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HomeMy WebLinkAboutC93-028 Jail Medical Care and Health Services AgreementC93-28-06 JAIL MEDICAL CARE AND HEALTH SERVICES AGREEMENT (Physician) THIS AGREEMENT is entered into on this Rf11 day of %)in n.� , 1993, by and between the Board of County Comtissioners of the County of Eagle, State of Colorado and the Eagle County Sheriff, hereinafter referred to jointly as "Detention Facility" and Avon Medical Center, P.C., hereinafter referred to as "Contractor". This Agreement is entered into pursuant to the Standards for the Accreditation of Medical Care and Health Services in Jails. Eagle County's Detention Health Administration Standards and the Eagle County Jail Health Care Services Agreement (hereinafter referred to as "Standards") as attached hereto as Exhibit A and incorporated herein by this reference, and shall be governed by the terms of said Standards and Agreements as have been adopted by the Detention Facility from time to time. Contractor hereby certifies that its employees performing this contract are duly authorized and licensed to practice medicine within the State of Colorado in accordance with the requirements of the Standards. Contractor hereby agrees to provide medical services to the Detention Facility that complies with the Standards and other applicable local, state and federal law. Contractor has read and understands the Standards and acknowledges its responsibility to provide services that meet these Standards. Continuing accreditation of the County Jail is contingent upon Contractor complying with the Standards. Contractor shall ensure that qualified staff is provided to comply with the terms of this Agreement. contractor understands its obligation to make the final medical judgment regarding care provided to inmates of the Detention Facility. The Detention Facility agrees that no restriction, other than those imposed by the Standards, shall be imposed upon the Contractor regarding the practice of medicine. Security regulations applicable to jail personnel will apply to the Contractor and his staff. The Detention facility agrees that if any special medical diets for inmates are prescribed by the Contractor, that such diets shall be prepared and served by Detention Facility food services personnel. All parties hereto agree to share the responsibility to assure that the informed consent portion of the Standards are observed, and to assure that written authorization from the inmate is obtained prior to the release of information in that individual's medical report. If Contractor fails or is unable to perform the required services, the County may make alternate arrangements for services in any manner it deems necessary in its sole discretion. TERM OF This Agreement shall be effective from January 1, 1993 to Jnnnary 1 , 1994 and mail be renewed annua l l _r. TERMINATION This Agreement may be terminated at any time upon 30 days written notice to the other party for any or no reason. JAIL PHYSICIAN Contractor designates Robert Arnold, M.D. as the primary physician to provide services hereunder. He shall have the designation of Jail Physician. FEE Contractor shall be paid a fee of $150.00 per hour for consultations made pursuant to this Agreement. ATT By: County Commissioners COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its BOARD OF COUNTY COMH'ISSIONERS By: "c GeorgeA. Gates, Chairman By: 2 A. Johnson, g e County Sheriff C\jailagr.93 AVON MEDICAL CENTER, P.C. CONTRACTOR By: \"�) Philip E. Freedman, M.D Managing Partner -3 ate.,. " EXHIOITA DETENTION HEALTH ADMINISTRATIVE STANDARDS J-01 The Sheriff of Eagle County will negotiate a written agreement with County Commissioners and a physician licensed in the state of Colorado to provide medical services to the detention inmates that comply with local, state, and federal standards. The physician will make the final medical judgment regarding care provided to inmates. This agreement will be reviewed and signed annually. J-02 The delivery of medical care to the detention population will be a joint effort of administrators and health care providers. 