West Virginia Code of State Rules › Agency 95 - Jails And Prisons Standards Commission › Title 95 - LEGISLATIVE RULE JAIL AND CORRECTIONAL FACILITY STANDARDS COMMISSION › Series 95-01 - WV Minimum Standards For Construction, Operation, And Maintenance Of Jails › Section 95-1-14 - Medical and Health Care Services

Current through Register Vol. XLI, No. 28, July 12, 2024
14.1. Right to
				medical care. All inmates shall have prompt access to necessary medical, dental
				and psychiatric care provided in a reasonable manner by licensed
				personnel.
14.2. Responsibility.
				Medical, dental and mental health decisions involving clinical judgements shall
				be the sole province of the responsible health care professional. The jail
				facility administrator shall provide administrative support for the
				availability of medical care to inmates and shall advise the health care
				professionals concerning jail facility security.
14.3. Responsible physician. A responsible
				physician shall be designated to approve health care policies, procedures and
				agreements which may include the use of emergency rooms in local hospitals.
				Each jail facility shall have agreements or provisions for twenty-four (24)
				hour coverage by an on-call physician. All physicians and dentists examining or
				treating inmates shall be licensed to practice in the State of West
				Virginia.
14.4. On site health
				authority. An on site health authority shall be designated and present at all
				times. The health authority may be a physician, physician's assistant,
				registered nurse, licensed practical nurse, nurse practitioner, paramedic,
				emergency medical technician, or a health trained staff member.
14.5. Medical autonomy and jail facility
				administration. Medical decisions shall be made only by the physician or his or
				her designee. It shall be made clear to the health authorities, that security
				rules which apply to non-medical jail facility staff also apply to health care
				staff. The jail facility administrator shall provide information and
				orientation concerning security rules to health care staff.
14.6. Duties and responsibilities.
				Appropriate state and federal licensure, certification or registration
				requirements and restrictions apply to personnel who provide health care
				services to inmates. The duties and responsibilities of medical care personnel
				shall be governed by written job descriptions approved by the responsible
				physician and the jail facility administrator. Verification of current
				credentials and job descriptions shall be on file in the jail facility. The
				provision of quality health care shall be ensured by the use of only qualified
				health care personnel to determine and supervise health care procedures.
				Written job descriptions shall include the qualifications required and the
				specific role in the health care delivery system of that position. Verification
				of qualifications may consist of copies of current certificates or
				licenses.
14.7. Administrative
				meetings and reports. There shall be meetings, at least quarterly, between the
				health care staff and the jail facility administrator to review and discuss
				health care programs in the jail facility. Notes of these meetings shall be
				kept by the jail facility administrator. The responsible physician shall submit
				quarterly reports on the health care delivery system and annual statistical
				reports. The report shall include topics such as the effectiveness of the
				health care delivery system, a description of any environmental factors which
				may require improvement, changes effected since the last report, and
				recommendations for corrective action if needed. The annual statistical report
				of inmate health care shall include the number and nature of sick call visits,
				diagnostic studies conducted, emergency services rendered, referrals to
				specialists, hospitalizations, special procedures performed, ambulance
				transports used, communicable diseases reported and deaths. The annual
				statistical report, along with an appraisal of the jail facility's health care
				system shall be submitted to the authority having jurisdiction over the jail
				facility by the responsible physician.
14.8. Review. Each policy, procedure and
				program in the health care delivery system shall be reviewed at least annually
				by the responsible physician and revised if necessary. Each policy or procedure
				document shall bear the date of the most recent review or revision and the
				signature of the reviewer.
14.9.
				Policies and procedures. The responsible physician shall write or approve
				pre-written health policies and procedures for the following components of jail
				facility health care:
14.9.1. Decision making
				for special problem inmates. Before inmates with diagnosed psychiatric or
				significant medical illnesses are given housing assignments, work assignments,
				disciplinary measures or transfers, the jail facility administrator and the
				responsible physician or their de­signees shall confer to consider any
				special precautions or preparations. A list of frequent illnesses which require
				special arrangements shall be developed. Special diets must be provided when
				requested by health personnel and approved by the responsible
				physician.
