1. AUTHORITY

   Ohio Revised Code 5120.01 authorizes the Director of the Department of Rehabilitation and Correction, as the executive head of the department, to direct the total operations and management of the department by establishing procedures as set forth in this policy.

   
   

2. ‌PURPOSE

   
   

   The purpose of this policy is to establish standard procedural guidelines for the delivery of medical services and the provision of unimpeded access to medical care for incarcerated persons (IPs) under the jurisdiction of the Ohio Department of Rehabilitation and Correction (ODRC).

   
   

3. ‌APPLICABILITY

   
   

   This policy applies to all persons employed by or under contract with the ODRC (excluding DPCS, CTA, and OPI staff) and to all IPs confined to institutions within the ODRC.

   
   

4. ‌DEFINITIONS

   
   

   The definitions for the terms below can be found at the top of the policies page on the ODRC Intranet.

   Definitions Link

   • Advanced Level Provider (ALP)

   • Chief Medical Officer (CMO)

   • Health Care

   • Health Care Administrator (HCA)

   • Intrasystem Transfer

   • Medical Emergency

   • State Medical Director

5. POLICY

   
   

   It is the policy of the ODRC to provide medical services and continuity of care to IPs. Continuity of care is provided from admission to transfer or discharge from the facility and shall include referral to community-based providers when indicated. These services are to be accessible to all IPs, include an emphasis on disease prevention, and reflect a holistic approach in accordance with approved levels of care.

   
   

6. PROCEDURES

1. Governance and Administration

   
   

   1. Responsibilities of Medical Operations

      1. The State Medical Director shall serve as the responsible physician and the medical authority for the ODRC and the medical services programs. The State Medical Director is responsible for the overall supervision of medical services.

      2. Medical Operations shall assist institution medical departments in the coordination of institution medical services.

      3. With input from institution field staff, Medical Operations shall utilize a health care staffing analysis to identify the types of health care providers necessary to provide the determined scope of services and essential positions needed to perform the health services mission in each institution.

      4. Medical Operations shall provide operational and fiscal support for all ODRC institution medical service programs.

      5. The Office of Correctional Health Care (OCHC) shall coordinate all medical continuous quality improvement activities within ODRC institutions.

      6. The OCHC Medical Operations Department shall manage equipment requests for institution health services.

      7. The OCHC Credentialing Coordinator shall coordinate the credentialing process for all advanced level providers (ALPs) including all physicians, dentists, optometrists, podiatrists, nurse practitioners, clinical nurse specialists, and physician assistants.

         
         

   2. Institution Health Authority

      1. The health care administrator (HCA) shall serve as the institution’s health authority.

      2. Responsibilities of the institution health authority shall include, but are not limited to the following:

         1. Decisions regarding the deployment of health resources and day-to-day operations of the medical services program.

         2. Development of a mission statement defining the scope of medical services.

         3. Development of mechanisms, including written agreements, when necessary, to ensure the scope of services is provided and properly monitored.

         4. Adherence to and assurance that all medical staff comply with ODRC policy and protocol.

         5. Review of health care policies and protocols on an annual basis.

            
            

         6. Development of institution medical procedures, when necessary, to address needs not addressed in ODRC policies. Each institution procedure and program in the institution’s health care delivery system shall be reviewed and revised, if necessary, and signed at least annually by the HCA.

         7. Review of the institutional staffing plan at least annually to identify whether the number and type of staff is adequate to provide the determined scope of services. Upon review, input shall be provided to the medical operations director.

         8. Establishment of systems for the coordination of care among multidisciplinary medical providers.

         9. Participation in the development of an institutional Continuous Quality Improvement (CQI) program.

         10. Coordination with institution administration to ensure there is adequate space made available for administrative, direct care, professional, and clerical staff. Such space shall include access to a conference area, a records storage area, a public lobby, and toilet facilities.

         11. Procurement and maintenance of equipment and supplies necessary for health services as determined by the HCA.

             1. Institution HCAs shall follow the purchase procedures outlined in DAS Policy PM-01, DAS Purchasing Procedures, for supplies not provided through the Ohio Department of Mental Health supply system.

             2. If the institution’s medical budget is exhausted, yet additional equipment essential to the provision of quality medical care is needed, a Request to Purchase (DRC1918), an Equipment Justification (DRC5372), and a Budget Adjustment Request (DRC2303) for such equipment must be forwarded to the OCHC Chief.

