Health Care Liaison

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The 2014 editions of the Standards for Health Services for jails and prisons saw significant changes to many standards. For Standard C-08 Health Care Liaison, the changes were made to assist the field in understanding when a health care liaison is required and to clarify the role of this person in the overall health care delivery system.

Why Is a Health Care Liaison Required?
The intent of this standard is that health care service continues to be coordinated when health staff are not available for an extended period of time, normally 24 hours or more. Because an inmate’s right to access to care does not disappear in the absence of qualified health care professionals, facilities must have a plan so staff can continue to coordinate health care and maintain patients’ rights to see a clinician, be given professional clinical judgment and receive care that is ordered. The health care liaison is responsible for maintaining this continuity of services when health staff are not on site.

When Is a Health Care Liaison Required?
A health care liaison is most commonly seen in facilities with health staff on-site Monday through Friday but not on weekends. For facilities that have health staff on-site daily but less than 24 hours per day, a health care liaison is not required. However, there must still be a plan in place that tells custody staff what to do when a health situation arises when health staff are not present. This standard does not apply to facilities that have health staff 24 hours per day, seven days per week.

Who Should Serve as a Health Care Liaison?
The health care liaison is typically a correctional officer, a child care worker (in juvenile facilities) or other person without a health care license. This person must be instructed in his or her role and responsibilities by the responsible physician or designee and receive instruction in and maintain confidentiality of patient information. Often, custody shift supervisors are chosen to fill this role, although it may be filled by anyone capable of carrying out the duties assigned to the health care liaison post.

Duties and Limitations of a Health Care Liaison
The definition of this post clearly outlines the limited aspects of health care coordination assigned to the health care liaison. These duties include the following:

• Reviewing receiving screening forms for follow-up attention

• Reviewing nonemergency health care requests

• Carrying out clinicians’ orders regarding diet, housing and work assignments

• Maintaining patients’ rights to privacy

It is important to note that the health care liaison does not deliver health care. Duties such as taking orders for new medications, administering injections and setting up or beginning new prescriptions from pharmacy stock exceed the limits of this post and do not meet the intent of this standard.

If a health care liaison’s duties include contacting the on-call provider or nurse for guidance, the advice should (1) fall within the duties outlined above or (2) if the problem is nonemergent, the patient should be referred to the next regularly scheduled sick call or (3) if the problem is urgent or emergent in nature, the patient should be referred to an outside health care facility for an evaluation by a health care professional. All other necessary health care that does not fall within these three parameters should be delivered by qualified health care professionals.

An Important Role
The health care liaison is an important role in the health care delivery system. Understanding both the responsibilities and limitations of this post will help facilities utilize the health care liaison appropriately and allow inmates access to care in a timely manner.

[This article first appeared in the Winter 2015 issue of CorrectCare.]

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