CH 14 Health Care (Policy.Corrections.CH 14 Health Care.WebHome)

1. Serious Health Care Need: A case that has been diagnosed by a physician as mandating treatment, or so obvious that even a lay person would easily recognize the necessity for a doctor's attention. A serious health care need is a valid health condition that, without timely health care intervention, will cause: 1) Excessive pain not controlled by medication; 2) Measurable deterioration in function (including organ function); 3) Death; or 4) Substantial risk to the public health.

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1. TB: Tuberculosis

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**CH 14_102 __REFERENCES__**

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1. Immigration and Customs Enforcement Standards:

11. 2000-18

11. 2000-19

11. 2000-21

11. 2000-25

1. Utah Counties Insurance Pool:

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11. ML-V.A.8

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1. Utah Sheriff's Association Jail Standards:

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11. H01.01.01: Written Policies and Procedures Governing Administration of Health Care Required

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11. H01.01.02: Content: Administration of Health Care

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11. H01.02.01: General Access to Requirements

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11. H01.02.02: Responsibility and Authority for Health Care Delivery

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11. H01.02.03: Cost of Health Care Services

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11. H01.02.04: Informed Consent

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11. H01.03.01: Contents: Health Care Records

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11. H01.03.02: Confidentiality

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11. H02.01.01: Written Policies and Procedures Governing Qualifications of Health Care Providers

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11. H02.01.02: Content

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11. H02.02.01: Administration/Coordination of Medical Services Delivery

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11. H02.02.02: Health Care Services Personnel Qualifications

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11. H02.02.03: Use of Interns and Students

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11. H03.01.01: Written Medical Screening Policies and Procedures Required

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11. H03.01.02: Content: Health Care Screening

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11. H03.02.01: Scope of Screening

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11. H03.02.02: Screening Follow Up

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11. H04.01.01: Written Health Care Policies and Procedures Required

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11. H04.01.02: Content: Health Care Policies and Procedures

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11. H04.02.01: Emergency Response

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11. H04.02.02: First Aid

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11. H04.02.03: Sick Call

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11. H04.03.01: Treatment Plans

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11. H04.03.02: Elective Procedures

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11. H04.03.03: Dental Care

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11. H04.03.04: Pregnancy-Related Care

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**CH 14_103 __GENERAL__**

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1. Policy:

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11. Reasonable, adequate, and timely health care shall be provided to inmates (including inmates in special management units) for serious health care needs. PCF's Medical Branch should operate in compliance with state and local laws and guidelines.

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11. Health care should include medical, dental, and mental health care services for serious health care needs.

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11. Health care shall not be denied as a disciplinary punishment.

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11. PCF should maintain access to a PHS/DHS Managed Health Care Coordinator via telephone calls, Treatment Authorization Request system, and via local ICE.

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1. Rationale:

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11. Reasonable, adequate, and timely health care for inmates' serious health care needs is required by law.

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11. Absolutely correct health care cannot be guaranteed.

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11. Ensuring that serious health care needs are met may:

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111. Prevent inmates from experiencing unnecessary pain and other harm; and

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111. Protect against liability from claims of deliberate indifference to the serious health care needs of inmates.

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**CH 14_104 __LEVELS OF SERVICE & EMERGENCY CARE__**

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1. Policy:

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11. PCF will provide both routine and emergency health care services to meet the serious health care needs of inmates.

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11. PCF should provide 24-hour emergency health care and should staff at least one nurse 24 hours per day, 7 days a week. The contract physician should be on call 24 hours per day, 7 days a week. Corrections staff should be trained in CPR and first aid in order to provide response within four minutes to health related emergencies. The Medical Branch should clearly post a list of telephone numbers for local ambulance and hospital services. Emergency care should include, but not be limited to:

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111. First aid;

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111. CPR;

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111. Crisis intervention; and

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111. Emergency transportation to an outside health care provider if an adequate response to a serious health care emergency is not possible within the jail.