         12. All other duties as assigned by the OCHC Medical Operations Department.

      3. The HCA shall be available to provide clinical and administrative supervision to institution medical staff twenty-four (24) hours per day, seven (7) days per week. In the event the HCA is not available to provide such supervision, the HCA shall arrange for back-up clinical and administrative supervision as follows:

         1. Designate the CQI coordinator to provide clinical and administrative supervision as acting HCA; or

         2. Designate the assistant HCA or arrange with the appropriate institution deputy warden to provide administrative supervision of the institution medical staff as acting HCA and designate an experienced staff nurse to provide clinical guidance; or

         3. Arrange with the HCA of a nearby ODRC institution for provision of clinical guidance and arrange with the appropriate institution deputy warden to provide administrative supervision of the institution medical staff.

            
            

   3. Responsibilities of the Chief Medical Officer (CMO)/Designee

      1. The CMO/designee shall have responsibility for all matters involving clinical judgment and shall not be countermanded by non-clinicians. The CMO/designee shall provide clinical leadership for the provision of medical services in conjunction with the HCA.

      2. Additional responsibilities of the CMO/designee include, but are not limited to:

         1. Coordinating on-call ALP coverage twenty-four (24) hours per day, seven (7) days per week, providing and sharing on-call responsibilities.

         2. Adherence to and assurance that all medical staff comply with ODRC policy and protocol.

         3. Conducting peer review/monitoring on institutional ALPs at least annually, which shall include a review of ten (10) patient records.

            1. The QIC shall maintain these confidential reviews.

            2. These reviews shall not replace the OCHC Medical Operations biennial peer reviews.

         4. Clinical care of the incarcerated population.

         5. Evaluation of IPs for referral consultations.

         6. Participation in collegial review process, per ODRC Medical Protocol B-1, Consultation Referrals.

         7. Review of the recommendations of the specialty consultants, which may include modification of the recommendation or development of an alternative plan of care.

         8. Monthly review of outstanding consults with the HCA, per ODRC Policy 68-MED-14, Specialty Health Care Services.

         9. Review of all medical emergency transfers to outside hospitals on the next working day, with the HCA.

         10. Review and approval of all medical restrictions.

         11. Provision of medical information/education for the health care and institutional staff.

         12. Provision of medical summaries or other written information.

         13. Attendance and participation in institution and departmental meetings and committees, including the Pharmacy and Therapeutics committee, CQI committee, and quarterly administrative meetings.

         14. Review of Health Care policies and protocols on an annual basis, and

         15. All other duties as assigned by the OCHC Medical Operations Department.

             
             

   4. ODRC Medical Policy and Protocol

      1. Each policy, protocol, and program in the health care delivery system is reviewed at least annually by the OCHC and revised, if necessary.

      2. Medical Operations shall develop, coordinate, and enforce system-wide medical service policies and protocols and shall provide direction related to health care issues.

      3. The State Medical Director shall be responsible for the review and revision of medical policies and protocols.

      4. The OCHC Chief shall be responsible for the review and revision of OCHC policies and protocols.

      5. Medical Operations shall be responsible for providing specific guidance and training/testing materials to all relevant field staff regarding significant changes in medical policy or protocol.

         1. Each HCA shall ensure all institutional medical advanced level providers (ALP) and nurses receive OCHC-generated training and testing regarding new and revised medical/medical-related policies and protocols.

            1. Policy and protocol testing shall occur during the initial on-the-job-training period.

            2. Policy and protocol testing shall also occur upon new and updated policy and protocol releases; this testing shall be completed within fourteen (14) calendar days of the policy/protocol effective date.

         2. Training and testing results shall be maintained and tracked through the CQI process.

      6. The institution HCA and the CMO/designee are responsible for ensuring each policy and protocol is implemented in accordance with ODRC guidelines.

      7. The managing officer/designee shall be responsible for reviewing and revising any institution’s post orders required to ensure compliance with medical policy and protocol.

         
         

   5. Institution Medical Strategic Planning

      1. As a part of the institution’s medical program strategic planning process, each HCA and CMO/designee shall develop measurable goals and objectives that shall be reviewed annually and updated as needed.

      2. During the annual review, each HCA shall assess the achievement of established goals and objectives and document findings. Program changes shall be implemented, as necessary, in response to the findings.

      3. As detailed in ODRC Policy 08-MAU-01, Internal Management Audits, the internal management audit system shall be used to monitor compliance with department policies and established standards.