1. The detention health physician and the Eagle County Nursing Staff will have medical protocols for management of common problems, emergency care, acute, and convalescent care and chronic disease. See appendix A. J-03 Administrative Meetings and Reports Health care (including mental health) services are discussed with staff at least quarterly and detention medical dentention physician and County Nurse are present. Minutes of these meetings are documented. Health care (including mental health) services are discussed. Administrative meetings are documented. Meetings between County nurse and Medical room supervisor are at least once weekly on an informal basis. County nurse and detention physician meet informally at least once monthly. Documentation of these meetings will be recorded. Annually a statistical report is rendered to the County Board of Health and the Sheriff. J-04 The health care policy and procedure manual shall be maintainedby the Eagle County Nursing Service and an additional copy in the detention medical exam room. The policies and procedures will be reviewed annually by the Detention Health Authority and Detention Administrator, J-05 The active medical records will be reviewed by the Eagle County Nursing staff and Detention Physician monthly. Ten percent will be reviewed at the quarterly Nursing Staff utilization record review. The review of medical records will be documented and disciplines present. J-06 If complaints regarding health care of detention inmates exist, they will be referred to Inter Mountain Medical Society or local dental facility for follow-up the same as complaints are handled regarding health care provided to residents of the county. Board of Health visits detention on a once monthly basis. 114 ` /dnk� J-07 The detention administration and the Detention.Physician or his/her designee have access to the inmate medical record. Medical information relevant to the inmates health and course of treatment will be shared with the detention medical deputy staff medical room supervisor, and Detention Administrator. Re: Chronic conditions such as Diabetes,Epilepsy, Respiratory, Heart, mental instabilities (Psychoses and suicidal ideation) Anyone with physical limitations is also discussed with detention staff, in order for the inmate to receive proper care. Inmates on medications with potential side effects will be reviewed with medical deputy supervisor and Detention Administrator, to help medical deputy staff respond appropriately should a crisis occur. J-08 The Detention Administrator and the Health Authority or their designee will have consultation as to actions being taken regarding inmates with significant medical or psychiatric illness. Any inmate with acute illness as defined by the Health Authority or his designee, including psychiatric illness, who requires health care beyond that which is available at the Eagle County Detentional Facility will be transferred to an appropriate facility. Inmates identified as having known psychiatric and medical illness shall be assigned following intake to: Housing assignment Program assignment Disciplinary procedures Admissions to and transfers from institutions The Eagle County health authority will be notified of the above assignments and will be notified prior to any changes of these assignments. J-09 In all cases of serious illness, accident or injury the detention administrator will notify the next of kin for the inmate. The inmate's next of kin or legal guardian will be notified as specified in the procedure manual in case of serious illness, injury or death. J-10 In the event of death of an inmate the coroner and the health authority will be notified immediately and an apporpriate post mortem examination conducted. In the event of death of an inmate: 1. Notify County Coroner's office immediately -- See Appendix A2. 2. A post mortem examination is requested by the Detention Physician if: a. Death is under suspicious circumstances. b. Inmate was not under immediate supervision of health professionals. J-11 The detention health care staff will remain neutral in collection of information for forensic purposes. 1. Outside health care providers will be obtained by Detention Administrator for the following services: 04*41 a. Psychological evaluations. b. Body cavity searches will be done in privacy. 2. In case of sexual assault, Eagle County Nursing Service professionals may gather evidence for forensic purposes with permission of inmate. J-12 The disaster plan is located at Eagle County Detention Facility. The health aspects of the facility's disaster plan will be developed by the health authority and coordinated with the facility plan. The disaster plan will be conducted two times yearly by all detentional facility employees. Detention Administrator will have documentation of date and time of disaster exercise. See Appendix A3. J-13 The Eagle County Sanitarian will do an onsite inspection bi-annually and as the Board of Health, or medical team requests. The Board of Health will conduct an onsite inspection monthly. J-14 Three meals are catered daily from local restaurant. The meals are transported and served on