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11. First aid kits should be immediately available to Booking, the Kitchen, housing units, and any area where inmates are required or permitted to work.

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11. Staff should not provide CPR on an inmate without a breathing barrier.

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11. Transportation for health care emergencies should be via ambulance. At least one officer should ride in the ambulance with the inmate. A minimum of two officers should be posted at the hospital, or other care facility, with each inmate.

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11. PCF should make arrangements with medical, dental, and mental health providers for accepting inmates with emergency health care needs.

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11. Dental care should be provided upon request when a dental emergency exists or when otherwise necessary. The contract dentist should determine what constitutes a dental emergency.

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11. Routine eye examinations and purchases of glasses or contact lenses are not provided by PCF. With approval from the PCF Medical Branch, inmates may be allowed to retain their personal prescription eye glasses or contact lenses. Approvals should be documented in the PCF computer system.

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11. Eye injuries or disease will be referred by the medical staff to an ophthalmologist. The scheduling and provision of these services will be at the discretion of PCF medical staff.

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11. Inmates may be provided medications and prescriptions under the direction of the PCF contract physician.

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11. Special diets may be granted to inmates after review and approval from medical staff.

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11. Inmates may receive involuntary health care under the direction of the contract physician. Before involuntary treatment is administered, staff should make reasonable efforts to educate and encourage the inmate to accept treatment voluntarily. Involuntary treatment should be administered in accordance with established guidelines and applicable laws and only after the contract physician determines the inmate's life or health is at risk. Medical staff should explain to the inmate medical risks associated with the refusal of treatment and document their treatment efforts in the inmate's medical file. The contract physician may recommend involuntary treatment when clinical assessment and available laboratory results indicate the inmate’s weakening condition threatens the life or long term health of the inmate.

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1. Rationale:

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11. Routine and/or emergency care may be required to meet the serious health care needs of an inmate.

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11. During emergency transportation, ambulances are better equipped to care for inmates during transport.

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11. Preparation and working arrangements must be in place at the time an emergency occurs. Once an emergency is underway, it is too late to begin learning how to deal with it.

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11. The use of prescription drugs within a jail setting must be considered with the security risks they may present.

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11. Involuntary health care may prevent serious harm or death.

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**CH 14_105 __MEDICATIONS__**

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1. Policy:

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11. Medications shall be stored in a secure area.

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11. Narcotic medications shall be stored in a locked container inside a secure area. A detailed inventory shall be maintained for all narcotic medications.

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11. Medications shall only be distributed by medical staff.

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11. A written record shall be kept of medications that are distributed.

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11. Whenever possible, medication distribution should be done through a cuff port. Medical staff should be accompanied by a certified officer during med pass. The officer should open and control the cuff port (not nurse).

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11. Forced medications shall not be permitted without explicit authorization from the contract physician.

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1. Rationale:

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11. Medications should be stored in a secure area to prevent unauthorized access.

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**CH 14_106 __INFORMED CONSENT__**

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1. Policy:

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11. A signed and dated health care consent form should be obtained from each inmate during the admissions process and prior to the inmate receiving health care services. If the inmate refuses, staff should document this on the consent form.

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11. Examinations, treatment, and other protocols (including hunger strike treatment) should be provided only with the informed consent of the inmate, except in cases of emergency health care.

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11. If the inmate is not competent to give informed consent, consent may be given by another person authorized under the Utah Code to provide consent.

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11. If an inmate refuses medical care or treatment, a Refusal of Treatment form should be signed by the inmate and the witnessing medical employee.

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1. Rationale:

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11. State law accords persons over eighteen years of age the right to refuse health care for personal or religious reasons. The U.S. Constitution may also provide a limited right to refuse treatment and to be informed of treatment options.

