Fifth Judicial District - Department of Correctional Services

DISTRICT POLICIES

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TITLE: Health Services General Provisions

POLICY

Safeguards will be taken to insure that residents and staff are reasonably protected and/or treated with regard to sudden illness, accident or other medical/health emergency. In the event of any medical/health emergency of staff or resident, action will be taken to reduce or eliminate the effects of the illness or injury as efficiently as possible. Emergency care will only be administered by staff who are certified in the administration of First Aid and/or CPR practices and only in so far as is needed to reduce or remove the threat of loss of life or limb.

Safeguards will be taken to insure that residents and staff are reasonably protected against and educated about bloodborne pathogens and communicable diseases (including AIDS, HIV, venereal diseases, and tuberculosis).

Routine and emergency medical and dental needs of residents will be met in the most cost effective manner possible.

PROCEDURE

  1. What to do in case of severe accident or illness and notification of relative (next of kin):
    1. In cases of sudden illness or severe accident requiring emergency medical care for either employees or residents of this facility, an ambulance or fire medics will be summoned via the phone. The resident will be sent to the emergency room at Broadlawns Polk County Hospital. If conscious, the individual being administered to will be asked if anyone (next of kin) should be notified. If unconscious or a very serious injury, next of kin will be notified by staff on duty at the time. Information pertaining to next of kin can be attained from the resident's file, in the case of a resident. In the case of a staff member, persons to be notified will be attained from the staff member's personnel file kept by the immediate supervisor or through the District's Personnel Technician at 1000 Washington, Des Moines, Iowa 50314. The injured/ill staff member will receive care at the Methodist Hospital Emergency Room.
    2. First aid will be administered to the resident only in accordance with first aid training provided to staff by the Red Cross.
    3. The staff on duty will contact a member of the management team as soon as possible to inform them of the situation.
  2. Health of Residents:
    1. Any resident who suspects or is suspected of having a communicable disease must submit to a physical examination within twenty-four (24) hours, with results immediately forwarded to the PPO II/Residential Counselor. This physical examination will be conducted by Broadlawns Medical Center or the resident's personal physician.
    2. Recommendations made as a result of the attending physician's physical examination will be considered in making the decision to isolate an offender. Segregation or isolation of an offender will be utilized, when necessary, to protect program staff and offenders.
    3. In case of serious injury or serious illness, the resident must immediately be transferred to Broadlawns Medical Center for medical attention.
    4. Offenders may receive health education information form Broadlawns Medical Center. This information may include such items as medical services provided, immunizations, personal hygiene, dental hygiene, nutrition, and information about venereal diseases and communicable diseases.
    5. Offenders will be coached and encouraged to use universal precautions while performing work details within the facility. Supplies will be provided to the offenders to protect themselves from communicable diseases while performing work details.
  3. Health of Staff:
    1. All employees will have a health examination by a licensed physician through the Polk County Health Department at commencement of their employment. They will receive a written statement that they are free from any communicable disease. They will be notified by their supervisor or the Personnel Technician of the time and date of their appointment. It is urged that each staff member have an annual medical checkup to determine freedom from any disease in a communicable form or acute or chronic inflammatory condition of the respiratory tract (i.e. tuberculosis). All new employees are required to have a tuberculin skin test prior to beginning employment and annually thereafter.
    2. No person under the influence of alcohol and/or drugs will be permitted to provide service to any resident of the facility.
    3. No staff member who has a disease in a communicable state as defined by the Department of Health, will be allowed to provide service to a resident of the facility and return of such employee to work will be subject to a physician's written approval. Any employee who suspects or is suspected of having a communicable disease must submit to a physical examination within twenty-four (24) hours with results forwarded to his/her Supervisor, prior to their return to work.
  4. Emergency Medical Care For Residents:
    1. In a medical emergency it is staff person's responsibility to see that the resident receives medical care.
    2. A medical emergency is defined as any illness or personal injury situation that in the judgment of staff on duty, calls for immediate attention.
    3. In determining if a particular situation constitutes a medical emergency, staff will consider the following:
      1. Assessment of the situation, utilizing previous first aid training.
      2. Personal knowledge and common sense.
      3. The wishes of the resident (If the resident demands to be taken for immediate medical care, it is staff's responsibility to comply).
    4. Whenever an emergency situation demands that the resident be taken to the emergency room, staff will decide on the mode of transportation. In cases where the nature and/or seriousness of the illness or injury is uncertain or where it is obvious, in the staff member's judgment that the resident should be moved, an ambulance will be called. Again, staff's first aid training should be the fundamental basis for such a decision.
    5. While awaiting the arrival of the ambulance, staff will administer first aid as deemed appropriate by the first aid training course.
    6. Whenever an emergency medical situation occurs, whether it is injury or illness, staff will complete a "Client Injury Form" as soon as possible.
  5. Routine Medical Needs for Residents:
    1. Residents are required to make their own medical appointments and to notify facility staff in advance of all appointments. The facility will ensure access to medical services and hospital services at all times.
    2. The facility will assist residents who have documented special dietary needs due to health reasons.
