Responsible Health Authority
This question comes up periodically; you are not alone in your confusion. The two roles are not the same person. The facility administrator is a custody-specific role, generally the top custody administrator (for instance, the warden or chief) who is specifically assigned to oversee facility operations. The responsible health authority (RHA) is a health services-specific role, generally the top health services person (for instance, the health services administrator or nursing supervisor) who is assigned to oversee health services operations. There are instances in which the RHA is a company (a private health services vendor), an agency (a local health department), or a regional- or corporate-level person (usually for small sites that do not have an on-site nursing supervisor). In these instances, the RHA must be designated to be on-site at least weekly.
From CorrectCare Volume 36, Issue 2, Fall 2022
The RHA should designate someone to be on-site at least once a week for each facility. In a system such as yours, that person may work under the supervision of the system’s health authority. If your outlying facility is large, it probably has a physician who visits at least weekly. Such a person, or an on-site administrator, is often the one who is designated as the facility’s responsible health authority.
— From CorrectCare Volume 33, Issue 2, Spring 2019
Standard A-02 Responsible Health Authority defines a health administrator as a person who by virtue of education, experience or certification is capable of assuming responsibility for arranging all levels of health care and ensuring quality and accessible health services for inmates. While an LPN may serve as the health services administrator, final clinical judgments must rest with a single, designated, licensed responsible physician.
Your second question refers to Standard E-04 Initial Health Assessment. While states vary in the scope of practice for LPNs, NCCHC standards are clear. An LPN may collect additional data to complete the medical, dental and mental health histories, and may take and record vital signs, but the hands-on physical must be performed by a physician, physician assistant, nurse practitioner or trained RN.
— From CorrectCare Volume 30, Issue 3, Summer 2016
I assume that the mental health authority is separate from that of health services in your facility. Just like health services are required to have a responsible physician, there should be a similar counterpart for mental health services; in the Standards, the term used is “designated mental health clinician” (A-02 Responsible Health Authority, compliance indicator #6). Here’s the definition: A designated mental health clinician refers to a psychiatrist, psychologist or psychiatric social worker who is responsible for clinical mental health issues when mental health services at the facility are under a different authority than the medical services.
— From CorrectCare Volume 25, Issue 3, Summer 2011
NCCHC accredits individual facilities, not systems, so the correspondence must come from the responsible health authority’s designee at the facility (standard A-02 Responsible Health Authority, Compliance Indicator 4). Usually this is the facility health services administrator. When materials are sent by contracted, system-level or regional providers, the facility-based designee must verify the documentation, usually by a cosignature. It doesn’t matter that the designee’s employer is a contractor.
— From CorrectCare Volume 24, Issue 1, Winter 2010
Standard A-02 Responsible Health Authority states that a health administrator is a person who by virtue of education, experience or certification (e.g., MSN, MPH, MHA, FACHE, CCHP) is capable of assuming responsibility for arranging all levels of health care and ensuring quality and accessible health services for inmates. If the sergeant is a Certified Correctional Health Professional (CCHP) or has other relevant educational credentials, then by virtue of his or her education, experience or certification this position would be appropriate.
— From CorrectCare Volume 23, Issue 4, Fall 2009