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Inmates shall not provide any type of health care. Responsibilities are limited to
housekeeping, food service and laundry. Inmates may be used as assistants to physically
handicapped inmates. A detailed protocol is required for utilization of inmates in these
functions.
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Medical protocols which are not inconsistent with the Health Care Settlement Agreement
or the Eighth amendment of the United States Constitution shall be enforced.
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Over-the-counter medications shall be made available in all housing units, including
confinement. A protocol shall be available listing the exact medications available and the
procedures for their use and control.
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All non-routine or urgent x-rays shall be taken at an appropriate community hospital or
other site. Routine x-rays may be handled at the institution where an inmate is housed,
however abnormalities must be immediately reported to the Chief Health Officer.
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At institutions which house 600 or more inmates, and also have inmates classified as
medical grades III or IV, registered nursing coverage is required 24 hours per day, 7 days
per week. If the institution is unable to employ the necessary RNs, a minimum of 16 hours
of RN coverage is required. (This is a recruiting issue, not a classification/staffing
issue.)
- During the 8 hours an RN is not available, the following is required:
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a. An inmate who requires 24 hour RN care must be hospitalized or transferred to a
facility where 24 hour RN coverage is available.
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b. A licensed medical professional at the RN level or above must be on call. All calls
for medical assistance from confinement or the general population require a licensed
Correctional Medical Technician (Certified) to respond. Any treatment needed exceeding the
authorized CMTC protocols must refer to the licensed professional on call. The CMTC can
not decline to see an inmate.
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Maintenance and storage of medical records shall be in accordance with the commonly
accepted standards within the professional health community at large.
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Chronic disease follow up clinics, in accordance with OHS protocols, are required at
least in the following areas: tuberculosis, seizure disorders, hypertension, diabetes.
Other such clinics as are medically indicated are required.
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Defendant shall exert his best efforts to obtain appropriate funding to make renovations
to medical space to conform with the minimum guidelines filed with the Court.
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The Assistant Secretary of Health Services is "the ultimate authority in the
Department for health care decisions."
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All CMT positions shall be eliminated from the DC system as incumbents leave the system
through attrition. The preferred licensure for a CMTC position is an LPN (with two years
experience providing health support services in a hospital, clinic, infirmary, nursing or
convalescent home) or health professional with a higher level of licensure. If unable to
employ LPNs, the department may hire a certified EMT or certified Paramedic with two years
of experience in providing health support services in a hospital, clinic, infirmary,
nursing or convalescent home, or ambulance or rescue service.
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There shall be an ongoing system of evaluation of Chief Health Officers and the complete
implementation of Departmental policies and procedures at each institution.
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All medical technicians shall be trained in using protocols and shall be supervised
pursuant to such protocols.
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Confinement screening shall be performed at a consistent time each day. The medical
representative (MD, PA, RN, LPN, CMT) shall have his or her presence announced and shall
have individual contact with each inmate.
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Sufficient staff shall be available at all times to escort inmates to the medical unit
or to outside medical care when needed.
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Controlled substances shall be stored under double lock.
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There shall be a separate infirmary record, with physician, clinical associate
admission, progress and discharge notes for each infirmary admission.
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Isolation rooms shall be retrofitted for suicide watch.
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All health care staff shall be CPR trained and certified. Certification shall be
obtained for new staff and maintained for existing staff.
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One-way breathing masks or Ambu bags shall be located at appropriate locations
throughout institutions. Placement of the masks or Ambu bags shall be reflected in a
protocol.
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A protocol shall be written, and training provided, for the use, maintenance, and
inventory of the crash cart, and the emergency response procedure.
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A formal review of each death shall be done by the medical staff as part of the quality
assurance program.
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The system for the delivery of health care shall be accordance with the commonly
accepted standard within the professional health community at large.