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**CH 14_107 __SCREENING AND EVALUATATION__**

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1. Policy:

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11. Inmates should be given a health care screening as a part of the admission process before the inmate is assigned to a housing unit and the inmate should not be accepted into PCF custody until after a screening has been completed. The screening should be conducted by a health care provider or a specially trained officer. Medical Branch staff will have discretion on who is accepted into the jail. If the jail is not able to properly and safely provide for their health care needs, the inmate may be refused admittance to the jail even after a medical clearance is completed. These cases should be immediately referred to the Medical Branch supervisor. The initial screening should include medical problems, mental health problems, and suicide risk factors. The following conditions should require a medical clearance from a physician (not a paramedic):

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111. Intoxicated inmates with a .30 BAC or higher shall be required to have a medical clearance. Factors such as coherence, slurred speech, ability to walk, and alcohol tolerance should be considered. The arresting officer should contact the PCF Medical Branch if an inmate is .30 BAC or higher or refuses to cooperate with a test and: (1) has no apparent injuries; (2) can walk under own power; and (3) is conscious and coherent;

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111. Altered level of consciousness or inability to walk under their own power;

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111. An inmate who is involved in a motor vehicle accident, having consumed alcohol, should be taken for a medical clearance or transported by ambulance if appropriate. An inmate who has been involved in a minor vehicle accident with no significant lacerations, obvious fractures, head trauma, serious blunt force trauma, or obvious injuries does not necessarily need to be taken for a medical clearance;

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111. If an inmate is pregnant, she should be treated as a healthy person unless there are known injuries or unstable medical problems affecting their current health. Just the fact that the inmate is pregnant does not mean she must have a medical clearance before being booked into the jail. However, the presence of high risk factors (e.g., no prior obstetric care, previous high risk pregnancies, drug addiction or withdrawal) may result in the inmate being requested to have a medical clearance;

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111. Any inmate having a seizure or who had one immediately before being transported to the jail needs a medical clearance;

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111. Obvious symptoms of drug or alcohol withdrawal;

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111. All inmates suspected of overdose of drugs or any prescription medication need to have a medical clearance;

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111. Mentally ill subjects who would otherwise require a medical evaluation to be admitted to the mental health unit should be taken for a medical clearance. Officers can talk with medical personnel at the jail if an exception is needed. Mentally ill subjects who are showing current signs and symptoms of major mental illness (i.e., psychosis or mania) will require a medical clearance prior to being admitted into the jail;

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111. All inmates who have had a Taser used on them and have possible injuries from a related fall should be taken for a medical clearance. Just the fact that the subject has had a Taser used on them does not mean they need a medical clearance. If the subject took a hard fall on a hard surface with the possibility of a head injury, a medical clearance will be required. Arresting officers should contact the PCF Medical Branch with any questions;

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111. Any time an inmate complains of sickness or injury or appears to be sick or injured, whether complaining or not, a medical clearance is required. This may include but is not limited to:

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1111. Unconscious inmates;

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1111. Inmates with uncontrolled or serious bleeding; and

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1111. When it is reasonable to believe the inmate may have a highly infectious, serious disease (e.g., tuberculosis, serum hepatitis, etc.).

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11. Inmates found to have health care needs should be referred to the Medical Branch for applicable follow-up. Health care referrals should be conducted in a timely manner. A copy of admission screening reports should be forwarded before the end of shift to the Medical Branch for review and follow up. Serious or obvious concerns should be relayed to medical staff immediately. A log entry of this event should be documented in the jail computer system.

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11. Under the supervision of the contract physician, medical staff should physically examine/assess arriving ICE detainees within 14 days of arrival.

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11. Inmates should be notified of procedures for accessing medical care at the time of initial admission and orientation.

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1. Rationale:

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11. Intake screening is an important part of determining inmates’ medical, mental health, and suicide risks.

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11. The intent of the screening process is to identify problems and other matters which require attention; thus, failure to follow up limits the value of the evaluation.

