Standards for public agencies

2020 Edition

Juvenile Justice Residential Services (PA-JJR) 7: Health Services

Youth receive health services and guidance that promote good health and well-being.
2020 Edition




Juvenile Justice Residential Services promote public safety by providing youth with a supportive, structured setting that helps them address their needs and develop the attitudes and skills needed to make responsible choices, avoid negative behaviors, and become productive, connected, and law-abiding citizens.
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures governing the provision of health services
  • Menus for the previous six months
  • Health education curricula and/or materials
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Youth served and their families
  • Verify employment of qualified medical practitioner either directly or via contract
  • Review case records

Fundamental Practice

PA-JJR 7.01

A qualified medical practitioner conducts:
  1. a health examination within seven days of admission; and
  2. a dental screening within seven days of admission, and a dental examination within 60 days of admission.


If the agency obtains a health record showing that the youth recently received a dental examination, it may not be necessary to conduct another examination within 60 days of admission. In those cases, the agency should ensure that the examination is conducted within six months of the date the last exam was completed (e.g., if the youth had an exam two months before admission, the next exam should occur within four months after admission). Dental screenings should still occur according to the timeframes referenced in the standard.
Note: Regarding element (b), the agency will receive a rating of 2 if it: (1) conducts screenings to identify any urgent dental needs, and ensures the follow-up services needed to address these needs are provided, (2) ensures youth have access to services if dental issues arise after the screening, and (3) ensures that all youth receive a dental examination within six months of admission, with appropriate follow-up thereafter.

Fundamental Practice

PA-JJR 7.02

Youth receive services needed to address any health-related issues identified during the assessment and have access to ongoing health care, including sick call, by a qualified medical practitioner.

Fundamental Practice

PA-JJR 7.03

In case of emergency, a physician or other qualified medical practitioner assumes 24-hour on-call medical responsibility.


It is permissible to use a local medical facility for emergency services, provided the agency has a written agreement with the facility.


PA-JJR 7.04

Health records include a written summary of the youth’s known medical history, including immunizations, operations, illnesses, prior reactions to medications, and allergies, and copies are provided to youth or their legal guardians upon request.


PA-JJR 7.05

To promote physical health and development of healthful habits, youth are provided with nutritious meals and snacks, and engaged in adequate exercise.


PA-JJR 7.06

To promote their ability to maintain positive health practices, youth receive appropriate support and education regarding:
  1. proper nutrition and exercise;
  2. personal hygiene;
  3. substance use and smoking;
  4. sexual development;
  5. safe and healthy relationships;
  6. prevention and treatment of diseases, including sexually transmitted diseases;
  7. HIV/AIDS prevention; and
  8. pregnancy prevention and responsible parenting.
NA The agency provides only detention services.

Fundamental Practice

PA-JJR 7.07

Pregnant youth are provided or linked with specialized services that include, as appropriate:
  1. pregnancy counseling;
  2. prenatal health care;
  3. genetic risk identification and counseling services;
  4. fetal alcohol syndrome screening;
  5. labor and delivery services;
  6. postpartum care;
  7. pediatric care, including well-baby visits and immunizations; and
  8. children’s health insurance programs.
NA The agency does not serve pregnant youth.


PA-JJR 7.08

Pregnant youth are educated about the following prenatal health topics:
  1. fetal growth and development;
  2. the importance of prenatal care;
  3. nutrition and proper weight gain;
  4. appropriate exercise;
  5. medication use during pregnancy;
  6. effects of tobacco and substance use on fetal development;
  7. what to expect during labor and delivery; and
  8. benefits of breastfeeding.


These topics may be addressed by qualified medical personnel in the context of the prenatal health care referenced in PA-JJR 7.07.
NA The agency does not serve pregnant youth.

NA The agency provides only detention services.