Juveniles in Adult Facilities
We are a large state prison for male adults but now have four juveniles. They were adjudicated as adults and are serving their time with us. Chronologically, however, they are adolescents. Which NCCHC standards do we follow for them?
You should follow the standards for health services in prisons. You are not required to meet NCCHC’s standards for juvenile facilities in addition to the prison standards just because you house a handful of adolescents. However, standard P-G-02 Patients With Special Health Needs encompasses juveniles and requires the development of a treatment plan and special attention to diet, exercise and nutrition. The juveniles in your facility should be on your list of special needs patients.
[For more guidance, see NCCHC’s position statement on Health Services to Adolescents in Adult Correctional Facilities.]
— From CorrectCare Volume 32, Issue 1, Winter 2018
Our prison houses juveniles adjudicated as adults. What is NCCHC’s age designation for adolescents? Those who work in adolescent medicine consider all youth to be adolescents up to age 21; I’m not sure that is NCCHC’s intent. In the 2008 prison Standards, P-G-02 includes adolescents in the list of patients with special health needs, and the dietary standard (P-F-02) discusses extra calories for adolescents.
NCCHC’s intent is that, from a health standpoint, adolescents should be treated as they would be in the community. All references to adolescents in the Standards, adult or juvenile, are based on the definition used by the medical/mental health field, not the legal definitions that vary from state to state. More a developmental stage of life than a chronological age, adolescence usually is considered to span the ages of 12-13 through 18-21. The Standards glossary defines it as “the period of life that begins with puberty and ends with completed growth and physical maturity, and requires special attention to exercise, nutrition, and appropriate social interaction.”
The concern is that adequate attention be given to the interventions that promote healthy physical development, with emphasis on immunizations, exercise as a necessity, adequate nutrition, preventive dental care, and early identification of and intervention for health care needs, including mental health and substance issues. In general, when surveyors review records of inmates under age 21, they are looking for documentation of those considerations. The treatment plans for adolescents certainly can be used as a template focusing on these developmental issues, with, of course, areas that can be individualized.
For more guidance, see NCCHC’s position statement on Health Services to Adolescents in Adult Correctional Facilities.
— From CorrectCare Volume 17, Issue 4, Fall 2003; updated February 2010