   6. Institution Administrative Meetings and Reporting Requirements

      1. Each institution HCA and CMO shall meet with and submit reports to the managing officer, appropriate deputy warden, and a security representative at least quarterly to address communicable disease and infection control issues/activities, issues pertinent to medical services and health environment; and shall develop and submit plans to address issues raised. Additionally, the HCA shall review with the managing officer and appropriate deputy warden any newly adopted or revised policies and protocols.

      2. Each institution HCA shall prepare and submit electronic monthly reports that include, but are not limited to, the following:

         1. Referrals to specialists,

         2. Prescriptions written,

         3. Laboratory and x-rays completed,

         4. Infirmary admissions,

         5. Off-site transports,

         6. Transports to outside emergency departments,

         7. Hospital admissions,

         8. Serious injuries or illnesses, and

         9. Deaths.

   7. Credentials Review

      1. The HCA shall verify the licensure status of each licensed or certified employee annually, as outlined in ODRC Medical Protocol K-2, Credentialing and License Verification. Verification of current credentials and job descriptions shall be maintained on file in each facility.

         1. The HCA shall provide each nurse holding a multistate license (MSL) with a copy of board-developed information concerning laws and rules specific to the practice of nursing in Ohio. Available at the following link: Ohio Law and Rules for MSL.

      2. A hard or electronic copy of the license/certificate verification from the appropriate board/certification website shall be maintained by the Quality Improvement Coordinator (QIC).

      3. The centralized background unit shall conduct a background investigation on all contractors, as outlined in ODRC Policy 34-PRO-07, Background Investigations. The results of this investigation shall be maintained in the contractor’s file.

2. Incarcerated Person (IP) Care and Treatment

   1. Vital signs (i.e., blood pressure, temperature, pulse, height, weight, and oxygen saturation levels) shall be completed on the IP and recorded for every medical encounter other than medication administration; specific vital signs appropriate to specific drug administration shall be completed as indicated by the drug parameters.

      
      

   2. A complete medical, dental, and mental health screening shall be performed on each IP, excluding intra-system transfers, at the time of the IP’s arrival at one of the ODRC’s reception centers in accordance with ODRC Policy 52-RCP-06, Reception Intake Medical Screening.

      
      

   3. Health appraisal data collection and recording shall include the following:

      1. A uniform process as defined by the OCHC Medical Operations Department.

      2. Health history and vital signs collected by health trained or qualified health care personnel.

      3. Collection of all other health appraisal data performed only by qualified health professionals.

      4. Review of results of the medical examination, tests, and identification of health-related problems is performed by an ALP.

         
         

   4. Medically Supervised Withdrawal

      1. Medically supervised withdrawal from alcohol, opiates, hypnotics, other stimulants, and sedative hypnotic drugs is conducted only under medical supervision at the facility or in a hospital setting when conditions warrant. Refer to Protocol B-24 Medically Supervised Withdrawal Guidelines.

      2. IPs experiencing severe, life-threatening intoxication (an overdose), or withdrawal are transferred under appropriate security conditions to a facility where specialized care is available. Refer to Protocol K-15, Assessment and Management of Substance Intoxication for additional guidance.

         
         

   5. Intra-System Transfer Procedures: Reference ODRC Medical Protocol B-12, Intra-System Transfer and Receiving Process, for specific process details.

      1. Prior to any intra-system or interagency (i.e., ODRC to county jail or other correctional agency) transfer, a nursing assessment shall be completed on all IPs to maintain the provision of continuity of care.

         1. The assessment shall include information about the IP’s health condition, treatments, allergies, scheduled appointments, pending specialty consults, pertinent test results, and prescribed medication.

         2. The medical evaluation shall include a determination of the IP’s suitability for travel, with particular attention given to communicable disease clearance.

      2. All prescribed essential medication shall be prepared in accordance with procedures outlined in ODRC Medical Protocol E-32, Preparation of Medications for Intra-System Transfers.

      3. Medical records shall be transferred with the IP and be handled in such a manner as to ensure confidentiality.

         1. Completed hard copy IP records shall be transported to the receiving institution.

         2. Refer to ODRC Policy 07-ORD-11, Confidentiality of Medical, Mental Health, and Recovery Services Information, ODRC Medical Protocol E-32, Preparation of Medications for Intrasystem Transfer, and ODRC Policy 69-OCH-06, Electronic Health Record Utilization and Responsibilities, for additional guidance.