thermal meal trays. The trays are covered with cellophane and thermal lid. A sample tray of each meal is stored in refrigerator for 24 hrs. PERSONNEL J-15 Verification of state licensure, certification or registration requirements and restrictions of all health personnel who provide services to inmates shall be on file at County Human Resources office and in the personnel files at the County Nurse's office. J-16 Job descriptions of County Nurse personnel are in the personnel files at Human Resources office and County Nurse's personnel files. J-17 A designated health trained staff member will be available for each shift. This member may be a correctional officer trained in limited aspects of health care. Orientation and training will be provided by Detention Administration or health care staff. Documentation of orientation and training will be filed in Detention Administrator's office with copy to Eagle County Nursing Service. J-18 County Nurses will visit Detention on two time a week basis and Detention Physician and/or his designee will visit two times a month or as needed. Detention Physician is on call to Detention personnel 24 hours per day. J-19 Health care providers' continuing education programs will cover professional staff. Detention administration will provide 12 hrs. annually for Detention medical room staff. ,o"'y ,AIM*1 J-20 The following orientation and training will be required as deemed by Detention Health Physician: 1. Basic first aid and CPR for all Deputies. 2. Orientation: P.A. - Nurses and Doctors 3. Colorado West Mental Health - Deputies, nurses and dentists. J-21 The non -medical personnel of Eagle County Detention Facility shall receive training from health authority or his designee and detention administration on such topics as: 1. Conducting and receiving screenings 2. Recognizing chemical or alcohol dependent inmates 3. Recognizing mentally retarded inmates 4. Dealing with mentally ill inmates 5. Suicide prevention 6. Dealing with violent inmates 7. Dealing with homosexual inmates The medical authority will train personnel in the skills needed for medication administration. Written guidelines will be documented in the procedure manual. J-22 Medication protocol is shared with correctional officers by Nursing Staff as well as Medical Room Deputy explaining procedure --written procedure is available to all deputies. 1. This procedure will be reviewed with medical room staff bi-annually. See Appendix B1.PROCEDURES: 1. Inmate Medication --General. A. Duty officers are accountable for the administration of inmate medication according to the orders of the medical staff during their respective shifts. B. Duty Officers will record all medication administered or refused during their respective shifts by placing initials on the Medication Kardex. C. Duty Officers will ensure that medication, syringes, needles and surgical instruments are stored in a locked cabinet not accessible to inmates. D. Duty officers will ensure that all medication is labeled with: 1. A prescription number. 2. Type of medication. 3. Prescribed dosage. 4. Date of prescription. 5. Inmate's name. 6. Physician's name. 7. Pharmacist will designate medication that can or cannot be crushed by typing it on prescription label. E. No officer will dispense medication to an inmate from another inmate's prescription. F. No inmate will be allowed to have medication in his/her possession while incarcerated in the Eagle County Facility unless authorized and ordered by a physician. No inmate will be allowed to possess sedative or narcotic medication. G. Detentions personnel will request liquid medication be prescribed by a physician whenever possible. H. All prescribed medication inadvertently left upon an inmate's release will be logged on the Daily Activity Log by duty officers and given to the Facility medical staff for appropriate destruction. I. Duty officers will require medical staff personnel to receipt the received medication by signing the Daily Activity Log noting the date and time possession was effected. , 2. Dispensing Prescribed Medication A. Duty officers will, during their respective shifts, dispense prescribed medication to an inmate at a prescribed time and dosage as ordered by a prescribing physician. B. Duty officers will ensure all medications are dispensed to inmates in accordance with instructions. C. Duty officers will observe the inmate closely when taking his/her medication to ensure the medication was swallowed. D. Duty officers will inspect the inmate's mouth to ensure the medication was actually swallowed. E. The inmate will be asked to initial the medication log if he has received