  6. Resident Major Medical Treatment
    1. Pre Institutional Residents:
      1. When a pre-institutional resident requires surgery or other expensive medical treatment the resident must bear the cost of the treatment personally or through health insurance coverage, or other source of payment must be sought to assist the resident in meeting these costs. Human Services or relief agencies may be able to assist the resident in obtaining such assistance.
      2. All of the options available to the resident will be carefully explained, and staff will assist the resident when necessary. If no viable options can be found or decided upon, the matter will be referred back to the court of jurisdiction.
    2. Work Release, OWI and Parole Residents:
      1. Medical treatment for Work Release, OWI and parolee offenders who are indigent may be obtained at the University of Iowa Hospitals, Iowa City, Iowa. This will be a matter between the offender and the University of Iowa Hospitals on whether or not the University of Iowa Hospitals will accept them and provide the medical services requested by the offender. Procedures are as follows:
        1. A report will be obtained from a local physician to determine if surgery or long term medical care is needed.
        2. Based on the physician's report, the Department of Corrections Central Office staff will determine whether the resident should be sent to the University of Iowa Hospitals or transferred back to the parent security institution. The Residential Director or designee will ensure that approval is obtained from the Department of Corrections and that the Iowa Medical Classification Center is notified of the transfer.
        3. The Medical Referral Request from will be completed as follows:
        4. Prior to referral the local physician will complete and sign the top portion of the Medical Referral Request form.
        5. The Residential Director or designee will then schedule the appointment with the appropriate clinic and complete the top portion of the form.
        6. Page 1 is to be retained at the facility.
        7. Upon arrival at University Hospitals, the resident provides Page 2 to the business office.
        8. After completion of treatment and prior to discharge from the hospital, the resident ensures that Page 3 is completed by the attending physician.
        9. Upon return to the facility, the resident provides Page 3 to the staff.
        10. Facility staff forwards page 3 to Medical Files at the Iowa Medical Classification Center.
      2. Residents will sign a Release of Information form authorizing the District access to pertinent medical records.
      3. Prior to admission to the University of Iowa Hospitals, the resident will sign Rules Form WR/OWI 67 3/01.
      4. Residents referred to an authorized medical treatment center or to the University of Iowa Hospitals will be furloughed for such treatment if feasible. The furlough will specify a limit of seventy-two (72) hours, to terminate following release from the hospital and transfer back to the facility. If treatment is not completed within seventy-two (72) hours, new furlough papers must be issued.
        1. If furloughed, staff may make travel arrangements utilizing family members, friends or University Shuttle Service, etc., provided there are no significant security concerns.
        2. Staff shall contact the Prison Guard through the University Hospitals receptionist for assistance in monitoring the furlough, general information, etc.
      5. The Iowa Medical Classification Center and the Assistant Director of Residential Services will be notified immediately when the resident is hospitalized.
      6. Staff will routinely make checks on hospitalized residents via telephone or site checks as allowable.
      7. Temporary release from the residential facility to an approved furlough site after minor medical procedures and beyond the standard 72 hours noted above could be considered. These are situations where the residential facility is unable to accommodate an offenders’ medical need (i.e. changing of an IV, using stairs) but it does not warrant a return to prison. The medical condition will be regularly reviewed by staff. When cleared by a physician, the offender will voluntarily return to the residential facility. If not resolved within two weeks, the offender may be classified and transferred to prison. An offender who willfully fails to return to the residential facility shall be processed as an escape. A daily fee will be charged for the supervision of an offender on medical furlough. Prior to approving a medical furlough, an offender will agree to and sign the Medical Furlough Release Agreement.
  7. Physical and Health Screening for Residents:
    1. All new residents entering the facility will complete a Client Medical History Form questionnaire covering physical health, mental health and substance abuse. This questionnaire will be reviewed by the health care provider contracted to perform physicals and screenings prior to the offender entering the general population.
    2. All non-federal residents entering the facility who are not coming from an institution will receive a physical within the first two (2) weeks to determine a general picture of overall health and to screen for communicable diseases, including a Mantoux test for TB. This will be conducted by the health care provider contracted to perform physicals and screenings. Federal residents will comply with procedures outlined in the Federal Statement of Work (SOW).
  8. Bloodborne Pathogens:
    1. All staff will receive annual training in occupational exposure to bloodborne pathogens which includes the following:
      1. Testing sites and who will conduct testing in the event of exposure or suspected exposure.
      2. Appropriate safeguards.
      3. When and under what conditions offenders are to be separated.
      4. Issues of confidentiality.
      5. Counseling and support services.
    2. Staff is encouraged to use universal precautions in the performance of their duties. Necessary supplies are provided to staff for protection from communicable diseases.
  9. First Aid:
    1. Each facility will provide first aid equipment which meets state and Red Cross standards and is available at all times at the facility for medical emergencies.
    2. A medical supply company will service the system of first aid supplies and equipment for the facility on a monthly basis. All necessary supplies will be replenished by this company as needed.
    3. The Assistant Director of Residential Services will ensure that Residential Officers are trained and certified in emergency first aid procedures and CPR.
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