The Department provides health services to all clients who are in out-of-home placements. Health care professionals are available on-site in all secure treatment and staff secure facilities and in 766-approved residential schools. Clients in small community based residential programs and foster care are taken to local practitioners for their health care needs. The Department is not the guardian for medical purposes and must seek parental or guardian consent for any invasive or risky medical procedure. Clients in detention are provided routine care as part of the Department's responsibility under the court's Mittimus for Detention.

Health services are provided to the larger cluster of secure programs through contracts with hospitals or health care agencies in each of the four DYS Areas. These contracts provide primary care delivered on-site by health staff during daytime hours, Monday through Friday and Saturday mornings. Pediatricians who specialize in adolescent medicine lead teams of nurse practitioners, physician's assistants, registered nurses and licensed practical nurses.

Health care concerns for clients in pre-trial detention focus on urgent and emergent care. The goal is to alleviate any painful condition, prevent deterioration of any condition and prevent the spread of disease to other clients or staff. All clients receive an assessment by a health trained individual at admission and an assessment by a licensed provider within 24 hours of admission to determine if the resident has any current medical problems (acute or chronic) or is currently being treated with medication and needs immediate attention and which needs to be continued while in custody. All detained clients are offered screening for sexually transmitted diseases and have access to sick call at least 3 days per week provided by on-site health staff. Detained clients also receive HIV/STD Risk Reduction education.

The health care goals for adjudicated clients include the following: A complete medical history and physical examination by an MD, NP or PA unless already completed during detention. This is repeated annually so long as the client is in out-of-home placement. Immunization status is reviewed and immunizations are updated as required. The Department provides all immunizations recommended for adolescents by the Mass Dept of Public Health. Clients are also screened for tuberculosis, STD's and other diseases as indicated by their history. A dental examination and treatment is scheduled as soon as possible after commitment. All DYS clients have access to sick call at least 3 days per week and receive HIV/STD Risk Education. Committed clients, and any detained client who is pregnant, are offered HIV counseling and testing.

This information is provided by the Department of Youth Services.