medication. If inmate refuses medication, deputy will initial medication log in red. F. Duty officers will return all medication to the medication cabinet and will ensure the cart is locked and placed in medical room. 3. Dispensing Non-prescription Medication A. Duty officers will dispense non-prescription medications to inmates at their request only after the inmate has signed a Request for Non -Prescription Medication form stating he/she is not allergic to the medication. B. Duty officers will implement procedures 2.B,C,D,E, and F (Dispensing Prescribed Medication) when dispensing non- prescription medication to an inmate. See Appendix B1. J-23 Food service workers shall be free from diarrhea, skin infections and other illnesses transmissable by food or utensils. They shall be properly trained in health and hygiene requirements. Food service is catered by Reuben's Restaurant and evaluated by detention administration. Special diets will be prepared and served to inmates according to order of Detention Physician. J-24 Inmate workers when cleaning of Medical Room will be supervised at all times. Inmates will not be used for the delivery of health care. SECTION C. SUPPORT SERVICES J-25 The Eagle County Detention Facility shall have First Aid 1_ 1 Kits approved by the health authority in designated areas. The health authority or designee shall inspect kits monthly for completeness. The First Aid Kits will be available to personnel in Control Room, Bookino-Room. 2nd floor work station. The First Aid Kit contents shall be: Roller gauze Antiseptic wipes Sponges First Aid Cream Triangle bandages Tweezers Adhesive tape Ammonia inhalants Band -aids Insta cold pack Gloves Scissors First aid book The kits will be replenished once monthly or as needed by Medical Room Deputy and/or his/her designee. J-26 Medical Room will be equipped with necessary equipment for medical staff and Medical Room deputy to provide care to inmates. J-27 The clinic space is on the second floor of Eagle County Detention Facility with additional equipment from Detention Health Physician and County Nursing Service. Inmates are transported to Medical Room with deputy escort one at a time. J-28 The inmates requiring diagnostic services will utilize the facility at the discretion of the Public Health Nurse or Detention Physician or designee. The laboratory and diagnostic services of Vail Valley Medical Center will be utilized as indicated by health authority. J-29 The Vail Valley Medical Center will be the inpatient hospital for medical illness. Psychiatric illness will be dependent upon psychiatric condition. Inmates who require hospital care will be transported. See Appendix B2. J-30 All pharmeuticals will be ordered by the attending physician and/or his/her designee through Eagle Pharmacy that contracts with Eagle County Sheriff's Department. Prescriptions of substances subject to abuse are accompanied by "stop order" time periods. Medications are dispensed and administered by the Detention medical deputy staff. ( See medication protocols for dispensing and administration.) All medicines administered are recorded in the inmate's record health record. Medicine cups are provided with each dose of oral medication administered. Inmates must have their own glass of water to receive medication. Ingestion of the medication is observed by the medical detention staff. County Nursing staff will notify the Detention Physician when drug orders are about to expire. Emergency drugs are available for staff use in life threatening situation. All drugs are stored under proper conditions of temperature, segration and security. Unused and out -dated medications are disposed of in the presence of the medical room deputy supervisor and the County )O' A"R' Nursing staff or the Detention physician. Inmates do not prepare, dispense, or administer medication. CARE AND/OR TREATMENT J-31 Duty officers during receiving screening will assist the inmate in completing the approved medical screening form. Receiving screening will be performed on all inmates before being placed in detention population. Procedure Inmate screening: 1. If need for emergency care, prisoner will be transferred immediately. 2. If inmate requires close monitoring, detention personnel will house inmate as such. 3. All receiving screening questions that are positive answers will be referred as soon as possible to detention health personnel. 4. See procedure under Appendix C1. J-32 Duty officers will explain on admission medical attention and requests, hours and time of medical personnel available. 1. All inmates with complaints will be given ample request slips. 