| Section
E: Inmate Care and Treatment |
J-E-01
Information on Health Services
(Essential) |
Formerly
J-31
This essential standard intends that the inmates have
knowledge about the availability of, and access to,
health care services. Topics that must be addressed
orally and in writing in a form and language inmates
understand include how to access health services, the
grievance process, and fee for service program, if one
exists. Written documentation may include facility
handbooks, a handout or postings in the housing areas. A
sign regarding access must be posted in the intake area. |
J-E-02
Receiving Screening
(Essential) |
Formerly
J-30
This essential standard is intended to fulfill a
threefold purpose: to identify and meet any immediate
health needs of those admitted; to obtain necessary
urgent or emergent treatment for an inmate in need of
care; and to identify and isolate inmates who appear
potentially contagious. This standard remains basically
the same; qualified health staff or health trained
personnel may do the receiving screening. The additional
question for women now is simply inquiry into the
possibility of pregnancy. |
J-E-03
Transfer Screening
(Essential) |
New
Recognizing that in large jail systems, transfer may
occur between facilities that are considered part of one
system, this essential standard has been added to the
jails to take the place of J-31 in facilities receiving
the transferred inmates. This is not a simple move from
one housing unit to another within the same facility,
but is the process for health staff to follow when a
jail transfers one of their inmates to another jail
within its system. While it is good practice to see the
transferred inmate, the requirement calls for a review
of the health record by a designated health staff member
within 12 hours of arrival of the transferred inmate.
This ensures continuity of care and prevents unnecessary
duplication of tests and evaluations. |
| (DELETED:
Formerly J-32 Oral Screening) |
(Now
included in J-35 Oral Care) |
J-E-04
Health Assessment
(Essential) |
Formerly
J-33
This essential standard intends that clinicians assess
and plan for meeting the health needs of the individual.
It is basically the same, requiring the full health
assessment within 14 days of admission to the jail
system. It explicitly notes that when the hands-on
physical is done by a mid-level practitioner, review of
significant findings by the physician is required; and
when trained RNs do the hands-on physical, the physician
must review all findings. TB testing is required as part
of the assessment. |
J-E-05
Mental Health Screening and Evaluation
(Important)
(Name change from "Mental Health Evaluation"
to better reflect purpose.) |
Formerly
J-39
This important standard intends to ensure that the
mental health needs, including those related to
developmental disability and/or addictions, are
identified. This standard remains basically the same.
Screening by mental health staff or trained health staff
takes place on all inmates. Further evaluation is done
by qualified mental health professionals for those
inmates whose screen is positive. This includes
appropriate individual and/or group testing regarding
intellectual functioning. See also essential J-G-04
Mental Health Services, which is a new companion to this
standard and explicitly addresses mental health
services. |
J-E-06
Oral Care
(Essential)
(Name change from "Dental Care" to reflect ADA
current practice.) |
Formerly
J-32 and J-40
Combining the former oral screening and dental treatment
standards into one, this essential standard intends that
inmates’ serious dental needs are met. As before, it
requires the oral screening by the dentist or trained
health staff within 14 days of admission and instruction
in oral hygiene and preventive education within 1 month
of admission. A new requirement is the need for an
examination by a dentist for those inmates who have not
yet been seen by a dentist whose stay is over 12 months.
