Download Washington County Sheriff`s Office

Scioto County Sheriff’s Office
Portsmouth, Ohio
WRITTEN DIRECTIVES
POLICY AND PROCEDURES
753
MEDICAL
Effective Date:
020106
Directives Rescinded:
Review Date: 090605
Pages 11
Reference:
Distribution:
Revised date:
Revision:
01
PURPOSE
The Scioto County Sheriff’s Office recognizes the right of all inmates to have access to
professional health care, which includes medical, dental, and mental health care.
02
POLICY
A licensed medical doctor and registered nurse will be contracted with to provide health
care services for inmates. No inmate will be denied access to medical care or treatment
for either punitive reasons or on the basis of an inmate’s classification status.
03
DEFINITIONS
Dispensing of Medication - Dispensing of medication is defined as the issuance of
one or more doses of prescription medication from a stock of bulk containers.
Communicable Disease – Any disease readily transferred from one person to another.
04
PROCEDURE
04.01 FACILITY MEDICAL PERSONNEL
753 MEDICAL 090605
1
The Scioto County Jail [SCJ] shall have a designated Physician Dr. Walker whom is
licensed to practice medicine in Ohio, who shall be responsible for inmate health care
services, pursuant to a written agreement.
Physician
He/she must approve all medical policies and procedures developed specifically for the
jail and whenever revisions are made to these procedures. This approval must be
documented in writing.
Registered Nurses
Nurses shall be licensed and shall be utilized to provide medical care to inmates. These
nurses will provide their services under the supervision of the Physician, following the
physician orders or written protocol. Verification of the current credentials and the
written agreement between the nurses and Scioto County will be maintained on file by
the Division Commander.
04.02 PRELIMINARY HEALTH SCREENING
All inmates shall have a preliminary health screening completed by a health trained
deputy sheriff prior to their being placed in general population. This screening shall be
recorded in a format approved by the Physician. This information is recorded in the
computer and is available to the medical staff.
Screening – The screening form [Form] shall include the following areas.
Inquiry into:

current illness and health problems;

dental problems;

mental health problems;

use of alcohol and drugs;

past and present treatment or hospitalization for mental disturbances or suicidal
ideation;

possibility of pregnancy; and

other health problems designated by the Jail Physician
Observation of:

behavior, including state of consciousness, mental health status, appearance,
conduct, tremors, and sweating;
753 MEDICAL 090605
2

body deformities and ease of movement; and

condition of skin, including trauma markings, bruises, lesions, jaundice, rashes,
infestations, and needle marks or other indications of drug abuse.
Medical Disposition of Inmate:

general population; or

general population with prompt referral to appropriate health care; or

referral to appropriate health care service for emergency treatment; or

medical observation, isolation, or supervision.

If the answer on the preliminary screening to alcohol/drug usage is yes, staff
should question the inmate to find out the amounts, frequency, date/time of last
usage and if the prisoner has any history of problems after ceasing use of alcohol
and or drugs.
04.03 INMATE PHYSICAL EXAMINATION
A physical examination and collection of health history and data will be conducted for
inmates whose confinement will exceed ten days, prior to their fifteenth consecutive day
of confinement. The record of these examinations will be maintained in the inmate’s
medical file by the medical staff.
Scheduling For Examinations – The doctor/nurse will utilize the daily disposition logs
to determine which inmates need scheduled for this examination. These logs are
maintained in the computer and can be printed in hard copy based on the medical staffs
need. [Number] The nurse should contact the day shift supervisor with any questions
concerning the status of an inmate.
Physical Examination – The physical examination shall be conducted in the medical
exam room by the Jail Physician and/or Nurse.
The Physical Examination Form, JA-31A, shall be used to record the results of this
exam and shall include at least the following items:

review of the preliminary health screening, located in the Jammin computer files;

collection of additional data to complete the medical, dental, mental health, and
immunization history;

recording height, weight, pulse, blood pressure, and temperature;
753 MEDICAL 090605
3

laboratory and/or diagnostic tests to detect tuberculosis and other suspected
communicable diseases;

other tests and examination as determined necessary by the jail physician;

medical examination including review of mental and dental status;

review of results of the medical examination tests and identification of problems
by the physician or other qualified health care personnel;

initiation of therapy when determined necessary by the physician;

