Chapter 5.12
HEALTH AND WELFARE

Sections:

5.12.010    Responsible physician and licensed staff.

5.12.020    Health care policies and procedures.

5.12.030    Health screening.

5.12.040    Access to health care.

5.12.050    Health care training.

5.12.060    Medications control.

5.12.070    Health care records.

5.12.080    Special medical issues.

5.12.090    Access to facilities.

5.12.100    Food.

5.12.110    Clothing, bedding and personal items.

5.12.120    Sanitation.

5.12.010 Responsible physician and licensed staff.

(1) The bureau shall designate a health authority with responsibility for health care services pursuant to a written agreement, contract or job description. The health authority may be a physician, health administrator or agency. When this authority is other than a physician, final medical judgments shall rest with a single designated responsible physician licensed in the state of Washington.

(2) Matters of medical and dental judgment shall be the sole province of the responsible physician and dentist respectively; security regulations applicable to facility personnel shall also apply to health personnel. The bureau chief shall develop a policy outlining steps to be followed in the event of a conflict between security and medical staff related to provision of medical care.

(3) State licensor and/or certification requirements and restrictions shall apply to health care personnel.

(4) All medical personnel shall practice within the scope of their license. Where applicable, treatment shall be performed pursuant to a written standing or direct order.

(5) Verification of current licensing and certification credentials shall be on file with the bureau.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009).

5.12.020 Health care policies and procedures.

(1) Written standard operating procedures approved by the responsible physician and the bureau chief shall include, but not be limited to, the following:

(a) Receiving screening;

(b) Non-emergency medical services;

(c) Deciding the emergency nature of illness or injury;

(d) Availability of dental referral examination, and treatment;

(e) Provision of medical and dental prostheses;

(f) First aid;

(g) Notification of next of kin or legal guardian in case of serious illness, injury or death;

(h) Providing chronic care;

(i) Providing convalescent care;

(j) Screening, referral and care of mentally ill and developmentally disabled prisoners and prisoners under the influence of alcohol and other drugs;

(k) Implementing the special medical program provided for in SCC 5.12.080(2)(b);

(l) Delousing procedures;

(m) Detoxification procedures;

(n) Pharmaceuticals;

(o) Communicable disease screening and control; and

(p) Segregation for prisoners with airborne communicable disease.

(2) The work of qualified medical personnel shall be governed by the responsible physician and applicable county personnel rules.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009).

5.12.030 Health screening.

(1) Receiving screening shall be performed on all prisoners upon admission before being placed in the general population or housing area. The findings shall be recorded on a printed or computerized screening form. The screening shall include inquiry into:

(a) Current illnesses and health problems;

(b) Medications taken and special health requirements;

(c) Screening of other health problems designated by the responsible physician;

(d) Behavioral observation, including state of consciousness and mental status;

(e) Notation of body deformities, trauma markings, bruises, lesions, ease of movement, jaundice and other physical characteristics;

(f) Condition of skin and body orifices, including rashes and infestations; and

(g) Disposition/referral of prisoners to qualified medical personnel on an emergency basis.

(2) The contents of the health screening record shall be subject to the confidentiality provisions of SCC 5.12.070(2).

(Added Amended Ord. 94-041, May 25, 1994).

5.12.040 Access to health care.

(1) Adequate equipment, supplies and materials shall be provided for the performance of primary health care delivery.

(2) At the time of admission, prisoners shall be advised, consistent with the provisions of SCC 5.08.010(1)(f), of the procedures for gaining access to medical services.

(3) Prisoners’ medical complaints shall be collected daily and acted upon by medically trained personnel. An appropriate priority shall be established with treatment by qualified medical personnel to follow.

(4) Work release prisoners shall be allowed to see their own physicians outside of the work release/special detention facility and shall be responsible for their own medical expenses.

(5) Sick Call.

(a) Sick call shall be conducted by a physician and/or other qualified medical personnel and shall be available to each prisoner at least five times per week;

(b) When sick call is not conducted by a physician, the responsible physician shall arrange for the availability of a physician at least once each week to respond to prisoner complaints regarding services which they did or did not receive from other medical providers; further, regardless of complaints, the responsible physician shall review the medical services delivered at least weekly.

(6) Medical and dental prostheses shall not be denied when the health of the prisoner/patient would otherwise be adversely affected as determined by the responsible physician.

(7) Emergency Care.

(a) First aid kit(s) shall be conveniently available in each bureau facility;

(b) Emergency medical and dental care shall be available on a 24-hour basis in accordance with a written plan which includes:

(i) Arrangements for the emergency evacuation of the prisoner from the facility;

(ii) Arrangements for the use of an emergency medical vehicle;

(iii) Arrangements for the use of one or more designated hospital emergency rooms, other appropriate health facilities or on-call physician and dentist services.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009).

