Section 701.90 Medical and Mental Health Care

Section 701

Section 701.90  Medical and Mental

Health Care

a)         Medical and Mental Health Services

All jails

shall provide a competent medical authority to ensure that the following

documented medical and mental health services are available:

1)         Collection and diagnosis of complaints.

2)         Treatment of ailments.

3)         Prescription of medications and special diets.

4)         Arrangements for hospitalization.

5)         Liaison with community medical facilities and resources.

6)         Environmental health inspections.

7)         Supervision of special treatment programs, such as alcohol and

drug dependency.

8)         Administration of medications, including emergency voluntary

and involuntary administration of medication, including psychotropic medication,

and distribution of medication when medical staff is not on site.

9)         Maintenance and confidentiality of accurate medical and mental

health records.

10)         Maintenance of detailed records of medical supplies,

particularly of narcotics, barbiturates, amphetamines and other dangerous

drugs.

b)         Physician, Mental Health and Dental Services

1)         A medical doctor shall be available to attend the medical and

mental health needs of detainees.

A)        Arrangements shall be made for provisions of emergency dental

care as determined necessary by a dentist or a physician.

B)        Professional mental health services may be secured through

linkage agreements with local and regional providers or independent contracts.

Linkage agreements and credentials of independent contractors shall be

documented.

2)         General medical physician services may be provided by:

A)        Staff physicians;

B)        Contractual services; or

C)        A nearby hospital.

c)         Admission Examination

1)         All persons admitted to confinement shall undergo a physical

assessment as prescribed in Section 701.40(i)

cts.

Linkage agreements and credentials of independent contractors shall be

documented.

2)         General medical physician services may be provided by:

A)        Staff physicians;

B)        Contractual services; or

C)        A nearby hospital.

c)         Admission Examination

1)         All persons admitted to confinement shall undergo a physical

assessment as prescribed in Section 701.40(i).

2)         Newly admitted persons suspected of having any type of

communicable disease shall be isolated and an immediate referral shall be made

to the jail physician for possible transfer to a medical facility unless the

admitting facility can safely and effectively segregate and maintain a

medically prescribed course of treatment.

3)         All detainees confined shall be given a medical screening by a

medical doctor, a physician assistant, a nurse practitioner, a registered nurse

or a licensed practical nurse within 14 days after confinement, and as required

by a medical doctor thereafter.

d)         Sick Call

1)         A schedule shall be established for daily sick call.

2)         The names of those detainees reporting to sick call shall be

recorded in the medical log.

3)         Detainees with emergency complaints shall receive attention as

quickly as possible, regardless of the sick call schedule.

4)         Non-medical jail staff may issue over-the-counter medication,

providing the attending physician gives prior written approval to the facility

for such issue and the issue is made at the request of the detainee.

e)         Written Record or Log

A written

record shall be maintained, as part of the detainee's personal file, of all

treatment and medication prescribed, including the date and hour the treatment

and medication is administered.  A written record shall be maintained of

over-the-counter medication, for example, aspirin, cough medicine, etc., issued

by jail staff.  A written record shall be kept of all detainees' special diets

written

record shall be maintained, as part of the detainee's personal file, of all

treatment and medication prescribed, including the date and hour the treatment

and medication is administered.  A written record shall be maintained of

over-the-counter medication, for example, aspirin, cough medicine, etc., issued

by jail staff.  A written record shall be kept of all detainees' special diets.

f)         Medical Security

1)         Security of medical supplies shall be maintained at all

times.  Drugs, including over-the-counter medication, and other abusable

medical supplies shall be secured and accessible only to designated staff.

2)         When a physician or other medical personnel attends patients

at the facility, a jail officer shall be present to maintain order, prevent

theft of medication, equipment or supplies, and to assure an orderly process.

3)         Detainees shall receive one dose of medication at a time and

shall be required to ingest medication in the presence of a medical staff

member or jail officer. Detainees may be approved by the jail administrator, in

consultation with a physician or other medical professional, to retain life

saving medication on his or her person.  Safety and security of the facility

and detainee shall be considered before granting approval.