14.9.2. Notification of
				next of kin. The jail facility administrator or responsible physician shall
				notify the next of kin or legal guardian of the serious illness, serious injury
				or death of any inmate in the custody of the jail facility.
14.9.3. Post mortem examination. The jail
				facility administrator or responsible physician shall immediately notify the
				State Medical Examiner of the death of any inmate. The jail facility shall
				cooperate with the State Medical Examiner in the conduct of post mortem
				examination if found to be necessary.
14.9.4. Minimum staff training requirements.
				Health trained staff is defined as jail personnel who have the equivalent of
				EMT training and also have received information regarding the symptoms of
				physical and mental illnesses common to the inmate population (including
				depression and chemical dependency), basic management of seizures, medication
				administration, health record maintenance, recognition of potentially suicidal
				behavior, ability to respond to health related situations within four (4)
				minutes, first aid training, and procedures for transfer of inmates to
				appropriate medical facilities or health care providers. Training may be
				effected through a local hospital, emergency room, county health department,
				county medical society, Red Cross chapter, or any other program approved by the
				responsible physician. An appropriate training course may be completed in
				approximately 60-80 hours. Each shift shall include at least one person who has
				become health trained as described in this subsection. Ideally these persons
				shall be from the health care profession but may be health trained jail
				facility personnel.
14.9.5. Suicide
				prevention. There shall be a written suicide prevention and intervention
				program that is reviewed and approved by a qualified medical or mental health
				professional. All jail facility staff who are responsible for inmate
				supervision shall be trained in the implementation of the program. The staff
				shall be responsible for intake screening and identification of potentially
				suicidal inmates in an effort to prevent suicide.
14.9.6. Prohibited inmate assignments.
				Inmates shall not be assigned the following duties:
a. Performing direct patient care
				services;
b. Scheduling health care
				appointments;
c. Determining or
				controlling access to health care by other inmates;
d. Handling or having access to surgical
				instruments, syringes, needles, medications or health records; and,
e. Operating medical equipment.
The
				  restrictions of this subsection shall not be construed to preclude inmates from
				  participation in a certified vocational training program. Inmates may be
				  permitted to perform janitorial or cleaning services in the medical areas under
				  the supervision of qualified staff.
14.9.7. Receiving Medical Screening. A
				receiving medical screening appraisal to elicit information pertinent to the
				inmates' health shall be performed on every inmate at the time of admission.
				The screening shall be recorded on a form which has been approved by the
				responsible physician. Screen­ing is a means to discover and prevent
				health and safety threats to both inmates and staff. The goal of receiving
				screening shall be to detect any communicable diseases, chemical dependence,
				potential for suicide, or other medical or psychiatric problems before the
				inmate is placed within the jail population. When the inmate has been
				transferred from another facility and is accompanied by a previously completed
				screening form, the form shall be reviewed and verified. The receiving
				screening shall be conducted by a health-trained staff member. No inmate in
				obvious need of medical attention shall be admitted to any jail facility until
				such time as the arresting or transporting officer shall obtain written medical
				clearance indicating that the inmate is physically capable of withstanding
				incarceration. The screening inquiry shall include the following topical areas:
a. Current illness and health problems,
				including dental problems;
b.
				Venereal diseases and other infectious diseases;
c. Current medication and special health
				requirements;
d. Use of alcohol or
				other drugs, including types of drugs used, mode of use, amounts used,
				frequency of use, date or time of last use, and history of problems which may
				have occurred after cessation of use;
e. Past and present treatment or
				hospitalization for mental disturbance or at­tempted suicide;
				and,
f. Other health problems as
				may be identified by the responsible physician.
14.9.8. Disposition. The receiving
				screen­ing process shall include a recommendation to one of the
				following population classifications: General population, with or without
				referral for appropriate health care services; emergency referral to
				appropriate health care services; or, medical isolation and special
				observation.