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**CH 14_108 __INITIATING CARE__**

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1. Policy:

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11. All inmates have access to health care services via the Medical Branch. Inmates may receive periodic examinations and other health care services at the request of the inmate. Inmates should be informed, orally and in writing, about how to access health care services. Inmates may request health care services via an Inmate Request form. However, verbal requests should not be ignored, should be forwarded to the Medical Branch, and should be documented in the PCF computer system. Inmate Request forms should be delivered in a timely fashion to the Medical Branch. Inmate requests should be screened by a nurse and/or the PCF contract physician (or the contract dentist for dental requests). The PCF contract physician or dentist should determine the necessary follow up care. Inmates should be provided Inmate Request forms daily, upon request. Inmate Request forms should be available in languages other than English, including every language spoken by a sizable number of the facility's inmate population (i.e., Spanish).

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11. Medical care should be initiated in a timely manner for inmates for whom it is known that there is a serious medical need.

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1. Rationale:

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11. A system of receiving, evaluating, processing, and responding to the routine health care complaints of inmates helps to ensure that inmates’ serious needs receive timely attention.

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11. Corrections officers and other non-medical staff have a responsibility for initiating medical care for inmates with serious medical needs because it is non-medical staff who interact most directly and frequently with inmates; thus, they are often the first persons to become aware of a serious medical need.

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11. Medical staff will discover serious medical needs in the ordinary course of their duties.

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11. In most cases, an inmate will be the first to know of personal medical problems; thus, an inmate is responsible for bringing personal medical needs to the attention of staff.

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**CH 14_109 __SPECIALIZED MEDICAL SERVICES__**

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1. Policy:

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11. Serious medical needs will be met even when specialized care is required.

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11. When specialized care is not available at PCF, arrangements will be made to resolve the need.

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11. Specialized medical care does not include organ transplants, cosmetic procedures, or other elective medical care and will not be provided.

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1. Rationale:

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11. Meeting inmates’ serious medical needs is constitutionally required. The medical care requirements vary according to individual health care issues.

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11. Providing organ transplants to jail inmates exceeds what is lawfully required.

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11. Cosmetic and other elective surgeries are not lawfully required.

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**CH 14_110 __COST OF SERVICES__**

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1. Policy:

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11. The cost of providing health care shall not be used to deny health care to which an inmate is lawfully entitled for serious health care needs; however, PCF officials may:

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111. Assess inmates a reasonable fee for health care services requested by the inmate; and

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111. Seek reimbursement for health care from the inmate's insurance carrier;

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111. Require inmates to pay for any health care provided at the inmates' request by a personal physician or other preferred provider. Inmates may request to be treated by a physician or provider of their choice (e.g., their family doctor). Requests must be reviewed by the Medical Branch Director and the PCF contract physician. In the event that the Medical Branch Director and the PCF contract physician do not agree, the Corrections Chief Deputy will make the final determination regarding approval or denial of the request. Inmates should be responsible for all costs related to using a physician other than the contract jail physician (e.g., transportation costs).

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11. PCF should not be responsible for elective health care procedures (e.g., cosmetic surgery or treatments, wart removal, etc.). Determination of elective status should be by the PCF contract physician. In the instance that a transplant or elective procedure is approved, the cost is the responsibility of the inmate.

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1. Rationale:

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11. PCF cannot deny or unreasonably delay care for inmates' serious health care needs.

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11. Inmates who could afford to pay the costs of their health care would often receive a windfall of free medical care resulting from their own wrongful acts which necessitated incarceration. Insurers of inmates might reap the same windfall if PCF were always required to indemnify the inmate for the cost of health care.

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**CH 14_111 __HEALTH CARE PROVIDER QUALIFICATIONS__**

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1. Policy:

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11. Health care providers working in the jail are required to meet the same certification and licensing requirements as do health care providers who provide services to persons not incarcerated. Health care providers will have current licenses and/or certificates as required by the State of Utah to perform their services. Those requiring health care qualifications should include, but not be limited to:

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111. Health care administrator/coordinator;

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111. Health care providers; and

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111. Others involved in assisting roles.

