Johnson County Kansas Sheri??s O?ice Division: Directive [Subject HEALTH SERVICES Detention: 13-01 [Date of Issue: 10-01-1998 Date of Revision: 05-03-2016 Rescinds; Us?? 14;: {313324; Reference; Authority: Maj or Wayne Rector DIRECTIVE The Detention Bureau will provide for the delivery of health care services, including medical, dental and mental health services, under the control of a designated health authority. When this authority is other than a physician, ?nal medical judgments rest with a single designated responsible physician licensed in the state. Arrangements are made with health care specialists in advance of need. (4D-01) ADNHNISTRATION OF SERVICES A. Medical, and dental matters involving medical judgment will be the sole provinces of the Health Services Staff. B. Health Services Staff will treat inmates with medical, dental and mental health problems. C. Health Services Staff authority shall meet with the Facility Administrator or their designee at least quarterly and provide statistical summaries and quarterly reports on the health care delivery system and health environment. (7D-26) D. Each policy, procedure, and program, in the health care delivery system, shall be reviewed at least annually by the appropriate health care authority and revised if necessary. Each document shall bear the date of the most recent review, or revision, and signature of the reviewer. E. Health Service Staff will maintain veri?cation of personnel credentials and job descriptions on ?le in the facility. F. Health Service Staff systematically determines health care personnel requirements in order to provide inmate access to health care staff and services. G. Health Services Staff shall provide a continuity of care from admission to discharge from the facility, including referral to community care when indicated. Page 1 of 10 H. The Detention Bureau shall provide adequate space, equipment, supplies, and materials as described in the provider contract for the Health Services Staff to deliver health care. I. Clinical treatment is performed pursuant to written, or verbal orders, signed by personnel who are authorized by the State of Kansas practice laws regarding medical orders. I . Inmate workers will not perform duties related to health care services, to include performing direct patient care, scheduling appointments, determining other inmate access to health care services, the handling or having access to surgical instruments, needles, syringes, medications or health care records, or operating diagnostic or therapeutic equipment. (4D-11) NIENTAL HEALTH SERVICES A. Mental Health Services are provided for inmates by contracted Health Service Staff. (4C-27) B. A written policy approved by the mental health authority, which outlines all activities for mental health service personnel, shall be on file. PHARMACEUTICALS A. Health Services Staff will have a written policy, practice, and procedure, for the proper management of pharmaceuticals which will address: (4C-38) 1. A formulary, speci?cally developed for the facility. 2. Prescription practices, including requirements that medications are prescribed only when clinically indicated, as one facet of a program of therapy; (2) ?stop order? time periods are required for all medications; and (3) the prescribing provider, reevaluates a prescription prior to its renewal. 3. Procedures for medication receipt, storage, dispensing, and administration or distribution. 4. Maximum security storage and periodic inventory of all controlled substances, syringes, and needles. 5. Dispensing of medicine on conformance with appropriate federal and state law. 6. Administration of medication by persons properly trained, and under the supervision of the health care authority and facility administrator or designee. 7. Accountability for administering or distributing medications in a timely manner, according to physician orders. B. drugs, such as antidepressants, and drugs requiring parenteral administration, are prescribed only by a physician, or authorized health services staff, by agreement with the physician, and then only following a physical examination of an inmate by the health provider. Such drugs are administered by the responsible physician, qualified health personnel, or health-trained personnel under the direction of the health authority. (4D?l 7) Page 2 of 10 C. Health Services Staff will follow written policy, procedure and practice, in compliance with applicable laws governing the administration of involuntary drugs. HEALTH SCREENINGS AND A. A Medical Screening, recorded on the approved screening form, will be performed by the Health Services Staff on all inmates, including transfers, upon their arrival at the facility. 