2. Request slips may be turned in to the detentional officer daily and or placed in the locked kit box next to the medical room. The medical staff will retrieve the locked kite slips on their next visit to the Jail. 3. The on duty health trained detentional officer will review request slips. If deputy deems necessary for detention health personnel to follow-up immediately, the County Health Nurse will be called and if not reached, the Detention Physician will be called. 4. Upon intake, health care services shall be communicated orally and in writing. See Appendix C2. J-33 A health appraisal will be performed within first 14 days of admission by Detention Health Physician or his designee. The County Health Nurse prior to his visit will complete the health history. The inmate may decline all appraisals except communicable disease testing. J-34 See Mental Health Services. See Appendix C3. Documentation of mental health services will be incorporated in the inmates individual health record. J-35 All inmates will have the opportunity to request medical assistance. Inmates request will be received by medical deputy and if deputy deems necessary for health personnel follow up the County Health Nurse will be called and if not reached, then Detention Health Physician will be called or his designee. t^. �\ J-36 See Item 7 under Administrative Services. Based upon written requests, sick call will be conducted by County Health Nurse approximately 2 times weekly. The physician or his designee will be available every 2 weeks. J-37 All health care treatments are performed in privacy in consideration of patient's dignity and feelings. Verbal consent for pelvic or rectal exam should be obtained. 1. Detention officer will be available to nurse or physician at all times. 2. Detention officer will not be in room during patient's exam unless requested by nurse or physician. J-38 The formal grievance process will be utilized to allow inmates to express their complaints regarding health services.This may be done formally or informally. Informal procedure: most valid grievances can be handled by discussing the problem with the Detention Administrator. Formal procedure:. Inmate must put grievance in writing and sent to the Detention Administrator. J-39 Treatment by qualified health personnel other than physicians and dentists will be performed pursuant to medical orders as prescribed by detention physician. 1. Verbal and telephone orders are written on the Request for service sheet by the nursing staff and faxed to Detention physician for signature to be returned to nursing staff within 72 hours. See appendix C4. 2. All'written medical orders from dentists or referring physician are incorporated into the permanent medical record. J-40 There will be standing orders approved and signed by Detention Health Physician. 1. All treatment by the County Health Nurse will be performed pursuant to direct orders or standing orders. 2. All direct orders will be written and signed by Detention Physician and/or dentist. 3. Telephone orders will be written and signed by Detention Physician. See Appendix C4. J-41 Infection control is under the authority of the Detention Physician and may be delegated to the County Nursing staff. 1. Throat cultures for beta strep are done as deemed necessary by nursing staff for sore throat complaints. 2. Required infections are reported in accordance with state and local laws. 3. An inmate with a communicable disease, except for simple upper respiratory infection and flu, will be isolated. See Appendix C4. J-42 Necessary health promotion will be provided to inmates by ?00*,\ fA� county nurse or Detention Health Physician. Health education and training in self -care skills will be provided to the inmates of Eagle County Detention Facility. This will include but not be limited to • 1. Pamphlets 2. Counseling 3. Diet 4. Health hazards, etc. See Appendix C5. J-43 The Eagle County Detenion medical staff will make every effort to insure that continuity of care exists from admission to discharge and to community facilities. 1. If at all possible previous medical records are obtained to enhance medical care. 2. Complete medical records are kept at Eagle County Detention Facility. 3. Medical information is summarized and transferred with inmate to another facility when authorized by inmate. 4. Referrals to community resources are made as necessary. J-44 The Eagle County Detention Facility provides 24hr. emergency care and availability. 