      4. Upon arrival at a new institution, all IPs shall be provided both verbal and written instruction, in a language that is easily understood by each IP, concerning access to medical care, the grievance process, copay requirements, and mental health services within the institution.

         1. Arrangements shall be made to provide this information to non-English speaking IPs in a language they can understand.

         2. When literacy or other communication problems exist, a staff member shall assist the IPs in understanding the information.

      5. Receipt of orientation information given to IPs shall be documented on the Medical Intake Signature Acknowledgement.

         
         

   6. A registered nurse (RN) or ALP shall conduct a health screening on each IP upon arrival which includes, at a minimum, those items needed to complete the Nursing Intra-System Transfer Receiving Assessment within eight (8) hours of arrival at the receiving institution. Consistent with ODRC Policy 67-MNH-02, Mental Health Screening and Mental Health Classification, and ODRC Policy 52-RCP-06, Reception Intake Medical Screening, the initial mental health screening shall also be completed at this time.

      
      

   7. Medical Needs During Transport

      1. Correction officers shall not provide nurse-administered medications and medical treatments during transport of an IP.

      2. The IP shall be permitted to retain certain self-carried medications in their possession, such as asthma inhalers and nitro-glycerin tablets, in accordance with ODRC Policy 310-SEC-03, Incarcerated Person (IP) Transportation, and ODRC Medical Protocol E-32, Preparation of Medications for Intra-System Transfers.

      3. IPs on oxygen maintenance therapies may be transported in ODRC vehicles to and from institutions/hospitals utilizing portable oxygen tanks when necessary.

      4. If the IP has a medical condition that requires a modification to the restraint procedures or any other special accommodations or precautions during transport, medical staff shall collaborate with the chief of security/managing officer.

      5. The security chief/designee shall ensure all special precautions are followed, including any required use of masks, gloves, or other personal protective equipment. Such notification shall also be made any time during a person’s incarceration when the treating ALP diagnoses a medical condition requiring such accommodation.

         
         

   8. General Medical Services

      1. An ALP shall be on call twenty-four (24) hours per day.

      2. IPs who have complaints about medical issues shall follow the procedures outlined in Ohio Administrative Code (OAC) 5120-9-31, Incarcerated Person (IP) Grievance Procedure. Whenever feasible, IP complaints should be resolved at the lowest step possible.

         
         

   9. Sick Call Services

      1. IPs shall be able to place requests for health services daily. Such requests shall be conveyed through readily available Health Service Requests (DRC5373) or the electronic equivalent, which are triaged daily by medical staff, as outlined in ODRC Medical Protocol A-2.35, Nurse Sick Call Access.

      2. A priority system shall be used to schedule clinical services, which shall be available to IPs in a clinical setting at least five (5) days a week, including nurse and ALP sick call.

      3. Clinical services shall be available to all IPs in a clinical setting at least five (5) days a week by an ALP or other qualified healthcare professional.

      4. No member of the correctional staff shall disapprove of an IP’s request for attendance at sick call.

      5. All health care encounters shall be conducted in a setting that respects IP privacy. Unless there is a known threat to the safety of healthcare staff, security staff shall maintain sound privacy by standing outside of the consultation area.

      6. Licensed medical personnel are expected to practice within their respective scopes of practice at all times.

      7. Staff medical resources shall be available through each medical services department.

         
         

   10. Restrictive Housing

       1. Security staff shall immediately notify medical staff when an IP is transferred to a restrictive housing unit. The institution medical staff must approve the transfer of an IP housed in the infirmary to a restrictive housing unit.

       2. Medical staff shall provide review and assessment of each IP transferred to a restrictive housing unit and log the information utilizing the Monthly Emergency Telephone Log (DRC5372), as outlined in ODRC Medical Protocol A-2.36, Nursing Telephone Triage.

       3. Unless medical attention is needed more frequently, each IP in restrictive housing shall receive a daily visit from a nurse.

          1. The visit ensures that IPs have access to the health care system.

          2. The presence of the nurse in restrictive housing shall be announced and recorded in the correction officer’s log.

          3. Nursing rounds and nurses sick call shall be conducted in each restrictive housing unit as outlined in ODRC Medical Protocol A-2.35, Nursing Sick Call Access.

       4. The HCA shall make weekly rounds in restrictive housing unit(s) to ensure daily quality nursing rounds are completed. In institutions that have more than one (1) restrictive housing unit, the units shall be rotated on a weekly basis.