5.12.050 Health care training.

(1) All correctional officers shall be trained in standard first-aid equivalent to that defined by the American Red Cross and usual emergency care procedures prior to employment or during the probationary period. Written standard operating procedures and training of staff shall incorporate the following steps:

(a) Awareness of potential medical emergency situations;

(b) Notification or observation determination that a medical emergency is in progress;

(c) "First aid" and resuscitation;

(d) Call for help; and

(e) Transfer to appropriate medical care provider.

(2) All correctional officers shall have training in receiving screening and basic life support cardiopulmonary resuscitation (CPR).

(3) All correctional officers shall be given training regarding the recognition of symptoms of mental illness, suicidal ideation and developmental disabilities.

(4) All persons responsible for the delivery of medications shall have training regarding the medical, security and legal aspects of such activity.

(Added Amended Ord. 94-041, May 25, 1994).

5.12.060 Medications control.

(1) The bureau’s standard operating procedures for the proper management of pharmaceuticals shall include:

(a) A formulary specifically developed for stock medications maintained within bureau facilities. Such formulary shall be in accordance with WAC 360-16-070 (clinic dispensary);

(b) A policy regarding the prescription of all medications, with particular attention to behavior modifying medications and those subject to abuse;

(c) A policy regarding medication dispensing and administration which shall include, but not be limited to:

(i) Non-medical personnel delivering medication(s) to prisoners;

(ii) Disposition of medication(s) brought in by prisoners at the time of admission to the facility;

(iii) Packaging of medication(s): The medications system shall insure that all medications are kept in containers which have been labeled securely and legibly by a pharmacist or the prescribing physician or in their original container labeled by their manufacturer. Medications shall not be transferred from the original container except for the preparation of a dose administration;

(iv) Safeguards with regard to delivery of medications to prisoners; and

(v) Disposition of unused medication(s);

(d) A policy regarding the maximum security storage and weekly inventory of all controlled substances, prescription medication(s), syringes, needles and surgical instruments. The bureau shall provide for a consulting pharmacist to determine that medication(s) have been properly managed.

(2) The person delivering medication(s) shall be accountable for following the orders of medical staff.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009.

5.12.070 Health care records.

(1) The medical supervisor, under guidance from the responsible physician, shall be responsible for maintaining prisoner medical record files. Such files shall contain the completed receiving screening form, health appraisal data collection forms, all findings, diagnoses, treatments, dispositions, prescriptions and administration of medications, notes concerning patient education, notations of place, date and time of medical encounters and terminations of treatment from long term or serious medical or psychiatric treatment.

(2) The medical supervisor shall insure the confidentiality of each prisoner’s medical record file and such file shall be maintained separately to the extent necessary to maintain its confidentiality.

(3) The medical supervisor or the medical supervisor’s designee(s) shall communicate information obtained in the course of medical screening and care to bureau authorities when necessary for the protection of the welfare of the prisoner or other prisoners, management of the facility or maintenance of security and order.

(4) A copy or summary of the medical record file shall routinely be sent to any jail or correctional institution to which a prisoner is transferred at the time of such transfer. A copy of such file or parts thereof shall also be transmitted upon the written authorization of a prisoner to designated physicians and medical facilities.

(5) The person delivering medications shall record the actual time of the delivery in a manner and on a form approved by the responsible physician.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009).

5.12.080 Special medical issues.

(1) Informed Consent.

(a) All examinations, treatments and procedures affected by informed consent standards in the community shall likewise be observed for prisoner care;

(b) No prisoner shall be given medical treatment against the prisoner’s will except as necessary to prevent the spread of communicable disease, to relieve imminent danger to the life of the prisoner or, in the case of serious mental disorders, to prevent imminent danger to the life of the prisoner or to the lives of others. Any other treatment without the prisoner’s consent shall be provided only pursuant to court order. All procedures required by chapter 71.05 RCW shall be followed in any case of involuntary commitment or involuntary treatment of mentally ill persons within a department facility;

(c) In the case of minors, the informed consent of parent, guardian or legal custodian applies where required by law;

(d) In all cases, the responsible physician shall give a clear statement to the prisoner/patient of the diagnosis and treatment.

(2) Special Medical.

