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Spotlight on the Standards
"Companion"
Standards
The
NCCHC standards for health services work together as a whole to
promote a strong and professional health services program at a
correctional facility. One decision in the 2003 revision of the
adult Standards was to split certain standards apart,
creating “companion” standards that focus on different
aspects of the same issue. The purpose and intent of such
companion standards appear clearer when different aspects of the
topic are considered separately.
One
example is the separation of operational and clinical aspects of
prescription medications that were combined in the former
standard Pharmaceuticals (J-26, P-27). The revised
Pharmaceutical Operations (J-D-01/P-D-01) focuses on the
administration, organization and management of a pharmacy
program, whether a full pharmacy is functioning on site or the
facility has a cupboard with individual medications for the
inmates. Practical and legal procedures and requirements are the
issues here.
The
companion Medication Services standard (J-D-02/P-D-02), on the
other hand, is concerned with the clinical issues that relate to
prescribing and administering medications. Here, emphasis is on
appropriate, timely, safe and sufficient provision of
medication. Both standards in this pair have an “essential”
status since provision of medication is part of the access to
care that the Constitution demands.
Sometimes
multiple standards can be viewed as companions. Both Health
Assessment (J-E-04/P-E-04) and Mental Health Screening and
Evaluation (J-E-05/P-E-05) are concerned with identification and
diagnosis of health and mental health conditions. Their
respective companion standards, Special Needs Treatment Plans
(J-G-01/P-G-01), Management of Chronic Disease (J-G-02/P-G-02)
and Mental Health Services (J-G-04/P-G-04) address the treatment
programs and opportunities that logically follow once problems
are noted.
Some
companion standards address apparently opposite sides of the
same issue. Consider consent for treatment, addressed in
Informed Consent (J-I-05/P-I-05) and the Right to Refuse
Treatment (J-I-06/P-I-06). Each standard stresses the
requirement that inmates exercise health rights as they would in
the community. Both are categorized as “important,”
reflecting best practices.
Nonemergency
Health Care Requests and Services (J-E-07/P-E-07) and Emergency
Services (J-E-08/ P-E-08) deal with the two ends of the health
care continuum—routine and emergency care. Both are needed and
both retain essential status.
Another
example relates to the need to balance confidentiality with
health and safety within the close confines of a correctional
facility. As a pair, the essential standards Communication on
Special Needs Patients (J-A-08/P-A-08) and Confidentiality of
Health records and Information (J-H-02/P-H-02) provide guidance
to balancing individuals’ rights and needs with the health and
safety of the whole. The first standard outlines what health
information is to be released, to whom, and how it is to be
shared when the health and safety of the individual inmate,
other inmates or staff are at issue; the second outlines the
usual confidentiality safeguards necessary to protect health
information.
Finally,
there are pairs where one standard requires a partner for
completeness. While Pregnancy Counseling (J-G-10/P-G-10)
addresses providing choices available in the community to the
pregnant inmate, Care of the Pregnant Inmate (J-G-07/P-G-07)
completes the requirements for care of mother and unborn child
during incarceration.
Once
the medical conditions of Intoxication and Withdrawal
(J-G-06/P-G-06) are dealt with, programs for treatment as noted
in the standard Inmates with Alcohol and Other Drug Problems
(J-G-08/P-G-08) must be addressed.
Finally,
choices considered in End-of-life Decision Making (J-I-04/
P-I-04) require implementation as outlined in Care for the
Terminally Ill (J-G-12/P-G-12).
(This article first appeared in the Spring
2003 issue of CorrectCare.)
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Standards Q&A
National Commission on Correctional Health Care
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Chicago, IL 60614
Phone (773) 880-1460 • Fax (773) 880-2424
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