Requirements for oral care by a dentist according to
treatment priorities remain. Dental care beyond the
urgent and emergent is given when in the dentist’s
judgment the inmate’s health would otherwise be
adversely affected if the condition is not treated. |
J-E-07
Nonemergency Health Care Requests and Services
(Essential)
(Name change to reflect focus of standard.) |
Formerly
J-34 & J-35
This essential standard intends that inmate routine
health care needs are met. It combines and clarifies
requirements for the daily handling of nonemergency
medical requests and the sick call process
itself. There are four elements specified with explicit
compliance indicators for each. These requirements are
essentially the same as in previous versions: (1) all
inmates have the opportunity to request care daily
(requests received by or collected directly by health
staff where health staff are on duty at least for one
shift every 24 hours); (2) requests are reviewed for
immediacy of need and required intervention (triaged)
daily; (3) frequency and duration of sick call by
qualified health care professionals (may be physicians,
mid-level practitioners, nurses) conducted in a clinical
setting meets the needs of population; and (4) providers’
clinics (physician and/or mid-level) available in timely
manner. General expectations regarding the timeliness of
sick call is within 24 hours (72 for weekends) of the
request (face-to-face triage by health staff is a sick
call encounter); while the expectation for the provider
clinic appointment is dependent on the nature of the
request. General expectations regarding the frequency of
sick call is a minimum of 2/week for facilities with an
ADP of less than100; 3/week, ADPs of 100-200; and 5/week
for facilities with ADPs greater than 200. |
J-E-08
Emergency Services
(Essential) |
Formerly
J-36
This essential standard intends that sufficient
emergency health planning occurs to prevent bad outcomes
in relation to emergencies. It remains basically the
same, requiring community hospital availability and an
emergency on-call system for health staff when such
hospitals are not located nearby. |
J-E-09
Segregated Inmates
(Important) |
Formerly
J-43
The intent of this standard is to ensure that inmates
placed in segregation maintain their medical and mental
health while physically and socially isolated from the
remainder of the inmate population. The standard remains
important in the jail setting. It is not the reason for
the inmate’s segregation (i.e., disciplinary,
administrative, etc.) that is the factor here, but the
conditions of confinement that dictate the frequency of
health staff monitoring.
Three degrees of isolation are defined and each requires
different levels of health staff monitoring.
"Extreme isolation" (inmates with little or no
contact with other individuals) is rare in the jail
setting and requires daily monitoring by health staff
and by mental health staff at least once weekly.
Some jails may house "segregated inmates with
limited contact with staff or other inmates," a
category that requires monitoring by health or mental
health staff three days/week.
Most segregation in the jail setting will fall under the
category of "segregated inmates," which
includes inmates who are in segregation but nonetheless
allowed periods of recreation or routine social contact
among themselves while being segregated from general
population. These require weekly checks by health or
mental health staff.
Correctional staff must notify health staff when inmates
are placed in segregation so that health staff may alert
corrections to any contraindications or accommodations
needed to meet the medical or mental health needs of the
segregated inmate. |
| (DELETED:
Former J-37 Written and Verbal Clinicians’ Orders) |
(This
former standard has outlived its usefulness; it is now
standard practice, and the issues addressed are
monitored through compliance with other standards; e.g.,
J-D-02 Medication Services.) |
J-E-10
Patient Escort
(Important)
(Name change from "Patient Transport" to
better reflect focus of the standard.) |
Formerly
J-38
An intent of this important standard is that the
facility provides sufficient escorting staff so that
patients can meet scheduled health care appointments,
appointments, within the facility or community; it
remains basically the same. Explicit reference is
included regarding providing necessary medications
during transport and alerting transporting staff to
health needs requiring attention during the transport. |
J-E-11
Nursing Assessment Protocols
(Important)
(Name change from "Assessment Protocols" to
clarify focus.) |
Formerly
J-41
This important standard intends to ensure that nurses
who provide clinical services are trained and do so
under specified guidelines. This standard explicitly
focuses on nursing assessment guidelines and explicitly
states that the use of standing orders for preventive
medicine practices (immunizations, flu shots, etc.) is
in compliance with the intent of the standard. |
J-E-12
Continuity of Care During Incarceration
(Essential)
(Change from "Continuity of Care" to reflect
focus of this standard. The former standard, which
covered the concept of continuity from all aspects—community
to corrections, within corrections, and corrections to
community—has been divided into appropriate standards.
See also J-E-13 Discharge Planning. |
Formerly
J-42
This revised essential standard focuses only on
continuity of care issues that occur during
incarceration and intends to ensure that patients
receive care as ordered by clinicians. The emphasis is
on being sure that diagnostic tests and treatment that
are ordered are delivered in a timely fashion, and that
results are reviewed with changes in treatment as
required. Sharing of information among providers of
different disciplines takes place as required. |
J-E-13
Discharge Planning
(Important) |
New
The intent of this important standard is that facility
clinicians ensure that patients’ health needs are met
during transition to a community provider as part of the
discharge process. Although new as a separate standard
due to the importance of this issue, the concept of
discharge planning was included in the former Continuity
of Care standard. Expectations for both planned and
unplanned discharges are given, and emphasize the active
role of the facility health staff in the planning. |