       5. ALP sick call shall be provided on a schedule that is determined by the HCA.

       6. Medical appointments, diagnostic tests or other medical procedures shall not be cancelled or rescheduled because of restrictive housing unit admission without the approval of the CMO/designee.

          
          

   11. Infirmary Care

       All institutions shall provide access to infirmary care either on-site or via transport to another facility. Specific procedural guidelines for infirmary care are outlined in ODRC Policy 68-MED-21, Infirmary Care.

       
       

   12. Chronic Disease Management

       1. When IPs are diagnosed with a chronic illness, institution ALPs shall develop a treatment plan that addresses the monitoring of medications, laboratory testing, health record forms, the frequency of specialist consultations and other guidelines outlined in the appropriate chronic care clinic protocol.

       2. An IP who requires close medical supervision, including chronic disease and convalescent care, shall have a written individualized treatment plan developed that includes directions to medical and other personnel regarding their roles in the care and supervision of the IP, approved by the appropriate ALP.

       3. Chronic disease management strategies are outlined in ODRC Policy 68-MED-19, Chronic Disease Management, and in the chronic care clinic medical protocols.

          
          

   13. Medical Emergency Services

       1. Each institution shall have a plan to ensure emergency medical, mental health, and dental services are available 24 hours per day.

       2. All correctional and healthcare personnel shall be trained to respond to health-related emergencies within a 4-minute response time. The training program is conducted on an annual basis and includes instruction on the following:

          1. Recognition of signs and symptoms, and knowledge of action that is required in potential emergency situations.

          2. Administration of basic first aid.

          3. Certification in cardiopulmonary resuscitation (CPR) in accordance with the recommendations of the certifying health organization.

          4. Methods of obtaining medical/mental health staff assistance.

          5. Signs and symptoms of mental illness, violent behavior, and acute chemical intoxication, and withdrawal.

          6. Procedures for IP transfers to appropriate medical facilities or health providers.

          7. Suicide intervention.

       3. Specific procedural guidelines for provision of emergency services and emergency response training are outlined in ODRC Policy 68-MED-20, Emergency Services, ODRC Medical Protocol B-8, Guidelines for Assessment and Processing of Medical Emergencies, and ODRC Medical Protocol B-32, CPR Standards for Health Care Staff.

          
          

   14. Sexual Assault

       1. When an IP reports or is suspected of being the victim of a sexual assault, they shall be referred, under appropriate security provisions, to a community facility for treatment and gathering of evidence.

       2. Specific guidelines for the management of a suspected sexual assault are outlined in ODRC Policy 79-ISA-01, Prison Rape Elimination, and ODRC Medical Protocol B-11, Medical Care Guidelines for Sexual Conduct or Recent Sexual Abuse.

          
          

   15. Pre-Release Guidelines

       1. The managing officer/designee shall ensure the medical department receives or has access to a list of IPs who will be released the following month. Immediate notification shall be given on those occasions when an IP is ordered released on a same day basis.

       2. Within fourteen (14) days of release, the IP’s medical record shall be reviewed and updated. A licensed nurse shall complete an electronic release medical summary for all IPs who are released.

       3. The ALP shall order, as outlined in ODRC Medical Protocol E-25, Dispensing Medication for Releases and Transfers, prescribed medical and mental health medication(s) that shall be issued to the IP upon release from an ODRC institution.

       4. If the IP is prescribed insulin, a Diabetic Going Home Kit shall be issued to the IP. Nursing staff shall verify the IP’s competency with self-administering insulin. Any necessary education shall be provided prior to release.

       5. If other injectable medication is prescribed, excluding all mental health injectable medications, the appropriate supplies shall be issued to the IP and education provided.

       6. Each institution’s health services department shall develop an institution specific procedure that promotes continuity of care after release. A list of referral sources shall be given to IPs who require medical follow-up after release. (See Attachment A, Resource Contact Information).

       7. The release medical summary, education regarding medical follow up care needs, and directions on accessing a Narcan Release Kit shall be provided to all IPs prior to release from the institution. IPs shall be provided with medications prior to release from the institution.

       8. The health care administrator (HCA) shall determine on a case-by-case basis whether those who have been issued state-owned medical equipment and assistive devices should retain the equipment or device upon release. Refer to Policy 78-REL-06, Incarcerated Person (IP) Release.

       9. The HCA shall assist unit management staff with release arrangements for hard-to-place IPs to avoid release to a local emergency department.