4C-23) B. When an inmate is identi?ed as being pregnant, the Health Services Staff will place the inmate under pregnancy management protocol. (4C-13) C. Health Services Staff will provide for inmates under the in?uence of drugs or alcohol by way of a physician approved protocol and procedure. D. All newly committed inmates will receive a health assessment completed by quali?ed Health Services Staff within 14 days. All health data will be collected, and recorded, per written policy, in a uniform manner by quali?ed Health Services Staff. (4C-24) E. All newly admitted inmates held more than 72 hours shall receive a dental screening and hygiene information within 14 days of incarceration, and a dental examination within 12 months. Inmates presenting dental problems that warrant treatment will be scheduled for a dental appointment. (4C-20) F. Health Service Staff shall have arrangements with health care specialists to care for inmates in need of specialized services. G. Health Service Staff shall have arrangements with appropriate staff, and facilities to provide for inmates requiring special medical programs, including chronic care, convalescent care, and medical preventive maintenance. H. Health Services Staff shall provide for medically necessary dental and medical prostheses, and orthodontic devices as determined by the responsible physician or dentist. (4C-35) 1. Health Services Staff shall transfer inmates to other appropriate facilities, or clinics, for needed treatment when such services are beyond the resources available in the facility. J. Health Services Staff will assess inmates? suitability for travel prior to transfer to another facility, and provide instructions for the transporting officers. (4D-27) K. Health Services Staff shall be responsible for providing health education to the inmates by a variety of means. (4C-21) L. Health Services Staff and Detention Bureau staff shall follow the facility?s written suicide prevention plan. (4C-32) M. HIV Positive Inmates will be handled by a written policy and procedure. Page 3 of 10 N. Health Services Staff shall have a post admission screening and referral for care of mentally ill inmates unable to adapt to the correctional environment. 0. The Facility Administrator and responsible physician or their designees shall engage in a consultation regarding inmates diagnosed with illness before housing assignments, program assignments, disciplinary measures and transfers in and out of the facility are made. (4C-20) (4D-21) P. All inmates undergoing detoxi?cation shall be under medical supervision. Q. The Health Services Staff shall provide for clinical management of chemically dependent inmates. (4C-37) R. All medical procedures shall be affected by the informed consent standards of the community, and heath care rendered against an inmate?s will only in accordance with state law. S. Inmate participation in medical research is prohibited unless based on need for a speci?c medical treatment that is not generally available. T. In the case of serious illness or injury, the inmate?s emergency contact may be noti?ed. (4D-12) U. Health Services Staff shall maintain health record ?les containing entries covering all aspects of the inmate?s medical treatment. (4D-23) (4D-26) V. Inmate Health Records are controlled by the Health Services Staff, separate from other inmate ?les, to maintain con?dentially of the health record. 14) W. The transfer and maintenance of Inmate Health Records are governed by the Health Services Staff written policy and procedure. (4D-48) X. Health Services Staff will provide inmates with care according to the Health Services policies and procedures. SICK CLINIC A. Sick Call is conducted by physicians and other quali?ed health professionals, in a clinical setting, and are available on a scheduled basis. B. Nursing Clinic sick call is available at a minimum of ?ve (5) times per week. Physician sick call is scheduled at a frequency based upon the size of the facility. (4C-03) GENERAL INFORMATION A. Security regulations will be adhered to at all times by Health Services Staff. Detention Center of?cers will be reSponsible for the security of inmates in the in?rmary/clinic area. B. All controlled substances, medications, syringes, and needles, will be stored in the medication storage room when not in use. C. Only the nursing staff will have access to the medication storage room. Detention Staff will not enter this area. Page 4 of 10 D. Restraints used for medical or purposes are used only when the safety and welfare of an inmate cannot be protected by less restrictive means. The Health Service Staff shall have a written policy governing the use of restraints. E. The nurses? clinic/in?rmary will be staffed twenty-four hours per day. F. At no time will an inmate be allowed to enter the nurses? station. G. The nursing staff will notify a Shift Sergeant whenever, the only nurse on duty, must leave the clinic/in?rmary area, in the event inmates are housed there. H. Nursing staff is responsible for, and held accountable, for radios and all keys (medical and non?medical) issued to them during their duty shift. I. Inmate personal medication will not be dispensed, unless the medical staff determines it to be an urgent medical necessity. Page 5 of 10 Review Date Reviewed By Latest Revision Date 10?01?98 Bureau Commander 10-12-98 04?01-99 Bureau Commander 04?12?99 01-01?04 Review Team 01 -28?04 12?13? 12 Bureau Commander 12-1 8? 12 07?16-13 Facility Administrator 07?1 7-13 05-13-14 Facility Administrator 05?13?14 08-03 -1 5 Facility Administrator 05-02? 1 6 Facility Administrator 0 1?04- 1 7 Facility Administrator 01 -05 - 8 Facility Administrator Page 6 of 10