14.9.9. Health
				Appraisal. Within fourteen (14) days of admission, a health appraisal shall be
				completed for each inmate which includes a medical history and examination
				which is recorded on a form approved by the responsible physician. Although a
				physician, physician's assistant or nurse practitioner must perform the
				physical examination, the health history may be completed by a health trained
				staff member. The health appraisal shall include the following:
a. Review of the earlier receiving screening
				by the examining clinician;
b.
				Collection of additional data to complete the medical, dental, psychiatric and
				dental histories;
c. Administration
				of laboratory and/or diagnostic tests to detect communicable diseases including
				tuberculosis;
d. Recording of
				current height, weight, pulse rate, blood pressure and temperature, any other
				diagnostic tests administered and comments concerning mental and dental status;
				and,
e. The results of the medical
				examination, test results and other information collected shall be reviewed by
				a physician who shall direct the initiation of appropriate medical care and
				treatment.
14.9.10. Care
				for persons under the influence of drugs. The responsible physician shall
				approve policies and procedures for the identification of alcohol and drug
				dependence as well as subsequent management and/or transfer for the care of
				persons under a drug influence. Unless the jail facility has special facilities
				and constant medical supervision to perform detoxification, detoxification
				shall not be performed at the jail facility; inmates who require detoxification
				shall be transferred to a hospital or detoxification center designated by the
				responsible physician. Procedures for adequate care of persons under the
				influence of drugs include written policies and training concerning medical
				screening, observation, referral evaluation, and safety protection.
14.9.11. Psychiatric illness. Post admission
				screening and referral for the care of mentally ill or retarded inmates whose
				adaptation to the jail facility environment is significantly impaired shall be
				provided. Psychiatric problems identified, whether identified during receiving
				screening or after admission, shall be followed up by medical staff. The
				urgency of the presenting problem shall determine the response. Potentially
				suicidal and psychotic patients are emergencies and require prompt attention.
				Inmates awaiting emergency evaluation shall be housed in a specially designated
				area with constant supervision by trained staff. Inmates shall be held only for
				the minimum time necessary before emergency care is rendered. All sources of
				assistance for mentally ill or impaired inmates shall be identified in advance
				of need and referral procedures shall be in place for use in cases where the
				need exists. No person shall be housed in a jail facility solely upon an
				involuntary commitment proceeding pursuant to W. Va. Code '27-5-1 et.
				seq..
14.9.12. There shall be
				consultation between the jail facility administrator and the responsible
				physician or their designees prior to the making of housing assignment, program
				assignment, imposition of disciplinary measures or the transfer of any inmate
				who is diagnosed as having a psychiatric illness.
14.9.13. Access to treatment. Upon admission
				each inmate shall be informed of his or her right of access to medical
				treatment; in addition to verbal instruction, each inmate shall receive an
				information sheet which includes information about the jail facility's sick
				call schedule, the procedures for registration for sick call and the grievance
				procedures concerning medical care. The medical information sheet shall be
				approved by the responsible physician.
14.9.14. Daily health complaints. The health
				complaints of inmates shall be solicited daily and acted upon by trained
				personnel such as a licensed nurse or registered nurse and followed by
				appropriate triage and treatment by qualified personnel. Triage is the sorting
				and allocation of treatment of patients according to priorities of
				need.
14.9.15. Sick Call. Sick call
				is the system through which each inmate reports for and receives appropriate
				medical services for non-emergency illness or injury; if an inmate's custody
				status precludes attendance at sick call, arrangements shall be made to provide
				sick call services in the inmate's place of detention. Inmates will have daily
				access to sick call forms which shall be reviewed that day by the health
				authority or other person designated by the responsible physician. All
				complaint forms will become part of the inmate's health record. Sick call shall
				be performed by a licensed physician, physician's assistant, registered nurse,
				or other person designated by the responsible physician. Sick call is a
				designated time to review non-emergency medical problems and shall be held at
				the following intervals:
a. In jail facilities
				of less than fifty inmates, one time per week;
b. In jail facilities of fifty to one hundred
				inmates, two times per week;
c. In
				jail facilities of one hundred to two hundred inmates, three days per week;
				and,
d. In jail facilities of more
				than two hundred inmates, five times per week.
