these techniques;


C)        storage rooms for building maintenance supplies and yard equipment shall be provided; and


D)        janitor's closets shall be provided with a floor receptor or service sink.


6)         All pharmaceuticals are to be kept in a locked cabinet or locked refrigerator (if indicated). The physician, nurse practitioner, or physician assistant and staff nurse are the only personnel who may have access to medications. Narcotics will not be kept at the Center.  Pharmaceuticals shall be stored and dispensed appropriately and inventoried as required by the Pharmacy Practice Act [225 ILCS 85].


7)         A Center shall develop standing orders and protocols for its nurse practitioner and/or physician assistant and medical director. Protocols for medical treatments must be reviewed and updated annually (signed acknowledgment must be available).