Cal. Code Regs. tit. 22 § 100163.04

Current through Register 2024 Notice Reg. No. 49, December 6, 2024

Section 100163.04 - [Operative 1/1/2025] Advanced Pedrc Requirements

(a) A hospital may be designated as an Advanced PedRC by the local EMS agency upon meeting the following criteria:

(1) All designated Advanced PedRCs shall be licensed by the Department of Health Services (DHS), Licensing and Certification Division, under California Code of Regulations (CCR), Title 22, Division 5, Chapter 1, as follows:

(A) As an acute care hospital pursuant to Article 1, sections 70003 and 70005.

(B) For pediatric service pursuant to Article 6, section 70535 et seq.

(C) For basic or comprehensive emergency medical services pursuant to Article 6, section 70411, et seq.

(D) For social services pursuant to Article 6, section 70535 et seq

(E) Community neonatal intensive care unit (NICU) or as an Intermediate NICU if it meets the following requirements, as per:

1. Article 6, Section 70545 et seq., for the provision of perinatal services and licensed by DHS, Licensing and Certification Division as a perinatal service;

2. Article 6, Section 70481 et seq., for the provision of neonatal intensive care services and licensed by DHS, Licensing and Certification Division as an Intensive Care Newborn Nursery (ICNN)

(F) If the hospital has a PICU then it shall be licensed by DHS, Licensing and Certification Division for intensive care services, and meet the requirements for the provision of intensive care services pursuant to CCR Title 22, Division 5, Chapter 1, Article 6, Section 70491 et seq.

(G) The emergency department in the hospital shall be able to stabilize critically ill or injured infant, children, and adolescents prior to admission to the PICU or transfer to a Comprehensive PedRC facility.

(2) Establish agreements with a minimum of one Comprehensive PedRC as approved by the local EMS agency, for consultation.

(3) Participate with a Comprehensive PedRC for pediatric emergency education for emergency care providers consistent with the local EMS agency plan for ongoing pediatric education.

(4) Establish transfer agreements with a Comprehensive PedRC to transfer pediatric patients for stabilization, ensuring the highest level of care.

(5) Establish transfer agreements for pediatric patients needing specialized care, if the specialized care is not available at a Comprehensive, Advanced or General PedRC, such as trauma, burn, spinal cord injury, and rehabilitation and behavioral health.

(b) All Advanced PedRCs shall meet the following personnel requirements:

(1) Advanced PedRCs shall have a physician and nurse Pediatric Emergency Care Coordinator (PECC).

(2) Respiratory care service in the pediatric service department and emergency department provided by respiratory care practitioners (RCPs) who are licensed in the state of California and who have completed formal training in pediatric respiratory care which includes clinical experience in the care of children.

(3) Social work services in the pediatric service department provided by a medical social worker (MSW) holding a master's degree in social work who has expertise in the psychosocial issues affecting the families of seriously ill infants, children, and adolescents.

(4) Behavioral health specialists with pediatric experience to include, but not be limited to, psychiatrists, psychologists, and nurses.

(5) The following specialties shall be on-call, and available for consultation to the ED or NICU within 30 minutes by telephone and in-person within one hour:

(A) Neonatologist.

(B) General Surgeon with pediatric experience.

(C) Anesthesiologist with pediatric experience.

(D) Pediatric Cardiologist.

(6) The following specialties shall be on-call, and available to the NICU or ED either in-person, by phone, or by telehealth, within 30 minutes:

(A) Radiologist with pediatric experience.

(B) Otolaryngologist with pediatric experience.

(C) Mental health professional with pediatric experience.

(D) Orthopedist with pediatric experience.

(7) The following qualified specialists shall be available twenty-four (24) hours a day, 7 days a week, for consultation which may be met through a transfer agreement or telehealth:

(A) Pediatric Gastroenterologist.

(B) Pediatric Hematologist/Oncologist.

(C) Pediatric Infectious Disease.

(D) Pediatric Nephrologist.

(E) Pediatric Neurologist.

(F) Pediatric Surgeon.

(G) Cardiac Surgeon with pediatric experience.

(H) Neurosurgeon with pediatric experience.

(I) Obstetrics/Gynecologist with pediatric experience.

(J) Pulmonologist with pediatric experience.

(K) Pediatric Endocrinologist.

(8) The hospital or LEMSA may require additional specialists or more rapid response times.

(c) The pediatric equipment, supplies, and medications in all Advanced PedRCs for pediatric patients from neonates to adolescents shall include all General PedRC equipment, and:

(1) Crash carts with pediatric resuscitation equipment that shall be standardized and available on all units, including but not limited to, the emergency department, radiology suite, and inpatient pediatric service.

(d) Additional requirements may be stipulated by the local EMS agency medical director.

Cal. Code Regs. Tit. 22, § 100163.04

Note: Authority cited: Sections 1797.107 and 1799.204, Health and Safety Code. Reference: Sections 1797.88, 1797.222, 1798.150, 1798.170, 1798.172 and 1799.204, Health and Safety Code.

1. Renumbering of section 100450.221 to section 100163.04 filed 9-5-2024; operative 1/1/2025 (Register 2024, No. 36).