14.9.16. Use of restraints or isolation for
				out of control inmates. The responsible physician shall approve a plan which
				guides the use of restraints or isolation and providing for mental health
				personnel to evaluate inmates who are repeatedly out of control or who remain
				out of control for more than a short amount of time. Use of physical restraints
				in the control of inmates inside the jail facility may only be used for the
				protection of the individual or others. The use of restraints shall be recorded
				in the inmate's record. Any time an inmate remains out of control for more than
				a short amount of time, mental health personnel shall be consulted.
14.9.17. Health Promotion/Wellness Promotion.
				The responsible physician shall consider plans which provide inmates with
				health education and preventive medical services.
14.9.18. Prevention of the spread of disease.
				Jail facilities shall establish an area for use by inmates who have medical
				problems which require separation or close observation. Inmates in such areas
				shall be allowed to participate in an appropriate form of exercise, including
				exercise of large muscle groups, for a minimum of one hour per day.
14.9.19. Dental Care. Dental care shall be
				provided to each inmate under the direction and supervision of a licensed
				dentist under the following conditions:
a.
				Each inmate shall receive a dental examination as a component of his or her
				health evaluation within fourteen days of admission; and,
b. Emergency dental treatment for conditions
				which adversely affect the inmate's health shall be provided within three (3)
				months of admission.
14.9.20. Special medical programs.
				Arrangements shall be made for the provision of special medical programs,
				including chronic care, convalescent care and preventive medical maintenance
				for inmates. The special medical program shall service a broad range of health
				problems, e.g., seizure disorders, diabetes, potential suicide, chemical
				dependency, and psychosis. These special medical programs require close medical
				supervision. Chronic care is medical service rendered to a patient over a long
				period of time for conditions such as diabetes, asthma, and epilepsy.
				Convalescent care is medical care provided to assist a patient in the recovery
				from illness, injury or surgery. Preventive medical maintenance includes health
				education and medical services such as inoculation and immunization and is
				provided to take measures in advance of the onset of illness or to provide
				instruction in the self-care of chronic conditions. Provided that, for purposes
				of this rule only, use of or withdrawal from the use of nicotine shall not be
				considered a chemical dependency or otherwise qualify the inmate for medical or
				psychological treatment or counseling.
14.9.21. Prostheses. The responsible
				physician or dentist shall determine the medical necessity for prosthetic
				devices. Prosthetic devices shall be provided when medically necessary to avoid
				adverse affect upon the inmate's health.
14.9.22. Management of pharmaceutical.
				Procedures for prescribing, dispensing and administering drugs shall be in
				compliance with federal and state laws and regulations. The responsible
				physician shall approve written procedures for the distribution,
				administration, accounting and disposal of medications. The responsible
				physician shall approve a written medication log which shall be maintained for
				each inmate receiving medication. The inmate's medication log shall include the
				date, time, name of drug and dosage administered. Any inmate who refuses
				medication shall sign a statement to that effect, which shall be signed by a
				staff member and filed in the inmate's medical record. Medications shall be
				administered only by a physician or nurse, or, after written approval from the
				responsible physician, by the health authority or health trained staff member;
				exception to this requirement may be made for self administration of insulin
				injections by inmates who have received appropriate instruction and are under
				the supervision of the health authority or a health trained staff member. The
				physician shall inform jail facility personnel of possible side effects of
				medication prescribed for inmates. When medications are taken orally, the
				person administering the medication shall take appropriate action to verify
				that the medication has been swallowed, thereby ensuring proper ingestion of
				the prescribed medication. The jail facility shall provide a locked storage
				area for medications and a list of stored medications shall be maintained.
				Refrigeration shall be provided if needed for proper storage of
				medications.
14.9.23.
