| Section
E: Inmate Care and Treatment |
P-E-01
Information on Health Services
(Essential) |
Formerly
P-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. |
P-E-02
Receiving Screening
(Essential) |
Formerly
P-32
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; the requirement for the prisons to do the TB
testing as part of the intake remains. While generally
continuing to require that health staff perform the
receiving screening, in prisons with less than 500
inmates, screening may be done by trained correctional
staff. The additional question for women now is simply
inquiry into the possibility of pregnancy. |
P-E-03
Transfer Screening
(Essential) |
Formerly
P-33
This essential standard is intended to ensure that
inmates continue to receive appropriate health services
for health needs already identified and unnecessary
repetitive tests are avoided when they are transferred
between separate facilities that are part of the same
correctional 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. |
P-E-04
Health Assessment
(Essential) |
Formerly
P-34
This essential standard intends that clinicians assess
and plan for meeting the health needs of the individual.
This standard is basically the same, requiring the full
health assessment within 7 days of admission to the
prison 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. For women, a
pelvic examination and Pap test is required. |
P-E-05
Mental Health Screening and Evaluation
(Essential)
(Name change from "Mental Health Assessment"
to better reflect purpose.) |
Formerly
P-35
This essential 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 P-G-04
Mental Health Services, which is a new companion to this
standard and explicitly addresses mental health
services. |
P-E-06
Oral Care
(Essential)
(Name change from "Dental Care" to reflect ADA
current practice.) |
Formerly
P-36
This essential standard remains basically the same and
intends that inmates’ serious dental needs are met.
Routine dental problems are managed in a timely fashion
in keeping with current community standards of practice.
Requirements for oral care by a dentist according to
treatment priorities remain. Oral screening by the
dentist or trained health staff takes place within 7
days; instruction on oral health, within 1 month of
admission; and a dental examination within 30 days. |
P-E-07
Nonemergency Health Care Requests and Services
(Essential)
(Name change to reflect focus of standard.) |
Formerly
P-37 & P-38
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. |
P-E-08
Emergency Services
(Essential) |
Formerly
P-41
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. |
P-E-09
Segregated Inmates
(Essential) |
Formerly
P-39 and P-45
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. Combines elements of
the previous standards on segregation for the prisons,
and is now essential. It is not the reason for the
inmate’s segregation (i.e., disciplinary,
administrative, "super-max" confinement, 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. The first
category, "extreme isolation," refers to
inmates with little or no contact with other
individuals, is relatively rare, even among the
so-called "super-max" settings, and requires
both daily monitoring by health staff and at least once
a week monitoring by mental health staff.
The category of "segregated inmates with limited
contact with staff or other inmates" is most often
referred to as disciplinary segregation and requires
monitoring by health or mental health staff three days a
week.
Most areas identified as administrative segregation will
fall under the category of "segregated
inmates"—those inmates who are in segregation but
nonetheless are 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 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 P-40 Direct 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.,
P-D-02 Medication Services.) |
P-E-10
Patient Escort
(Important)
(Name change from "Patient Transport" to
better reflect focus of the standard.) |
Formerly
P-42
An intent of this important standard is that the
facility provides sufficient escorting staff so that
patients can meet scheduled health care 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. |
P-E-11
Nursing Assessment Protocols
(Important)
(Name change from "Assessment Protocols" to
clarify focus.) |
Formerly
P-43
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. |
P-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 P-E-13 Discharge Planning. |
Formerly
P-44
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. |
P-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. |