1. Inmates with medical emergencies will be transported by ambulance or police vehicle to Vail Valley Medical Center emergency room 476-2451 or the Vail Mountain Medical offices 476-56 95 during business hours 8:00am to 5:00pm Monday thru Friday and Saturday A.M. 2. The Detention Health Physician and/or dentist should be notified of transport to emergency room. Phone numbers for emergency care and transport are posted in facility in permanent place. a. Posted in Detention Administrative office. b. Posted in booking room. Following occurrences define emergency: Severe bleeding Suicide attempt Unconsciousness Severe burns Severe pain Sudden onset bizarre behavior Health and life threatening situations In case of serious illness, accident and/or injury the Detention Administrator will notify next of kin. Staff of Eagle County Detention Facility shall be able to administer first aid and call for assistance. Inmates with acute illnesses: 1. Detention Physician will be notified. 2. Transfer to designated medical facility by health authority shall follow as soon as possible, consistent with medical problem. a. Detox center for alcohol, Colorado West Alcohol Recovery Center, Phone number 945-8439. b. Dental Facilities c. Vail Valley emergency 476-5695. d. Psychiatric emergencies will be handled by Colorado West Mental Health "on call" personnel 24 hrs./day. r0 J-45 Dental hygiene history is taken admission. Dental care will be provided supervision of a dentist in the State o within first 14 days of under the direction and f Colorado. J-46 Screening of ectoparasites will occur at admission. Inmates suspected or proven to be infested with ectoparasite will be treated on individaul basis. Procedure: Screening of ectoparasites is part of the routine receiving process. Jail health staff will visually inspect the prisoners skin for signs of ectoparasitic infestation. If infestation is suspected or proven: 1. Ascertain the inmate is not pregnant SEE protocols 2. Total showering with kwell shampoo or soap 3. Total change of clothing and bedding 4. Mattresses will be clean jail specified disinfectant 5. All clothing and bedding will be laundered . 6. If an ectoparasite problem is ina tank, all residents of that tank shall receive treatment. J-47 Food service is catered by Reuben's Restaurant and will be evaluated by Detention Administration. Special diets will be prepared and served according to Detention Physician. Regular and therapeutic diets are evaluated for nutritional adequacy by a registered dietitian every six months. J-48 All inmates have access to the recreation program as set up by the Detention Administrator. J-49 Smoking is allowed in Eagle County Detention Facility. Inmates whose health would be comprised by exposure will be housed in a non-smoking cell. The medical room is designated as a non-smoking area. J-50 Hygiene articles and supplies are issued on a regular basis . Each inmate will have water. Bathing is permitted inmates will be furnished: 1. non-irritant soap 2. Tooth paste -tooth 3. feminine hygiene 4. laundry serviceSee SPECIAL TREATMENT access to hot and cold running daily. To maintain personal hygiene 5. deodrant brush 6. comb and brush 7. shampoo Appendix C1. J-51 Health evaluation of inmates in segregation. Inmates removed from the general population will have the same access to medical care and attention as the general population. NO punitive action will ever include limited access to medical care. Procedure 1. Medical personnel will evaluate isolated inmate at least three times weekly and more if requested by medical detention deputy and documentation is made of /00ON "Ib\ each encounter. 2. Inmates are seen frequently by detention deputies, and if determined to be suicidal are seen every ten minutes. A log of each encounter or visit is made by deputy. J-52 See Detention Administraters policy All inmates who are incarcerated and intoxicated when received in Eagle County Detention Facility will be reviewed with the Detention Facility Physician or his/her designee. At Physicians discretion inmate will be transferred to: 1. Colorado West Detox Center in Glenwood Springs. J-53 Chenically dependent inmates Chemical dependency is a much less frequent event than alcohol intoxification . Chemical dependency can usually be handled at the detention facility. Although the individual may be uncomfortable, close contact with Detention Facility Physician and mental health professional, provides an acceptable plan of treatment for the inmate. See Appendix C-3. J-54 Provisions for preventive medical maintenance such as the administration of Gammma Globulin for infectious hepatitis, isolation , or other preventive measures shall be the responsibility of the medical authority when deemed necessary to protect the health of the inmates and/or personnel in Eagle County JAIL. Procedure: Once health authority has deemed isolation necessary; 1. Inmate will be housed in a separate cell complete with separate toilet, shower, and sink. 2. Inmate will be fed on disposable trays. 