development and implementation of a treatment plan; and

mental health assessment.
04.04 EMERGENCY MEDICAL CARE
Emergency medical care is available 24 hours a day for inmates. An emergency
medical situation includes but is not limited to any health/life threatening condition such
as severe bleeding, unconsciousness, serious breathing difficulties, head injury, severe
pain, and severe burns.
Emergency Medical Situation
In the event of an emergency medical situation, the Urgent Care/ Life ambulance
service shall be contacted or if unavailable a reasonable alternative service. Staff will
administer first aid until the rescue squad arrives.
Rescue Squad
If the rescue squad personnel determine immediate medical care is needed, the inmate
will be transported by the rescue squad to Southern Ohio Medical Center or a
reasonable alternative facility if directed to do so by Southern Ohio Medical Center.
Guarding the Inmate
The inmate shall be guarded by Sheriff’s Office personnel when transported to the
hospital. Felons shall be guarded by Deputy Sheriffs. The on-call supervisor shall be
contacted whenever an inmate is transported to the hospital for emergency treatment.
Non-felon female inmates shall be guarded by female deputy sheriffs. If there is only
one female Deputy Sheriff on duty, another female Deputy Sheriff will be called to duty
as soon as possible. Female felons will be guarded by female Deputy Sheriffs.
Training
Deputy Sheriffs shall receive first aid/CPR training during their basic training course and
will thereafter receive annual refresher training in first aid.
753 MEDICAL 090605
4
Medical Emergency Response Kits
These kits are located at the housing officer’s duty post and at the booking officer’s duty
post. These kits will be checked for proper inventory on a monthly basis by the nurse
and shall be replenished whenever supplies are used. Each kit contains a monthly
check-off sheet which the nurse signs off on when she checks the kit.

CPR Protective Mask;

(1) protective eye shield / mask;

(4) latex gloves or non- latex equivalent; and

(2) large wound compresses.
Documentation
All emergency medical situations shall be documented by the Deputy sheriff in a jail
Incident Report, JA-50, with a copy placed in the inmate’s medical file for review by the
facility’s medical staff. The original report will be submitted through the chain of
command to the Sergeant.
04.05 SICK CALL
Sick call shall be conducted by the physician or nurse, under the supervision of the
physician, a minimum of three times a week. Sick call will be conducted in the medical
examination room of the jail facility.
Shift Supervisor
The shift supervisor will assign a Deputy sheriff to supervise inmates during sick call.
This officer will be stationed immediately outside the medical examination room and will
be of the same sex as the inmate being seen by medical staff. Only one inmate is to be
in the medical examination room at a time.
04.06 DAILY MEDICAL COMPLAINTS
All inmates shall have on equal opportunity to report medical complaints to medical staff
on a daily basis. These medical complaints shall be referred to the nurse or physician.
Non-emergency Medical Complaints
These complaints shall be documented on the Medical Care Form, JA-31. If the inmate
cannot read or write, this form will be completed by a deputy sheriff. These requests
shall be maintained in the inmate’s medical file after review by the medical staff.
Medical complaints shall be reviewed by the nurse/Doctor. If the nurse is not available
to review a medical complaint, the shift supervisor shall contact the on-call physician for
further instructions.
Medical Treatment
753 MEDICAL 090605
5
Medical treatment as deemed necessary by the physician or the nurse under the
supervision of the physician shall be provided.
04.07 PERSONAL PHYSICIAN
Inmates shall be permitted treatment by their own personal physician provided that:

treatment will be given at the SCJ;

treatment will be at the inmate’s expense;

identity of and Ohio Medical License of the personal physician is verified;

jail physician approves the request;

personal physician provides the Jail physician a documented copy of his
diagnosis and treatment; and

request and approval is documented on an Inmate Request form.
Documentation of Treatment
Documentation of this treatment shall be placed in the inmate’s medical file.
04.08 MEDICAL RECORDS
Health records for each inmate will be maintained in a format approved by the
physician. Health records include all medical contacts and requests including any
psychiatric, dental, and other consultative services received or requested by an inmate.
Confidential
Health records of inmates are confidential and will be accessible only to those
personnel designated by the physician. The Division Commander, Sergeant, and
medical staff are authorized to have access to medical records.
Correction Staff
Staff may be advised of an inmate’s health status only to preserve the health and safety
of the inmate, other inmates, or the jail staff. Such authorizations will be at the discretion
of the supervising physician.
Security of Medical Records
Health records will be maintained in locked filing cabinets or a secured room and will be
maintained by the medical staff.
753 MEDICAL 090605
6
04.09 INMATE MEDICATION
Administering Medication
Deputy sheriffs, Correction Officers – Prescription and non-prescription medications will
be administered by Deputy sheriffs, Correction Officer who are trained in the Sheriff’s
Office procedures regarding the administration of medications and medical supplies and
who have completed the required basic training for Deputy sheriff, Correction Officer in
Ohio. The administration of medication shall be under the supervision of the physician
and the Jail Administrator. The administration of all medication will be in accordance
with federal and state laws.