(a) Staff shall report any symptoms of prisoner mental illness or retardation to medical personnel for appropriate evaluation and treatment;

(b) A special program shall exist for prisoners requiring close medical supervision. A written individual treatment plan for each of these patients shall be approved by the responsible physician. The treatment plan shall include directions to medical and non-medical personnel regarding their roles in the care and supervision of the patient;

(c) Appropriate medically supervised treatment in accordance with written procedures established under SCC 5.12.020(1) shall be given in the facility to prisoners determined to be mentally ill or under the influence of alcohol, opiates, barbiturates and similar drugs when such care is not provided in a community health facility;

(d) Reasonable physical restraint, when necessary for medical reasons, shall be medically directed, except that in an emergency reasonable physical restraint may be used to control a grossly disturbed or violent prisoner, but the review and direction of the health care staff or local mental health professionals shall be promptly obtained.

(Added Amended Ord. 94-041, May 25, 1994).

5.12.090 Access to facilities.

(1) Regular bathing (shower) shall be permitted at least four times each week.

(2) Each prisoner shall have access to toilet, sink, drinking water and adequate heat and ventilation.

(Added Amended Ord. 94-041, May 25, 1994).

5.12.100 Food.

(1) General Food Requirements.

(a) At least three meals a day shall be served at regular intervals. The morning meal shall be served within 14 hours of the previous day’s evening meal;

(b) The bureau may arrange for prepared meal service or serve frozen packaged meals, provided these meals conform to the other requirements of this section;

(c) Meals shall be served in a reasonable manner, hot food served hot, cold food served cold.

(2) Nutritional and Caloric Intake.

(a) Menus shall be reviewed by a qualified nutrition consultant to insure that diets approximate recommended dietary allowances;

(b) Diets ordered by medical staff shall be strictly observed.

(3) Kitchen Facilities.

(a) Kitchen facilities shall be maintained in a sanitary condition and inspected at least annually by the local health district. The health district inspection will include the food serving process in prisoner housing areas. If corrective responses are required, the bureau shall document compliance and arrange for a re-inspection if required by the health district.

(b) The bureau shall conduct regular inspections of the food service by a staff member specially trained for this purpose.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009).

5.12.110 Clothing, bedding and personal items.

(1) Clothing.

(a) Provision shall be made for staff to treat clothing to prevent migration of lice. Alternatively, separate insect proof clothing storage shall be provided to prevent lice migration;

(b) The bureau shall insure that prisoners’ outer garments are laundered and made available to them at least once a week and that prisoners’ undergarments and socks are laundered and made available to them at least twice a week. In the work release/special detention facility this requirement may be met by providing laundry facilities to the prisoners;

(c) The bureau shall, if necessary, clean and sanitize personal clothing prior to storage.

(2) Bedding.

(a) Each prisoner shall be issued clean bed linens for the first night’s detention and at least once a week thereafter. Bed linens shall include:

(i) One detachable cloth mattress cover and one sheet; or

(ii) Two sheets; or

(iii) One double sized sheet.

(b) Mattresses shall have a washable surface and shall be sanitized at least semiannually and before being reissued to another prisoner;

(c) Blankets shall be issued upon arrival and shall be washed at frequent intervals to maintain a clean condition, but at least once every 60 days and always before reissue;

(d) No prisoner shall be required to sleep directly on the floor.

(3) Personal Care Items.

(a) Personal care items issued to each prisoner shall include, but not be limited to, soap and towel. Female prisoners shall be supplied with necessary feminine hygiene items. Work release/special detention facility prisoners may be allowed to provide these personal care items for themselves;

(b) A toothbrush with dentifrice and comb shall be provided for all prisoners. Such items shall be available for purchase or shall be issued at booking and as needed. Prisoners without funds shall have access to these minimum items without cost.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009).

5.12.120 Sanitation.

(1) General.

(a) All bureau facilities shall be kept in a clean and sanitary condition, free from any accumulation of dirt, filth, rubbish, garbage or other matter detrimental to health;

(b) Staff shall insure that prisoners clean their own living area daily. Convicted prisoners may be required to clean other space within the confinement area. Pretrial detainees may be permitted to do so voluntarily.

(c) All bureau facilities shall be inspected by a qualified sanitarian at least once per year. If corrective responses are required, the bureau shall document compliance and arrange for a re-inspection if required by the sanitarian. The bureau shall conduct regular sanitary inspections of bureau facilities by a staff member specially trained for this purpose.

(2) Insects, Rodents and Pets.

(a) Insects and rodents shall be eliminated by safe and effective means. Prisoners shall be removed from areas in which insecticides and rodenticides are being used;

(b) Pets shall not be allowed in bureau facilities.

(3) Laundry. The bureau shall arrange for adequate laundry services.

(Added Amended Ord. 94-041, May 25, 1994; Amended by Amended Ord. 08-137, Nov. 10, 2008, Eff date Jan. 1, 2009)