3. Cell is cleaned daily with a disinfectant solution the cleaner will wear gloves. 4. Instructions for the staff are taped to the cell door: a. wash hands on entering and leaving b. double bag all trash c. launder linens and clothing separately d. handle all body fluids with gloves J-55 Not applicable to our facility. The Eagle County Detention Facility does not have an infirmary. J-56 Care of the Physically Disabled , Mentally Ill, or Developmentally disabled Inmates with moderate or severe disability, mental illness, or developmental disability whose adapatation to the correctional environment may be significantly impaired will be referred for appropriate evaluation and follow-up care while incarcarated. Procedure: 1. Inmates requiring referral will be brought to the attention of the health authority by the nurse or the mental health counselor. r /42ft\ 2. The health authority will evaluate the inmate and specify which referral agency or physician is to be utilized. 3. Appropriate referral will be made by the health authority and or his designee. 4. All pertinent information will be incorporated into the medical records and transfer of these records will be by signature of the inmate releasing the record to respective health authority. J-57 Implementation of special medical programs shall be the primary responsibilityof the qualified medical authority responsible for Eagle County Detention Health. Special medical programs will be discussed with the Sheriff and Detention Administrator. An individualzed treatment plan will be developed for those inmates requiring specialized medical supervision . The plan would be created by the physician and nurse, to include goals, treatment plan /interventions, and designation of responsible parties. Procedure: 1. Any inmate with a special need will be evaluated by the Health authority. 2. Obtain written release of information from the inmate and send for past medical records if possible. 3. Document acute and chronic problems on Problem list and incorporate into medical record. 4. Medical record will reflect, documentation of goals, treatment plan/intervention, and responsible party on Treatment plan. This record will be forwarded to next facility with patients release of information. J-58 The Eagle County Detention staff will attempt to identify, monitor and refer any potential suicide risk. Procedure: 1. Detention deputies upon receiving screening will be alert to suicide potential. Staff members are trained to recognize verbal, behavioral,and situational clues that indicate suicide. 2. Health authority is made aware of potential suicide and upon his or her discretion may refer inmate to Mental health worker. 3. Assessment of potential suicide risk is handled by the mental health professional as assigned to the detention facility by the mental health center. 4. Detention Administrator and health authority will inform deputies of further protocols to follow on individual inmate. 5. Any inmate who verbally indicates suicide will be moved downstairs and put on suicide watch 6. Any inmate who is segregated due to suicidal tendencies shall have all items removed from his cell until the crisis has passed. Example; bedding sharp objects, flammable materials and in case of a suicide attempt clothing, the clothing will also be removed, until the /dlnb� crisis has passed . Detention physician/his designee, and mental health professional will be notified immediately. J-59 Any alleged sexual assualt will be responded to immediately and appropriately. Procedure: 1. The staff member on duty will immediately inform the medical deputy and the Detention Administrator. 2. Inmate will be transported to Vail Valley Medical Center for exam and evaluation. 3. Upon return to the detention facility, inmate will be housed separately from the alleged assailant. J-60 Medical restraints will not be used as part of the health care services. Security restraints will be utilized as required in transporting inmates and in other appropriate situations. Sleeping pills and tranquilizers for medical purposes will be at the discretion of the attending physician. J-61 Prenatal care, counseling and assistance in planning for their unborn child will be provided for pregnant inmates. Procedure: 1. County Nursing Staff will coordinate care, appointments with physician and Detention Administrators at her discretion. 