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11. Interns, students, and other non-certified/non-licensed personnel involved in the delivery of health care services to inmates should be:

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111. Permitted to work only under the direct supervision of a certified/licensed health care professional (e.g., a physician, nurse, physician's assistant, or nurse practitioner); and

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111. Limited to those functions that are well within the limits of their training and expertise.

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1. Rationale:

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11. Certification and licensing are required by law.

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11. Reasonable assurance should exist that persons involved in the delivery of health care are qualified and meet licensing requirements.

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11. Not all tasks and functions which occur in the process of delivering health care to inmates must be done by certified or licensed personnel. There are a large number of functions which, under the direction of a health care professional, can be handled by students, interns, or others. If supervised and limited in what they can do, the students, interns, or trainees can handle such functions without risk to inmates.

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**CH 14_112 __RESPONSIBILITY AND AUTHORITY__**

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1. Policy:

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11. The PCF contract physician should have responsibility and authority for medical and mental health care delivery and decisions concerning the nature, necessity, urgency, and levels of medical and mental health care for inmates. Consistent with Utah law, the physician may delegate the responsibility for certain medical functions to nurses.

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11. The PCF contract dentist should have responsibility and authority for dental care delivery and decisions concerning the nature, necessity, urgency, and levels of dental care for inmates.

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11. The delivery of health care to inmates should be supervised by the highest ranking member of the medical staff (i.e., the Medical Branch Director). The Medical Branch Director should have responsibility and authority for administrative tasks and decisions regarding the Medical Branch not covered by the contract physician or contract dentist.

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1. Rationale:

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11. Designation of responsibility is crucial to ensure consistent delivery of quality health care, to eliminate any question of decision-making authority in the event of questions or conflicts related to health care decisions, and generally ensure compliance with legal and medical requirements.

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**CH 14_113 __TUBERCULOSIS__**

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1. Policy:

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11. Every arriving ICE detainee should receive a TB test during the admission process within one business day of arrival.

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11. ICE detainees not screened should be housed separate from the general population.

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1. Rationale:

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11. TB testing of ICE detainees is required by ICE standards.

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**CH 14_114 __CONTROL DEVICES__**

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Reference policy: [[AE 02 Restraints.>>doc:Policy.Administrative.AE 02 Restraints.WebHome]]

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**CH 14_115 __ISOLATION__**

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1. Policy:

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11. Therapeutic isolation may be used under the direction of the contract physician.

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11. Inmates found to have the following types of medical problems will be held in isolation until they can be fully evaluated:

111. Tuberculosis;

111. Hepatitis;

111. HIV/AIDS;

111. Open wounds or sores;

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111. Fractures, prosthetic limbs, canes, or casts;

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111. Oxygen or breathing apparatus; or

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111. Physical disability which would prevent safe housing in general population.

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11. Rationale:

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111. Isolation may prevent the spread of a disease or illness or may be necessary to maintain safety and security.

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**CH 14_116 __PRIVACY OF CARE__**

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1. Policy:

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11. Examinations will be conducted in private, if possible. Exams will not be observed by security personnel unless the inmate poses a risk for the health care provider. Whenever possible, two members of the medical staff will be present at these exams.

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1. Rationale:

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11. Health care should be provided with consideration for the patient's rights and dignity, within security parameters.

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**CH 14_117 __PREGNANCY__**

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1. Policy:

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11. Health care should be provided for female inmates who are pregnant, lactating, or in need of postpartum care.

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11. Pregnant inmates should be referred to the contract physician for a medical evaluation.

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11. Pre-natal care for pregnant inmates should be provided by PCF.

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1. Rationale:

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11. Pregnancies and the period following pregnancy are periods of time when women may require additional medical care. It makes sense to provide additional medical attention during that time to reduce the possibility of medical problems related to pregnancy.

