Current through Register Vol. 48, No. 38, September 20, 2024
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).
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.
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.
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. 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.
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.