| Section
A: Governance and Administration |
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Y-A-01
Access to Care
(Essential)
|
Formerly
Y-01
This essential standard has not changed from the 1999
version. It remains the principle upon which all
National Commission on Correctional Health Care
standards are based.
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Y-A-02
Responsible Health Authority
(Essential)
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Formerly Y-02
This essential standard intends that there is a
coordinated health care system. It explicitly clarifies
that the RHA (or on-site designee) is expected to be on
site weekly; where the authority is regional or
corporate, a local designee is available. Where there is
a separate organizational structure for mental health
services, a designated mental health clinician
coordinates services with the RHA.
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Y-A-03
Medical Autonomy
(Essential) |
Formerly Y-03
This essential standard remains basically the same. It
endorses the key principle that clinical decisions are
made for clinical purposes, by clinical staff and
without interference. It notes that health staff are
otherwise subject to the same security regulations as
all other facility employees. |
Y-A-04
Administrative Meetings and Reports
(Essential) |
Formerly Y-04
This essential standard is intended to facilitate the
health care delivery system through joint monitoring,
planning and problem resolution between the facility’s
health and correctional administrators. While remaining
the same, the listing of annual statistics to be
reported has been made explicit: the number of juveniles
receiving health services by category of care, referrals
to specialists, deaths, infectious disease monitoring
(e.g., TB, hepatitis, HIV, STDs), emergency services
provided and dental procedures performed. |
Y-A-05
Policies and Procedures
(Essential) |
Formerly Y-05
An intent of this essential standard is to articulate in
writing the official approved policies and procedures to
be followed by the staff in fulfilling their duties. It
explicitly clarifies that either a manual or compilation
of P&Ps is acceptable, and that system-wide or
corporate P&Ps must be site-specific. While health
services policies and procedures must be reviewed/signed
annually by the RHA, copies of the policies and
procedures included in the health services manual or
compilation that originate from a corporate, system or
corrections authority are the current version from that
authorizing authority. The P&Ps are to be readily
accessible to health staff. |
Y-A-06
Continuous Quality Improvement Program
(Essential) |
Formerly Y-06
This essential standard is intended to ensure that a
facility utilizes a structured process to find areas
within the health care delivery system that need
improvement and, when found, facility staff develop and
implement strategies for improvement. It explicitly states that the physician’s chart reviews
should be of 5% up to 25 records per quarter (physician
participation in a CQI committee that studies chart
reviews is an alternative). Certain health service
processes (receiving screening, health assessment, sick
call, emergency care, acute care hospital admissions,
medical emergencies, medication errors and deaths) are
reviewed at least annually. |
J-A-07
Emergency Response Plan
(Essential)
(Name change from Emergency Plan) |
Formerly Y-07
This essential standard intends to ensure that a
facility protects the health, safety and welfare of
inmates, staff and visitors during emergencies, and has
been changed significantly to better reflect emergencies
that occur in correctional settings.
At least one mass disaster drill is required per
facility per year. The health emergency “youth-down”
response is practiced at least annually. Documented
critiques of actual occurrences are acceptable.
Requirements regarding the written plan remain the same;
aspects of health care to be included in the plan are
specified.
If full-time health staff are not assigned to a
particular shift, a drill on that shift is not required.
If no full-time health staff are assigned to the
facility, while the standard remains applicable, the
drill is not required but recommended. |
Y-A-08
Communication on Special Needs Patients
(Essential) |
Formerly Y-08
An intent of this essential standard is to guide
facility practices regarding patients with special
needs. It remains basically the same.
Note: This standard addresses necessary communication
from health staff to corrections; Y-H-03 Access to
Custody Information is the “companion” standard
addressing communication from corrections to health
staff. |
Y-A-09
Privacy of Care
(Important) |
Formerly Y-09
An intent of this important standard is to respect the
privacy of a health encounter and to protect a
patient’s dignity. This standard remains basically the
same; reasonable efforts to guard privacy when security
is a concern are made. |
|
Y-A-10
Procedure in the Event of a Juvenile Death
(Important)
|
Formerly Y-11
This important standard intends to avoid preventable
deaths via a threefold focus on the appropriateness of
clinical care provided, the effectiveness of the
facility’s policies and procedures as they are
relevant to the circumstances surrounding the death, and
the identification of trends that require further study.
Changes to this standard include no longer requiring the
autopsy unless the law requires it. However, both an
autopsy and a psychological autopsy in the event of a
suicide are recommended for the additional learning
opportunities they provide. While all deaths of
juveniles for which the facility is responsible are to
be reviewed regardless of where the death took place,
expected deaths may be reviewed under a modified death
review process.
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Y-A-11
Grievance Mechanism for Health Complaints
(Important)
(Name change from Grievance Mechanism)
|
Formerly Y-12
This important standard intends to protect the
patient’s right to question his/her health care and
remains basically the same. Explicit clarification is
given that grievance responses are expected to be
professional and timely.
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Y-A-12
Notification in Emergencies
(Important)
|
Formerly Y-10
This important standard remains the same.
Note: This is the only standard that appears in the
juvenile standards that does not appear in the adult
versions.
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Y-A-13
Federal Sexual Assault Reporting Regulations (Important)
|
New
This new standard addresses
facilities’ reported compliance with the Prison Rape
Elimination Act of 2003. |
