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MICHAEL D. CREWS SECRETARY PROCEDURE NUMBER: 401.001 PROCEDURE TITLE: MOVEMENT RESTRICTIONS DURING COMMUNICABLE DISEASE OUTBREAKS RESPONSIBLE AUTHORITY: OFFICE OF HEALTH SERVICES EFFECTIVE DATE: MARCH 26, 2014 INITIAL ISSUE DATE: OCTOBER 21, 1999 SUPERSEDES: HEALTH SERVICES ADMINISTRATIVE MEMORANDUM NO. 96-2 RELEVANT DC FORMS: NONE ________________________________________________________________________________ ACA/CAC STANDARDS: 4-4354, 4-4354-1, 4-4355, 4-4357-1, AND 4-ACRS-4C-09 STATE/FEDERAL STATUTES: AND 392.655, F.S. SECTION 381.0011, 381.0031(2), 381.00315(4), 384.32, FLORIDA ADMINISTRATIVE CODE: RULES 33-401.105 (5), 33-602.206, 64D-3.030, 3.031, AND 3.038, F.A.C. Procedure 401.001 PURPOSE: To provide guidelines to prevent the spread of communicable diseases, including the utilization of movement restrictions. DEFINITIONS: (1) Chief Health Officer/Institutional Medical Director refers to the designated health authority with which final clinical judgment rests on medical issues concerning inmates at assigned institutions and any satellite facilities. The Chief Health Officer/Institutional Medical Director is a Physician licensed in accordance with either chapter 458 or 459, F.S. (2) Clinical Contract Monitor, Public Health refers to the employee located in the Office of Health Services in the central office who oversees all Department infection control issues. (3) Communicable Disease refers to any disease caused by transmission of a specific infectious agent, or its toxic products, from an infected person, an infected animal, or the environment to a susceptible host, either directly or indirectly. (4) Epidemic/Outbreak refers to the occurrence of significantly more cases of the same disease than past experience would have predicted for that place, time, and population. When a disease is thought to rarely (or never) occur, a single case of that disease is considered an epidemic (e.g., smallpox). (5) Infection Control Nurse refers to an individual designated by the institutional Director of Nursing, Chief Health Officer/Institutional Medical Director to oversee the tuberculosis screening and control program at a specific location. (6) Movement Restriction refers to a restriction of movement of one (1) inmate or multiple inmates that limits their activity to a specific area. An area of restriction may be limited to a single cell, or as broad as an entire institution. (7) Regional Infection Control Coordinator refers to designated contracted employee who is responsible to oversee the infection control program within the designated region. (8) Regional Medical Director refers to the contracted employee who is responsible for the delivery of health services within the designated region. SPECIFIC PROCEDURES: (1) INSTITUTIONAL RESPONSIBILITIES: (a) During normal working hours (8 a.m. to 5 p.m., Monday through Friday), as soon as the Chief Health Officer/Institutional Medical Director or her/his designee at the institution becomes aware of the possible existence of a communicable disease epidemic or outbreak, will: 1. assess the clinical status and treatment options; and 2. notify the following people in the order listed: (Note: The Warden will be informed even if staff are not sure a problem exists.) 2 Procedure 401.001 a. b. c. d. the Warden or designee; the Regional Infection Control Coordinator; the Regional Medical Director; and the central office Clinical Contract Monitor, Public Health or designee. (b) After hours (5 p.m. to 8 a.m., on weekends and holidays) the above notification will be made by phone to the on-call Chief Health Officer/Institutional Medical Director, and s/he will notify the Regional Medical Director. The decision to implement a movement restriction must come from the Regional Medical Director. (c) The Warden or Duty Warden will notify the Emergency Action Center of a situation that may lead to a movement restriction (staff will refer to “Emergency Action Center,” Procedure 602.012). (d) The institutional Infection Control Nurse will report to the County Health Department as defined in the Infection Control Manual, Chapter XII, “Infection Control Reporting to the Department of Health.” (e) During outbreaks, the Regional Infection Control Coordinator will coordinate the epidemiological investigation with the institutional Director of Nursing, and, as indicated, the regional Department of Health Epidemiologist. (2) CENTRAL OFFICE RESPONSIBILITIES: (a) The Assistant Secretary for Health Services or her/his designee in consultation with the central office Clinical Contract Monitor, Public Health will decide if a movement restriction will be mandated. After hours (5 p.m. to 8 a.m. and on weekends and holidays) the decision to implement a movement restriction will be made by the Regional Medical Director. (b) The central office Clinical Contract Monitor, Public Health will: 1. Communicate the decision concerning movement restriction through e-mail. The email will provide a. the initiation date; b. time of movement restriction; and c. a date/time the movement restriction will either be reevaluated or lifted. 2. Send the e-mail notification to the following staff (after hours [5 p.m. to 8 a.m. and on weekends and holidays] the notification will be made the next working day): a. Assistant Secretary for Health Services; b. Medical Services Director; c. Nursing Services Director; d. Clinical Contract Monitor, Nurse Compliance; e. Pharmaceutical Services Director; f. Impaired Inmate Coordinator; g. Assistant Bureau Chief of Classification Management-Population Management and Reception/Youthful Offender Services or designee; h. Public Affairs Director; 3 Procedure 401.001 i. j. k. l. m. n. o. p. q. r. Health Services Administration and Program Director; Warden of the institution; institutional Health Services Administrator; institutional Director of Nursing; Chief Health Officer/Institutional Medical Director; regional Medical Director; regional Infection Control Coordinator; Regional Directors; Assistant Secretary of Institutions; and Deputy Assistant Secretary of Institutions. (3) INMATE MOVEMENT DURING A MOVEMENT RESTRICTION: (a) When it becomes necessary to transport or remove an inmate from a movement restriction setting, the Chief Health Officer/Institutional Medical Director, Warden, or other designee will first notify the Clinical Contract Monitor, Public Health or designee in the central office. (b) The Clinical Contract Monitor, Public Health will: 1. work with the Assistant Secretary for Health Services and Medical Services Director to determine if contact must be made with the county health department or the State Health Officer pursuant to Rule 64D-3.038, F.A.C.; and 2. coordinate the move with the Bureau of Classification Management. (c) The Assistant Secretary for Health Services or designee will remove the movement restriction as soon as the spread of the communicable disease is no longer a threat. (d) The central office Contract Monitor, Public Health or designee, will communicate the decision concerning lifting the movement restriction through e-mail to the staff identified in section (2)(b)2a through 2r of this procedure. (4) OTHER PREVENTION AND CONTROL ACTIONS: (a) The Clinical Contract Monitor, Public Health will coordinate movement restriction or prophylactic medication for inmates who were moved to other institutions with the institutional Director of Nursing or designee at the receiving institution. (b) Conditions of quarantine are issued by the Department of Health. __________/S/___________________ Secretary 4