3. Health Care Services and Support

   
   

   1. Specialty Health Services

      1. The CMO/designee shall determine if an IP needs specialized healthcare services not available within the institution. If the CMO/designee determines medical services are needed that are beyond the scope provided by the medical department of the parent institution, a referral shall be made for IP transfer under appropriate security provisions to a facility where such care is available, as outlined in ODRC Policy 68-MED-13, Medical Classification.

      2. Each institution shall develop a written list of referral sources, to include emergency and routine care. This list shall be reviewed and updated annually by the HCA.

      3. Hospital inpatient and specialty health services are provided by community providers, as outlined in ODRC Policy 68-MED-14, Specialty Health Care Services.

         
         

   2. Ancillary Services

      1. Laboratory Services: The ODRC-contracted lab provides full service, and high complexity laboratory testing for all institutions.

      2. X-ray services are available either on-site, at the Franklin Medical Center (FMC), in community facilities contracted by ODRC, or at institutions with privatized medical services.

      3. Dental services are available to every IP as outlined in ODRC Policy 68-MED-12, Dental Services.

      4. Pharmacy services are provided for each institution as outlined in ODRC Policy 68-MED-11, Pharmacy Services.

      5. Exercise areas shall be available in each institution to meet the exercise and physical therapy requirements of individual IP treatment plans. Refer to Protocol K-14, Medical Holistic Services Referral to Recreation.

      6. Medical and/or dental adaptive devices (i.e., eyeglasses, hearing aids, dentures, wheelchairs, or other prosthetic devices) shall be provided when medically necessary, as determined by the responsible ALP and through the collegial review process, as outlined in ODRC Medical Protocol B-1, Consultation Referrals: Initiation, Process & Follow-Up.

         
         

   3. Medical Transportation

      1. The safe and timely transportation of IPs for emergency and routine medical, mental health, and specialty clinic appointments, both inside and outside the institution, is the joint responsibility of the managing officer/designee and the HCA.

      2. Each institution shall provide transportation that assures access to medical services that are only available outside of the institution in accordance with ODRC Policy 310-SEC-03, Incarcerated Person (IP) Transportation, and ODRC Policy 68-MED-20, Emergency Services. Decisions concerning transportation shall incorporate the following requirements:

         1. Prioritization of medical need: Referrals to specialty consults shall be designated as routine or to be scheduled within a specific timeframe within the EHR and processed in accordance with ODRC Policy 68-MED-14, Specialty Health Care Services and ODRC Medical Protocol B-1, Consultation Referrals: Initiation, Process & Follow-Up.

         2. The urgency of the medical need for ambulance versus standard transport as designated by the institutional ALP or other health care designee.

         3. A medical escort shall be used to accompany security staff if necessary. If medical escort is required, ambulance transport must be used. Institutional medical staff shall not act as medical escort.

         4. The transfer of medical information shall be followed as outlined in ODRC Medical Protocol B-8, Guidelines for Assessment and Processing of Medical Emergencies, and ODRC Policy 68-MED-14, Specialty Health Care Services.

            
            

4. Health Promotion and Disease Prevention

   
   

   1. Each institution shall offer an ongoing program of health education and wellness information to all IPs.

      
      

   2. Each institution shall also offer a holistic services fair annually for IPs, which may include informational booths, speakers, and access to free health screenings.

      1. Participation and attendance of all institutional holistic services areas, including education, medical, behavioral health, religious, recreational and recovery services, is mandatory.

      2. Medical services shall coordinate the event.

      3. Holistic services fair admission shall be extended to family and support persons of IPs and community partners.

      4. Notification of the holistic services fair shall be publicized in IP common areas at least thirty

         (30) days prior to the holistic services fair.

      5. A list of activities/booths offered during the holistic services fair shall be publicized.

      6. IP participation shall be captured via individual signatures.

         
         

   3. Periodic Examinations

      1. Every institution shall make periodic physical examinations available to all IPs as outlined in ODRC Medical Protocol B-5, Health Examination Guidelines for Incarcerated Persons.

      2. Appropriate IP education regarding health maintenance and disease prevention shall be made available to IPs during the physical examination.

         
         

   4. Medical staff shall collaborate with other holistic services areas to ensure the holistic needs of the IPs at the institution are met. Medical staff shall participate in a holistic family event at least quarterly.