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**CH 14_118 __HOSPITALIZATION__**

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1. Policy:

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11. Inmates requiring hospitalization should remain in the hospital until cleared by the attending physician.

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11. Hospitalized inmates should be guarded by at least two certified officers throughout the duration of the stay (unless the inmate is released from custody). At least one officer should remain in the inmate's room.

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11. Inmates should not be allowed to use the telephone or have visitors unless authorized by the Corrections Chief Deputy.

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1. Rationale:

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11. Hospitals are less suited for the security management of inmates than jails and prisons. Thus, increased security precautions should be taken.

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**CH 14_119 __TREATMENT PLANS__**

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1. Policy:

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11. Health care professionals providing medical, mental health, or dental care to inmates should document a treatment plan for each inmate requiring treatment.

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1. Rationale:

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11. To ensure continuity and appropriateness of treatment there should be a documented treatment plan to guide health care delivery to inmates.

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11. Treatment plans are of value to prevent inmates from manipulating medical providers or playing one against another.

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**CH 14_120 __HEALTH CARE RECORDS__**

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1. Policy:

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11. The health care delivery process should be documented by creating and maintaining individual health care files for each inmate.

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11. Health care files should include:

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111. Initial health screening forms completed during the admissions process;

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111. Medical and mental health evaluation reports, if prepared;

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111. Inmate sick call requests;

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111. A chronological health record including:

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1111. All contacts with jail health care providers;

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1111. Findings, diagnoses, prescriptions, treatments, treatment plans, and progress reports;

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1111. The names of health care providers responsible for each health care transaction;

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1111. Dates, times, and other information necessary to document the actions taken;

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1111. Medication records, including prescription information (frequency, dosage, etc.) and dispensing (when and by whom);

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1111. Records relating to outside referrals for health care; and

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1111. Other information related to inmate health and health care.

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11. Jail officials should maintain inmates' health care records in a confidential manner. Inmate health care records should be maintained and stored in a locked area within the medical unit, separate from other inmate files. Inmate medical records should not be copied and placed in other non-medical files. Access to electronic medical files should be restricted to medical personnel only.

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11. Access to inmate health care records should be limited to:

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111. PCF medical staff;

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111. Non-medical PCF staff to the extent that the information is needed for the staff member to properly complete required duties (e.g., staff assigned to assist health care providers, staff assigned to classify or handle persons with a communicable disease, etc.);

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111. Persons for whom a release has been obtained from the inmate consistent with GRAMA requirements. The release of confidential medical records to outside sources shall be authorized by the inmate and witnessed by a staff member. This should be documented in writing and signed and dated by the inmate and witness;

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111. Compliance with discovery requirements in preparing to defend litigation; and

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111. Other circumstances consistent with GRAMA requirements.

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1. Rationale:

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11. Complete and accurate health care files prepared in a timely manner are critical to documenting the health care delivery process.

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11. Health care records are necessary to:

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111. Ensure continuity of care;

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111. Furnish health care providers an accurate history of each inmate's health care history while in the jail;

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111. Provide health care providers sufficient information to make proper diagnoses and/or treatment orders; and

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111. Document health care transactions in the event of litigation.

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11. Records containing data on an individual describing medical history, diagnosis, condition, treatment, evaluation or similar medical data are deemed to be "private" under GRAMA.

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**CH 14_121 __FORENSIC INFORMATION__**

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1. Policy:

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11. The Medical Branch staff will not routinely participate in the collection of evidence by or for outside agencies or on unbooked individuals. Exemptions may be directed by the on duty supervisor.

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11. Medical staff will assist staff of the WCSO in any lawfully ordered collection of evidence including DNA, body substances, hair, body cavity searches, and other searches required for reasons of security.

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1. Rationale:

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11. The liability of the WCSO in regard to collection and preservation of forensic evidence has to be limited in areas outside the WCSO jurisdiction to protect safety, security, and budgetary interests.

