Nonemergency Health Care Requests

Standard E-07 Nonemergency Health Care Requests and Services requires that oral or written requests for health care are picked up daily by qualified health care professionals and triaged within 24 hours. When a request describes a clinical symptom, a face-to-face encounter between the patient and a qualified health care professional occurs within 48 hours (72 hours on weekends). The intent is that a patient is seen within 48 hours (72 hours on weekends) from the time the request is picked up. The requests should be triaged in the first 24 hours and the face-to-face encounter should be conducted within the next 24 hours.

— From CorrectCare Volume 31, Issue 3, Summer 2017

Upon receipt of a written request for health care, it must be triaged within 24 hours and if the request describes a clinical symptom, a face-to-face encounter with a qualified health care professional must occur within 48 hours from receipt of the written request. The “clock” does not start over again after triage. Your question also refers to the need for the patient to be seen by a “provider,” which is normally a physician or midlevel provider. The standard says that the encounter must be with a “qualified health care professional,” which also includes nurses. Please see the glossary for a definition of who is considered qualified health care professionals.

— From CorrectCare Volume 29, Issue 2, Spring 2015

This standard intends that inmates’ routine health care needs are met. Therefore, facilities should not limit the number of health care requests an inmate can make. However, if the requests are for the same issue, it is not necessary to respond to all of them.
— From CorrectCare Volume 28, Issue 4, Fall 2014

No. The 48-hour time frame begins upon receipt of the written or oral health care request. Triage is required within 24 hours and a face-to-face assessment (when the request describes a clinical symptom) by a qualified health care professional is required within the next 24 hours. This is applicable for all medical, dental and mental health requests.
— From CorrectCare Volume 28, Issue 2, Spring 2014

There are a couple of standards that must be considered. Standard J-E-06 Oral Care requires that oral treatment, not limited to extractions, is provided according to a treatment plan based on a system of established priorities for care when, in the dentist’s judgment, the inmate’s health would otherwise be adversely affected. Standard J-E-07 Nonemergency Health Care Requests and Services requires that oral or written requests for health care are received daily by qualified health care professionals and triaged within 24 hours. Based on physician-approved protocols, qualified health care professionals schedule inmates, when indicated, for sick call or the next available clinician’s clinic. Not every sick call request requires a sick call appointment; however, when a request describes a clinical symptom, a face-to-face encounter between the inmate and the health care professional is required.

If the request you described does not include a clinical symptom, then a face-to-face visit would not be required by the Standards. I would advise working closely with the dentist at your facility to determine the appropriate response to requests for fillings or cleanings.

— From CorrectCare Volume 28, Issue 1, Winter 2014

Having a nurse triage complaints directly at the housing unit is certainly an acceptable method. However, three caveats must be considered. The first is access. Consider this triage system for seven days a week instead of five. If you plan to use a bifurcated system (personal triage Monday through Friday, written slips Saturday and Sunday), you may be creating some problems for access. Bifurcated systems are confusing for staff and inmates and may increase the risk of someone not being able to get their health needs known during the weekend. The second caveat is documentation. The standard requires that inmate requests are documented, so the triaging nurse needs to maintain a log of triaged complaints. The third caveat is privacy. All due caution should be taken to ensure that the triage encounter is performed with some privacy so that the inmate feels unencumbered when relating his or her health issues.

— From CorrectCare Volume 26, Issue 4, Fall 2012

The standards do not address how frequently an individual must be seen for a particular condition. That decision rests with the treating clinician. If the clinician wishes to schedule monthly check ups for this patient, he/she should write the order accordingly. The standards do state that inmates must have an opportunity daily to request medical assistance and that their requests must be triaged and acted upon as appropriate (E-07 Nonemergency Health Care Requests and Services). This does not mean, however, that an inmate must be seen each time he/she makes a request. In your case, I would suggest that each time this inmate makes a request, you bring it to the attention of the treating clinician and let him/her decide whether the patient needs to be seen and, if so, when. If the clinician determines the patient does not need to be seen until the next scheduled visit, that information should be communicated to the patient exactly that way (e.g., “Dr. Jones says she will see you at your next scheduled visit on Jan. 15”).

— From CorrectCare Volume 22, Issue 4, Fall 2008