      1. Each quarter, a different service area under holistic services shall be responsible for coordinating the event.

      2. The event shall be extended to family and support persons of IPs and community partners, when applicable.

      3. When medical services is not responsible for coordinating the quarterly event, it shall be an active participant in the event by providing materials, information, staff, and other items to ensure medical services is appropriately represented.

5. Personnel and Training

   
   

   1. Institution Medical Staffing

      1. A staffing plan for each institution shall be developed through Medical Operations from a staffing analysis which defines the scope of services to be provided and determines the essential positions needed to perform the medical services mission. The HCA shall review this staffing plan with the medical operations director at least annually to provide input in determining whether the number and type of staff is adequate.

      2. Adequate health care personnel shall be available within the institution for health assessments, medication administration, triaging of complaints and problems, chronic care, management of emergencies, and follow-up services.

      3. Written job descriptions shall be prepared by OCHC Medical Operations for qualified health care staff and approved by the HCA. These job descriptions are reviewed with each employee upon hire and annually at the time of the employee’s performance evaluation.

      4. The specific duties and responsibilities of health care staff shall be clearly defined and delineated.

      5. Work assignments shall be developed in compliance with the licensee’s scope of practice.

      6. Nursing students, medical students, and interns delivering medical care in the institution shall work, commensurate with their level of training, under the direct supervision of a clinical instructor who is responsible to the HCA.

         1. There shall be a written agreement between the ODRC, coordinated and approved through the OCHC medical education manager prior to student/intern placement, and the training or educational facility, that covers the scope of work, length of the agreement, and any legal or liability issues.

         2. Students or interns shall agree in writing to abide by all facility policies including those relating to the security and confidentiality of information.

         3. For additional details, refer to ODRC Policy 38-CED-05, Internship Guidelines.

      7. Incarcerated workers are restricted to defined job duties within the health care area and shall work under the supervision of the custody staff. IPs shall not be used for the following:

         1. Performing direct patient care services, except under direct supervision by qualified staff as part of an apprenticeship program.

         2. Any duties that allow direct or indirect access to confidential medical information.

         3. Scheduling health care appointments.

         4. Any activity that determines access of other IPs to health care services.

         5. Handling or having access to surgical instruments, syringes, needles, medications, or health care records.

      8. Upon receiving appropriate training developed by the HCA and approved by the regional nurse administrator (RNA), incarcerated workers may perform familial duties consummate with their level of training. The training shall be documented on the Incarcerated Person’s Training form (DRC1953). These duties may include:

      9. Peer support and education.

         1. End-of-Life Care activities including service as a companion, letter writing, and reading.

         2. Assist impaired IPs on a one-to-one basis with basic life functions/activities of daily living, which may include but are not limited to:

            1. Assisting vision-impaired IPs with communication facilitation, ambulatory guidance, spatial awareness, organization of personal property, etc.

            2. Assisting mobility-impaired IPs with ambulatory guidance, wheelchair maneuvering, transportation of items, organization of personal property, etc.

            3. Assisting hearing-impaired IPs with communication facilitation, spatial and auditory awareness, etc.

            4. Assisting speech-impaired IPs with communication facilitation, etc.

         3. Serving as a suicide companion or peer supporter if qualified and trained through a formal program that is part of a suicide-prevention plan.

         4. Optometric assistance, as part of ODRC’s eyeglass fabrication process, when directly supervised and in compliance with applicable tool control policies.

         5. Denture fabrication, when directly supervised and in compliance with applicable tool control policies.

         
         

   2. Continuing Education and Staff Development

      1. The HCA shall work with the institution training department and the chief of security to ensure all health care personnel receive training in the implementation of the institution’s medical emergency plans.

      2. Health care personnel must participate in annual training drills of the medical services delivery aspects of the critical incident management plan.

      3. Medical staff are encouraged to take advantage of the various medical in-service training classes offered by the department. Staff development classes are regularly offered at the Corrections Training Academy (CTA). A schedule of these classes is available in the CTA catalog of class offerings.

         
         

6. Special Medical Considerations

   
   

   1. Security of Medical and Dental Equipment

      1. Security of all medical and dental equipment and instruments is of paramount importance. Medical and dental staff shall conform to the procedures outlined in ODRC Policy 310-SEC-36, Tool Control, and to each institution’s specific tool control procedures.

      2. All medical and dental staff shall adhere to the procedures outlined in ODRC Medical Protocol E-2, Pharmacy Administrative Operations.