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**CH 14_122 __HUNGER STRIKES__**

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1. Policy:

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11. When an inmate has declared a hunger strike or refused food or drink for 72 hours or more, staff should immediately refer the inmate to the Medical Branch for observation, evaluation, and monitoring. This referral should be documented in the jail computer system.

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11. A inmate on a hunger strike should be counseled and advised of the medical risks and should be encouraged to end the hunger strike or accept medical treatment. Staff should document all treatment attempts and risk counseling.

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11. If an ICE detainee declares a hunger strike or refuses food or drink for 72 hours or more, ICE should be immediately notified and should receive necessary updates.

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11. Staff should isolate an inmate on hunger strike to an observation cell. Medical staff are authorized to place an inmate in a special management cell or locked hospital room.

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11. Medical staff should record the weight and vital signs of hunger striking inmates at least once every 24 hours.

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11. Staff should record the inmate's fluid intake and food consumption.

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11. During the initial evaluation of an inmate on a hunger strike, medical staff should:

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111. Measure and record height and weight;

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111. Measure and record vital signs;

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111. Perform urinalysis;

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111. Conduct psychological/psychiatric evaluation;

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111. Examine general physical condition; and

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111. If clinically indicated, proceed with other necessary studies.

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11. During a hunger strike:

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111. Staff should provide the inmate at least three meals a day and document this in the jail computer system;

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111. Staff should provide the inmate an adequate supply of drinking water or other beverages;

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111. All food items should be removed from the inmate's cell (other than provided meals during meal times).

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11. Staff should receive training on identification, response, and management of hunger strikers during initial orientation and annually thereafter.

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11. Only the contract physician may order an inmate's release from hunger strike care.

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**CH 14_123 __RELEASE OF INMATE__**

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1. Policy:

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11. The Medical Branch should be given advance notice prior to the release, transfer, or removal of an ICE detainee.

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11. ICE detainee medical records (or a copy) should be transferred with the detainee. The medical records should be sealed in an envelope and the envelope will be marked: “MEDICAL CONFIDENTIAL.”

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1. Rationale:

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11. The advance notice to the Medical Branch prior to the release, transfer, or removal of an ICE detainee is required by ICE standards.

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**CH 14_124 __INMATE WORKERS__**

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1. Policy:

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11. Inmates should not be authorized to perform any duties related to health care including, but not limited to:

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111. Performing direct patient care;

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111. Scheduling medical appointments;

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111. Determining access of other inmates to health care services;

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111. Handling or having access to surgical instruments, syringes, needles, medications, or health records; and

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111. Operating health care equipment.

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11. Janitorial services of the treatment rooms and offices in the Medical Branch may be provided by inmate workers under the direct supervision of corrections staff.

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11. Inmate workers will receive blood borne pathogen training and universal precaution training before cleaning in an area which might expose them to blood borne diseases. This training will be documented in the jail computer system.

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1. Rationale:

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11. Allowing inmates to perform health care duties or to have access to health care equipment could compromise patient care or facility security.

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**CH 14_125 __TERMINAL ILLNESS__**

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1. Policy:

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11. Chronically or terminally ill inmates should be transferred to an appropriate medical facility.

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11. PCF should not accept chronically or terminally ill contract inmates. If a contract inmate becomes chronically or terminally ill while housed at PCF (or if such is discovered or diagnosed while housed at PCF), the contracting agency should be immediately notified. PCF should defer notification of next-of-kin of the inmate's condition to the contracting agency.

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1. Rationale:

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11. PCF is not properly equipped to adequately manage chronically or terminally ill inmates.

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**CH 14_126 __SUICIDE PREVENTION AND INTERVENTION__**

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Reference policy: [[CG 02 Suicide Prevention and Threats of Harm>>doc:Policy.Corrections.CG 02 Suicide Prevention and Threats of Harm.WebHome]].

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