4)         Detainees shall not be assigned to work with or have access to

medical supplies, patients, records or medications.

g)         First Aid Training

At least one

member of the jail staff on each shift shall have successfully completed, and

received biannual recertification from, a recognized course of first aid

training, including cardiopulmonary resuscitation (CPR).

h)         Mental Health

Training

Annually, jail officers and other

personnel primarily assigned to correctional duties shall be trained on suicide

prevention and mental health issues.  The training shall be approved or

provided by a mental health professional

and

received biannual recertification from, a recognized course of first aid

training, including cardiopulmonary resuscitation (CPR).

h)         Mental Health

Training

Annually, jail officers and other

personnel primarily assigned to correctional duties shall be trained on suicide

prevention and mental health issues.  The training shall be approved or

provided by a mental health professional.

1)         Suicide

prevention training shall include the nature and symptoms of suicide; the

specifics of identification of suicidal individuals through the recognition of

verbal and behavioral cues, situational stressors, evaluation of detainee

coping skills and other signs of potential risk; monitoring; evaluation;

stabilization; and referral of suicidal individuals.

2)         Mental

health training shall include the nature of mental illness; symptoms; specifics

of identification of mentally ill individuals through the recognition of verbal

and behavioral cues symptoms of mental illness, situational stressors,

evaluation of detainee coping skills and other signs of potential risk;

monitoring; evaluation; stabilization; and referral of the mentally ill

detainee.

i)          First Aid Supplies

Those

facilities not having a dispensary shall maintain a stock of first aid supplies

for the treatment of cuts, bruises, sprains and other minor injuries.

j)          Tuberculosis (TB) Isolation

The following

standards shall be followed for TB isolation rooms, where provided, and

associated shower rooms.

1)         Supplied air to a room should be a continuous and constant

volume. Variable air volume devices should be locked open.  Air flow should be

measured and balanced to original building specifications.  The air supplied

must be a minimum of six air changes per hour.

2)         Air returns shall be permanently sealed.

3)         All air from the room shall be exhausted to the exterior of

the building.  Exhaust air volume in a room must always be greater than the

supplied air volume

me devices should be locked open.  Air flow should be

measured and balanced to original building specifications.  The air supplied

must be a minimum of six air changes per hour.

2)         Air returns shall be permanently sealed.

3)         All air from the room shall be exhausted to the exterior of

the building.  Exhaust air volume in a room must always be greater than the

supplied air volume.  Several rooms may be exhausted from one exhaust fan.

A)        Where feasible, the exhaust fan outlet at the exterior of the

building shall be situated to prevent room air from being discharged near

inhabited areas, building air intakes and exterior zones of stagnant or trapped

air.

B)        Where the above is not feasible, room air should be directly

exhausted through a high efficiency particulate air (HEPA) filtration system.

If a HEPA system is utilized, the system shall be installed and filters shall

be replaced as recommended by the system manufacturer.

4)         An air pressure switch or sail switch should be placed in the

exhaust air duct.  This switch should illuminate a red light at an occupied

station when air flow in the duct is disrupted.  A sign should be placed next

to the red light instructing individuals to call the maintenance department

immediately when the red light is illuminated.  Facilities using a window

exhaust fan or through wall unit shall install a similar indicator light

showing loss of power.

5)         A differential air pressure gauge should be used to monitor

each isolation room.  The gauge shall have two ports and shall be piped per the

manufacturer's instructions.  One port shall be piped to the isolation room.

The other shall be piped to the hallway outside that room.  The gauges shall be

placed in a location where they are convenient to read, but are also protected

from vandalism and damage.  They may require a cover or other protective

device.  The staff shall be responsible for monitoring these gauges to ensure

differential pressure is being maintained

port shall be piped to the isolation room.

The other shall be piped to the hallway outside that room.  The gauges shall be

placed in a location where they are convenient to read, but are also protected

from vandalism and damage.  They may require a cover or other protective

device.  The staff shall be responsible for monitoring these gauges to ensure

differential pressure is being maintained.

6)         Operable windows must be closed permanently or made

inoperable.

7)         The corridor door to the isolation room must have a door

closer installed.  The corridor door must not be allowed to remain in the open

position when the room is occupied.