				Administration of medications. Persons administering medications shall do so
				under the supervision of the responsible physician and shall have received
				training appropriate to their assignment. They are accountable for
				administering medications according to orders as to both frequency and dosage,
				and for recording the administration of medications in a manner and on a form
				approved by the responsible physician. Training from the responsible physician
				shall include the medical aspects of administration or distribution of
				medication. Training from the jail facility administrator shall include
				security matters inherent to the administration and distribution of medications
				in a jail facility.
14.9.24. Health
				records. A separate file shall be established for each inmate at the time of
				his or her receiving screening for the collection of medical information. The
				health record shall be sufficiently detailed to enable a practitioner to give
				continuing care and permit the retrospective determination of the inmate's
				condition and treatment at the time of examination and treatment and to provide
				information which will enable consulting medical professionals to render advice
				on the inmate's care and treatment. Entries in this record shall be made in
				ink, be legible, be signed by the maker, and dated. Records shall be maintained
				for at least seven (7) years following the inmate's most recent incarceration.
				The file shall contain the following:
a. The
				completed receiving screening form;
b. The completed health appraisal, if the
				inmate was incarcerated for more than thirty (30) days;
c. All findings, diagnoses, orders and
				treatments;
d. A medication log
				sheet;
e. The results of
				laboratory, x-ray or other diagnostic procedures;
f. Any completed medical complaint
				forms;
g. The date, place and time
				of health encounters;
h. Dental,
				psychiatric or other consultation reports;
i. Consent and refusal forms; and,
j. Release of information forms.
14.9.25. Transfer of records. When
				an inmate receives off-site examination or treatment or is transferred to
				another facility or hospital the inmate's health record or a copy of the
				summary shall accompany him or her. Documentation of any off-site examination
				or treatment shall be made in the health record by the physician or other
				health professional involved. Health records shall be returned to the jail
				facility with the inmate or, in the event of the transfer or hospital admission
				of the inmate, as soon as possible thereafter. Written authorization by the
				inmate is required for the transfer of health record information, except in an
				emergency situation where the inmate is unable to authorize the
				transfer.
14.9.26. Confidentiality.
				The inmate's medical information, health record, and confidences entrusted to a
				physician or other medical care professional in the course of screening,
				examination or treatment are confidential and shall not be disclosed to anyone
				except in the following instances:
a. With the
				informed consent of the inmate;
b.
				When required by law, e.g., the reporting of communicable diseases;
c. When the security of the institution or
				the safety of the individual requires disclosure, and then only to the extent
				necessary for the protection of the inmate and the security of the jail
				facility; and,
d. When the chief
				administrative officer requests review of medical information, subject to all
				other requirements of this subsection.
14.9.27. Facilities and equipment. When
				health services are provided within a jail facility the jail facility shall
				provide a private ex­amination/treatment area and such equipment
				necessary and appropriate for the delivery of medical care as provided in this
				section. Medical equipment shall be periodically inspected and kept in good
				repair.
14.9.28. First aid kits.
				Each jail facility shall have one or more first aid kits which contain, at a
				minimum, bandages, gauze, slings, adhesive tape and band-aids. The responsible
				physician shall designate the number, location and contents of first aid kits
				and shall provide for the periodic inspection and replenishment of the
				kits.
14.9.29. Informed consent.
				The informed consent of inmates is necessary for all medical examinations,
				treatment and procedures except those required by law, e.g., the treatment of
				infectious diseases when public health law requires such treatment, or in the
				event of an emergency. Informed consent is the voluntary consent of an inmate
				to an examination, treatment or procedure after receiving information
				concerning the material facts regarding the nature, consequences, risks and
				alternative procedures. In the event a minor is admitted, the consent to
				medical care must be obtained from a parent, guardian or legal
				custodian.
14.9.30. Medical
				research. The use of inmates for medical, pharmaceutical, or cosmetic research
				or experiments is prohibited.
14.9.31. Serious illness or injury. A process
				to notify an inmate's next of kin in the event of serious illness or injury
				shall be developed. The jail facility's admission form shall provide for
				identification of the inmate's choice of a person to be notified in the event
				of serious illness, serious injury or death. When possible, permission for
				notification shall be obtained from the inmate.