Medications will be administered according to the orders of the prescribing
practitioner or the jail physician, in a timely manner and in the prescribed
amounts and forms.

The following procedures shall be followed in administering medication:
o enter the housing area with only the required medications and supplies;
o identify the medication, dose, and schedule for medication;
o identify the inmate, have him/her approach the service counter and do not
permit anyone else to approach while administering the medication;
o if the inmate takes the medication, observe the inmate swallow the
medication with water.
o Officer will initial box that corresponds with medication time that was given
to the inmate.

Medication will be administered at meal times and bedtime. Exceptions to these
times will be at the physician’s orders.

Inmates may carry and administer their own medication only upon specific orders
by the physician.

Disciplinary action may be taken against inmates found to be stockpiling or
hoarding medication, and the medication could be discontinued after review and
approval by the physician.
Control of Medication
753 MEDICAL 090605
7
Inmate medications and medical supplies shall be stored in the locked storage room
located in the medical exam room. Medication requiring refrigeration shall be kept in the
refrigerator also located in this room. Access to this locked room is limited to medical
staff and those officers authorized to administer or use inmate medications or supplies.
Unused Prescription Medication – Prescription medication where the seal has not been
broken shall be returned to the pharmacy for credit. Medications purchased by inmates
shall be returned to the inmate upon release from the incarceration.
Inmates admitted with Medication – Inmates who are in possession of medication when
admitted to the facility shall only receive that medication after approval of the facility
physician. This approval shall be documented in writing on the Medication Approval
form and filed in the inmate’s Medical file.
Medication Brought to the Facility for the Inmate – Inmate medication that is brought to
the jail by family or friends will not be used until approved by the physician. This
approval shall be documented in writing on the Medication Approval form.
Daily Inventory – Controlled medications shall be inventoried daily by the midnight shift
housing officer on the Inmates records.
Syringes and Hypodermic Needles – These items shall be secured in a lockable cabinet
located in the medical office and will be inventoried monthly by the nurse and
documented on the inventory form. Any discrepancies should be brought to the
attention of the physician and the shift supervisor.
Used syringes and hypodermic needles will be placed in the appropriate sharps
container and disposed of by the nurse following the procedures of the nurses’
employer (Southern Ohio Medical Center).
Documentation and Accountability
A Medication Log, JA-32B, will be prepared for each inmate.

All administered medication including non-prescription medication and supplies
will be documented on this log.

The medication log will contain the following information:
o
o
o
o
o
o
inmate name;
inmate booking number;
medication name, strength, and dose;
prescription number;
date and time medication is administered;
officer administrating medication
753 MEDICAL 090605
8
o Completed medication logs shall be filed in the inmate’s medical file,
which is confidential and shall be kept secured in a locked cabinet in the
medical office. Only authorized personnel shall have access to these
records.
04.10 DENTAL CARE
The physician or a dentist licensed in the State of Ohio shall provide inmates with
professional dental services as determined necessary by the physician.
Emergency Treatment
Inmates will have access to a dentist for emergency dental care for acute dental
problems, such as severe pain, broken teeth, infections, bleeding gums, and broken
dental prosthesis necessary for eating. If a dental emergency is suspected the physician
shall be contacted for instructions. The physician’s instructions and any treatment
provided will be documented on an incident report with a copy placed in the inmate’s
medical file.
Routine Examination
Only preventive measures and/or treatment determined as correcting a condition, which
would otherwise adversely affect the inmate’s health, will be provided by the dentist.
Requests for Dental Examination
An Inmate will only be eligible to submit a request for routine dental examinations if
he/she has been incarcerated over twelve months. All such requests will be reviewed by
the medical staff to determine if the inmate is eligible for this examination.
Documentation
Routine dental examinations or treatment will be documented on an incident report with
a copy placed in the inmate’s medical file.
04.11 MENTAL HEALTH
Inmates exhibiting signs of mental illness or developmental disability shall be referred
immediately to qualified mental health personnel. [See Directive 757, Suicide
Prevention Plan]
Non-crisis and Crisis Mental Health Care
Care shall be provided to inmates by qualified staff from Shawnee Mental Health
Services.
Signs of Serious Mental Disorder
Staff from SMHS shall be contacted immediately to interview inmates exhibiting signs of
mental disorder. The signs of mental disorders include:

expressions of suicidal thoughts;
753 MEDICAL 090605
9

appearance of disorientation; and

irrational or inappropriate behavior or speech.
Isolate Inmates – Inmates exhibiting serious signs of mental disorder shall be isolated
from other inmates and shall be personally observed at least every ten (10) minutes
until they have been examined by staff from SMHS.
Documentation – Situations requiring emergency mental health interview shall be
documented on an incident report with a copy placed in the inmate’s medical file for
review by medical staff.
Inmates Requests for Non-crisis Counseling – Inmates requesting counseling by
SMHS staff will be seen by the counselor during the counselor’s normally scheduled
visit to the facility.
Documentation – of this counseling shall be placed in the inmate’s medical file.
Transporting an Inmate to a Psychiatric Hospital - Whenever an inmate is
transported to a psychiatric hospital for treatment upon the recommendation of SMHS
staff, a Custody Notification form [Number] will be completed by the transporting officer.
A copy of this form will be given to the admitting officer of the hospital. An incident
report will be completed and the original of the Custodial Notification form will be
attached to the incident report. The shift supervisor will notify the on-call supervisor prior
to transporting the inmate.
04.12 INFECTIOUS DISEASE CONTROL
To prevent the spread of infectious disease within the jail, these procedures will be
followed: [See Directive 422, Communicable Diseases]

All staff will be given a medical examination prior to employment.

All staff will be offered hepatitis vaccinations and tuberculosis testing.

The facility will be kept in a clean and sanitary condition as outlined in the
Sheriff’s Office written directives.

Inmates who are to be assigned to work in food service must be medically
cleared prior to this assignment.

Surveillance by both medical staff and corrections staff for outbreaks of infectious
disease will be an on-going process. The physician shall be notified immediately
whenever an infectious disease is suspected or identified in an inmate.
753 MEDICAL 090605
10

The physician shall determine what precautions are necessary and may include:
o inmate medical testing and treatment;
o level of inmate isolation required;
o special sanitation requirements; and
o staff precautions required.

Inmates requiring medical isolation shall be housed in the isolation cellblock.

Reporting of infectious disease by medical staff shall be done in accordance with
local and state laws.
04.13 PREGNANT INMATES
Pregnant inmates shall receive pre-natal care as determined necessary by the facility
physician.
Inmates who report to staff that they are or possibly are pregnant, shall be referred to
medical staff for any necessary pre-natal care.
04.14 INMATE MEDICAL CO-PAYS
All convicted inmates shall be charged medical co-pays for services rendered to them
while incarcerated in the Scioto County Jail. The purpose of this policy is to help offset
the ever increasing costs of medical care for inmates.
Fees for medical care include:




Nurse’s sick call visit
Doctor’s sick call visit
Dentist visit
Prescription
(per prescription per every refill)
 Court Ordered lab tests
(STD’s, T.B. tests for Septa)
These fees are subject to change.
$ 5.00
$ 10.00
$ 10.00
$ actual cost
$ actual cost
Free medical services for inmates include:




Admission screening during booking process
Mental health screening and follow up
Preliminary health appraisal
Medical emergencies (as determined by medical staff or jail
753 MEDICAL 090605
11




administration)
Follow up visits initiated by medical staff
Referrals by Corrections Staff
Referral by medical staff to specialists
Chronic disease visits and follow up
All inmate medical fees shall be deducted from the inmate’s commissary account by
the booking officer. These funds shall be paid into the jails’ commissary account. If an
inmate lacks sufficient funds to pay the medical fee, a past due payment shall be
posted to his/her account. If anytime in the future funds are placed into his/her
account, the medical fee shall be deducted at that time.
Inmates are required to sign the “Inmate Co-Pay Charge Document” that explains
these charges. If the inmate refuses to sign, medical staff and a deputy sheriff shall
mark the document “refused to sign” and place their signature on the document. The
inmate will still be responsible for the medical fees.
The original document will be placed in the inmate’s booking jacket and a copy
forwarded to the Captain.
NO INMATE SHALL BE DENIED ACCESS TO MEDICAL SERVICES DUE TO LACK
OF FUNDS
05
SPECIAL PROVISIONS
05.01 TRAINING / REVIEW
New Employees
Supervisors will review this directive with all new personnel.
New Officer
The Field Training Officer should review this directive with the new officer during the
FTO program and document the review in the FTO report.
Approved:_________________________________________ Date:______________
Scioto County Jail Physician
By Order of the Sheriff_______________________________
753 MEDICAL 090605
Date_______________
12