         
         

   2. Scheduled coordinated visits which are initiated by the Veteran’s Association (VA) are permitted for the purpose of establishing VA benefits only.

      
      

   3. Second Opinions/Private Pay

      1. IPs do not have the option to receive a second opinion in medical matters. Likewise, a "private physician" is not permitted to treat an individual while incarcerated.

      2. IPs generally do not have the option to purchase or receive prescription medication or medically related items from outside sources. Certain medically indicated devices may be authorized on a case-by-case basis. Such exceptions may include, but are not limited to:

         1. Back or knee braces,

         2. CPAP machines,

         3. Nebulizer compressors,

         4. Eyeglasses (note: ODRC does not provide contact lenses to IPs unless medically indicated),

         5. Specialized wheelchairs, and

         6. Other medically necessary equipment that meets security requirements, if authorized by the institution’s chief of security, HCA and CMO/designee.

      3. Healthcare insurance programs in place prior to the person’s incarceration may be accessed for medical services while the individual is incarcerated by the ODRC. Decisions to seek reimbursement from third party payers shall rest with the OCHC Chief and shall be considered on a case-by-case basis.

Attachment:

Appendix A Resource Contact Information

Referenced ODRC Medical Protocols:

A-2.35 Nursing Sick Call Access A-2.36 Nursing Telephone Triage

B-1 Consultation Referrals: Initiation, Process & Follow-Up B-5 Health Examination Guidelines for Incarcerated Persons

B-8 Guidelines for Assessment and Processing of Medical Emergencies B-11 Medical Care Guidelines for Sexual Conduct or Recent Sexual Abuse B-12 Intra-System Transfer and Receiving Process

B-24 Medically Supervised Withdrawal Guidelines B-32 CPR Standards for Health Care Staff

E-2 Pharmacy Administrative Operations

E-25 Dispensing Medication for Releases and Transfers

E-32 Preparation of Medication for Intra-System Transfers K-2 Credentialing and License Verification

1. Medical Holistic Services Referral to Recreation

2. Assessment and Management of Substance Intoxication

Referenced ODRC Policies:

07-ORD-11 Confidentiality of Medical, Mental Health, and Recovery Services Information 08-MAU-01 Internal Management Audits

34-PRO-07 Background Investigations 38-CED-05 Internship Guidelines

52-RCP-06 Reception Intake Medical Screening

67-MNH-02 Mental Health Screening and Mental Health Classification

68-MED-11 Pharmacy Services

68-MED-12 Dental Services

68-MED-13 Medical Classification

68-MED-14 Specialty Health Care Services 68-MED-19 Chronic Disease Management 68-MED-20 Emergency Services

68-MED-21 Infirmary Care

69-OCH-06 Electronic Health Record Utilization and Responsibilities

78-REL-06 Incarcerated Person Release

79-ISA-01 Prison Rape Elimination

310-SEC-03 Incarcerated Person Transportation 310-SEC-36 Tool Control

Referenced Forms:

Request to Purchase DRC1918 Incarcerated Individual’s Training DRC1953 Budget Adjustment Request DRC2303 Monthly Emergency Telephone Log DRC5372 Health Service Request DRC5373

Health Care

It is important that you establish yourself with a primary care pro-vider upon release to continue your healthcare.

Your primary care provider can obtain a copy of your medical records while you were incarcer-ated by sending a signed release of information to the facility.

Resource Contact

Information

Reducing Recidivism Among Those We Touch

4545 Fisher Road Suite D

Columbus Ohio 432228 www.drc.ohio.gov

Contact Information of Agencies for Assistance

Social Security Administration 1-800-772-1213

Opportunities for Ohioans

with Disabilities 1-800-282-4536

Medicaid Consumer Hotline-

1-800-324-8640

Ohio State University Hospital (614) 293-8000

Ohio Department of Health (Sexually Transmitted Infection Prevention and Treatment)

(614) 644-2714 or

(614) 995-5599

Ohio Department of Health (614) 466-3453

Ohio Department of Health

(COVID 19)

1-833-427-5634

Ohio Department of Aging (614)466-5500

Substance Abuse and Mental Health Services Administration (SAMHSA)

1-877-726-4727

Ohio Department of Job and Family Services (Child Support)

1-800-686-1556

Ohio Department of Job and Family Services (Benefits)

1-844-640-6446

Ohio Unemployment Services 1-877-644-6562

Ohio Department of Veteran

Services

(614) 644-0898