2. Inmate will receive appropriate referral to respective service required or requested . Example: Abortion counseling, pregnancy crisis center, ministerial counseling, physician counseling, mental health counseling, nursing counseling, social services. J-62 Pregnant inmates will receive regular comprehensive prenatal care while incarcerated in Eagle County Detention Facility. Procedure: 1. If inmate is already under the care of a private practitioner, she will continue under his/her care while incarcerated. 2. If inmate has no prior prenatal care, an appointment will be made with Detention Physician in his office for appropriate planning of care. 3. All treatment, exams and evaluations will be documented in inmates medical record. 4. Treatment programs is incorporated into medical reord including advice on appropriate levels of activity, safety precautions, nutritional guidance and counseling. Prenatal -and Childbirth videos may be provided inmate with detention nurse for explanation of information. J-63 Medical and dental prostheses shall be the responsibility of the individual prisoner. The medical authority will evaluate whether or not inmate can survive without prostheses. MEDICAL RECORDS J-64 A medical record file will be kept for each inmate. The medical record shall contain the following information: completed receiving screening form, health appraisal form, all findings, diagnosis, treatments, and dispositions, prescribed medications and their administration, lab, x-ray and diagnostic consent and refusal forms, discharge summaries of hospitalization consultant, reports and treatment plans, progress notes, problem sheet. See Appendix C7. J-65 The active health record from the confinement record and the health record is controlled medical deputy. will be maintained separately under lock and key. Access to by the health authority and the J-66 Copies of the health record shall be sent to the facility to which an inmate is transferred. Any other transfer of information must be by written consent of the inmate. Inactive health records shall be retained according to the legal requirements of Eagle County and the State of Colorado. J-67 Retention ofmedical records will be at the Eagle County Detention Facility. Procedure: All medical records are kept for at least 10 years. Juvenile records will be kept for 10 years following 18th birthday. MEDICAL - LEGAL ISSUES J-68 Informed consent practices applicable in Colorado are observed for inmate care, regarding all examinations, treatments and procedures. The informed consent of next of kin, guardian, or legal custodian applies when required by law. J-6 9 An inmate may, at any time refuse medical treatment or evaluation. Refusal of medical care and treatment is documented on medical request form and signed by County Nursing staff or Detention Physician witnessed by medical room deputy. J-70 Forced psychotropic medication in Eagle County Detention Facility will be employed only under following conditions: 1. The inmate poses a clear and immediate threat to self or others. 2. The responsible medical authority clearly documents in the medical record the inmates condition and the threat posed and the reason for forcing the medication. J-71 Medical research is not performed and is prohibited in Eagle County Detention Facility. ice\ �\ TO: DETENTION DEPUTIES. FROM: MARGE GATES/ K. BITTERMAN. SUBJECT: MEDICATION/ MEDICATION LOGS. A. MEDICATIONS 1. DEPUTIES MUST PASS MEDICATION FROM MED CART IN LIBRARY. 2. MEDICATIONS MUST BE LOGGED*IN DETAIL. 3. INMATES WILL TAKE MEDICATION AS PRESCRIBED BY PHYSICIAN. 4. ALL MEDICATION MUST BE PLACED IN WATER BEFORE GIVING TO INMATE. 5. ALL ANTI -PAIN MEDS WILL BE TERMINATED AT THE END OF 14 DAYS - UNLESS OTHERWISE SPECIFIED BY JAIL PHYSICIAN OR HIS DESIGNEE. 6. ALL REFUSALS OF MEDICATION IN "RED" BY DEPUTY. B. MEDICATION LOG 1. IDENTIFICATION OF DEPUTIES (initials and name) WILL BE AT THE TOP OF LOG. 2. DRUGS, DOSE, HOW GIVEN AND HOW OFTEN TO BE ADMINISTERED AND DATE ORDERED, CRUSHED OR NON -CRUSHED, AS DESIGNATED BY PHARMACIST. 3. DAYS OF THE MONTH -SPACE FOR INITIALING ADMINISTRATION OF THE DRUG. 4. IN LEFT HAND CORNER NUMBER OF TABLETS WHEN THE DRUG IS A NARCOTIC. 5. REFUSALS WILL BE LOGGED BY THE DEPUTY SIGNING HIS INITIALS IN RED PEN. LOGGING OF MEDICATIONS MUST BE DONE AT ADMINISTRATION OF MEDICATION. 6. OTHER REQUIRED INFORMATION: (SEE KARDEX) ADMISSION DATE: ALLERGIES: AGE: POD NUMBER NAME FLAG WITH STICKER PICTURE CAUTION - YELLOW SUICIDAL - RED 7. INSIDE BACK WILL BE NON-PRESCRIPTION DRUG, INMATE HAS SIGNED CONSENT SAYING HE IS NOT ALLERGIC AND WILL REQUEST AS NEEDED, ie., DECONGESTANTS (WITH APPROVAL) ASPIRIN TYLENOL ANT -ACIDS