Standards Q&A

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Subjects

Access to Care		Initial Health Assessment
Access to Custody Information		Inmate Death
Accreditation		Inmate Workers
Administrative Meetings and Reports		Intoxication and Withdrawal
Aids to Impairment		Juvenile Standards
Blood Draw Procedures		Juveniles in Adult Facilities
Chronic Disease Services		Medical Autonomy
Clinic Space, Equipment & Supplies		Medical Necessity
Clinical Guidelines		Medication Services
Clinical Performance Enhancement		Mental Health Screening & Evaluation
Confidentiality		Mental Health Standards
Continuing Education		NCCHC Awards
Continuity of Care		Nonemergency Health Care Requests
Continuous Quality Improvement		Opioid Treatment
Dental Exams		Oral Health Care
Discharge Planning		Pharmaceutical Operations
Disciplinary Reports		Policies and Procedures
Documentation		Professional Credentials
Emergency Response Plan		Professional Development
End-of-Life Decision Making		Psychotropic Medication
Environmental Health and Safety		Receiving Screening
Facility Construction		Responsible Health Authority
Family Support Resources		Restraint and Seclusion
Forensic Information		Right to Refuse Treatment
Health Assessment		Segregated Inmates
Health Care Liaison		Self-Defense
Health Records		Sick Call
HIPAA Issues		Special Needs Patients
Hospital and Specialty Care		Staffing
Infants in Correctional Facilities		State Regulations
Infection Control Program		Suicide Prevention
Infirmary Care		Transfer Screening
Information on Health Services		Transgender Health Care
Informed Consent		Use of Tobacco

The Latest Column

Below are the questions from the latest Standards Q&A column, posted in March 2013.

Forensic Information

We have a federal court security expert who has requested that detention medical staff provide data to security when they perform a presegregation assessment after inmate-on-inmate assaults and similar information when there is an exam following use of force by custody. Is this a violation of the NCCHC standard on forensic information (I-03)? Is there any information medical can provide under these circumstances? I think even asking the inmate to provide a release of information would be coercive.

First we must ask ourselves what is the purpose of conducting a presegregation assessment? What is the purpose of conducting an evaluation after the use of force? Such evaluations are generally performed for the benefit of the patient to ensure that he or she does not suffer from injuries as a result of the altercation. Hence, this medical information needs to be protected in the same manner as any other medical information. NCCHC holds to the same community standard of care when it comes to protecting confidential patient information.

The second question that has to be raised is what “data” is being requested? If it is information that breeches the patient–physician confidential bond, then it should not be released. However, if it is information that notifies security that there is or is not a contradictory reason to place the inmate in segregation, then yes, that is allowed. A patient release of information should be obtained if more information is required (photos, drawings, description of injuries or description of the event).

CONTINUITY OF CARE

A hospital in our area recently changed its policy regarding inmates. They are saying that if an inmate is sent to the hospital, the hospital staff cannot contact the jail once the inmate is to be released from the hospital and therefore another warrant has to be issued for their arrest before that person returns to jail. I’m trying to do research on where in the HIPAA law this is stated.

NCCHC is not aware of such practice. The standard on Continuity of Care (E-12) requires that when an inmate returns from an emergency room visit (or hospital stay), the physician sees the patient, reviews the discharge orders and issues follow-up orders as clinically indicated. You should consult with legal counsel to check for local statute or regulation that may impact on this issue.