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Correctional Managed Health Care

Policy Manual

Correctional Managed Health Care Policy Manual
Policy # Effective Date Title Format
  03/2024 Table of Contents PDF
    Disclaimer PDF
    Transmittal Memos and Signature Pages HTML
    Policy Review Schedules:  
         Policy Review for January PDF
         Policy Review for April PDF
         Policy Review for July PDF
         Policy Review for October PDF
A-01.1 03/07/2017 Access to Care PDF
A-02.1 03/17/2016 Responsible Health Authority PDF
A-02.2 01/2024 Treatment of Injuries Incurred in the Line of Duty PDF
A-03.1 03/17/2016 Medical Autonomy PDF
A-04.1 3/17/2016 Administrative Meetings PDF
A-04.2 02/15/2019 Health Services Statistical Report PDF
A-05.1 10/2023 Correctional Managed Health Care Policies PDF
A-06.1 04/2022 Quality Improvement/Quality Management Program PDF
A-06.2 04/2022 Professional and Vocational Nurse Peer Review Process PDF
A-07.1 04/2022 Emergency Plans and Drills PDF
  04/2022      Attachment A: Disaster Drill Evaluation Form PDF
A-08.1 04/2022 Decision Making for Serious Mentally Ill Patients PDF
  04/2022      Attachment A: Mental Health Disciplinary Review Form PDF
A-08.2 04/2023 Transfers of Offenders with Acute Conditions PDF
  04/2022      Attachment A: Approved Medical Transportation Criteria PDF
A-08.3 07/13/2023 Referral of Inmates to the Development Disabilities Program (DDP) PDF
A-08.4 09/08/2022 Inmate Medical and Mental Health Classification PDF
  11/05/2019      Attachment A: Guidelines for Completing the Health Summary for Classification Form PDF
A-08.5 08/23/2016 Coordination with Windham School System PDF
A-08.6 08/23/2018 Medically Recommended Intensive Supervision Screening PDF
  05/02/2013      Attachment A: MRIS Screening Form PDF
  03/07/2017      Attachment B: MRIS Medical Summary PDF
A-08.7 07/2022 PULHES System of Inmate Medical and Mental Health Classification PDF
  07/2022      Attachment A: PULHES Background and Information PDF
  07/2022      Attachment B: Guidelines For Coding PUHLES PDF
A-08.8 08/17/2021 Medical Pass PDF
A-08.9 02/24/2022 The Chronic Mentally Ill Treatment Program (CMI-TP) PDF
A-08.10 07/2023 The Program for Aggressive Mentally Ill Inmate (PAMIO) PDF
A-09.1 10/2022 Privacy of Care PDF
A-10.1 10/2022 Notification Requirements Regarding Critically Ill Inmates PDF
A-11.1 10/2023 Procedure to be Followed in Cases of Inmate Death PDF
  10/2021      Attachment A: Initial Notification to Health Services of Inmate Death PDF
  10/2023      Attachment B: Deaths in Custody – Death Report for Bureau of Justice Statistics PDF
  10/2021      Attachment C: Inmate Death Summary PDF
A-11.2 10/2022 Pronouncement of Death by Licensed Nurses PDF
A-12.1 10/2022 Grievance Mechanism PDF
  10/2021      Attachment A: Getting Medical Treatment – English PDF
  10/2021      Attachment B: Getting Medical Treatment – Spanish PDF
  10/2021      Attachment C: Informal Resolution Process PDF
A-12.2 10/2023 Patient Liaison Program PDF
A-13.1 10/2022 Provider Peer Review PDF


Infection Control Policy

C-18.1 03/17/2016 Licensure and Credential Verification PDF
C-19.1 03/17/2016 Continuing Education/Staff Development PDF
C-19.2 04/2022 Correctional Managed Health Care Reference Materials PDF
  04/2022      Attachment A: Sample Correctional Managed Health Care Bookshelf PDF
C-20.1 04/2022 Training for Correctional Officers PDF
C-22.1 08/17/2021 Inmate Workers PDF
C-23.1 08/23/2016 Position Descriptions PDF
C-24.1 10/2022 Staffing Levels PDF
C-25.1 10/2022 Orientation Training for Health Services Staff PDF
D-27.1 03/17/2016 Pharmaceuticals PDF
D-27.2 01/2023 Heat Stress (formerly B-15.2) PDF
  01/2023      Attachment A: Drugs Associated With Heat Stress PDF
  01/2023      Attachment B: Comorbidities That May Affect Heat Tolerance PDF
D-27.3 04/13/2023 Photosensitivity PDF
D-28.1 08/23/2016 Clinic Space, Equipment, and Supplies PDF
D-28.2 04/2022 Sharp, Needle and Syringe Control PDF
D-28.3 04/2022 Facility Repairs and Renovations PDF
D-28.4 04/2022 First Aid Kits PDF
D-28.5 08/23/2016 Equipment, Supplies and Inventory PDF
D-29.1 10/1995 Access to Diagnostic Services PDF
D-30.1 10/2022 Hospital and Specialized Ambulatory Care PDF
D-30.2 10/2023 Scheduling Approved Consultations to Specialty Health Services PDF
E-31.1 03/17/2016 Information on Health Care Services PDF
E-31.2 04/2022 Organ or Tissue Donation PDF
  04/2022      Attachment A: Donor Information Sheet PDF
  04/2022      Attachment B: Retraction of Tissue and Organ Donor Status PDF
E-31.3 03/18/2018 Obtaining Community Hospital Inmate Information PDF
E-31.4 04/2022 Management of Inmates Who Have Received Solid Organ Transplants PDF
E-32.1 10/12/2023 Receiving, Transfer and Continuity of Care Screening PDF
  06/2015      Attachment A: SAFPF Detoxification Medications List PDF
E-34.1 07/13/2023 Health Appraisal of Incoming Inmates PDF
E-34.2 08/28/2019 Periodic Physical Examinations PDF
E-34.3 03/17/2016 Use of Force Procedures PDF
E-34.4 04/2022 Reporting Suspected Abuse PDF
E-34.5 04/2022 Chemical Agents and the Use of Force Contraindication List PDF
E-35.1 04/2022 Mental Health Appraisal for Incoming Inmates PDF
E-35.2 04/2022 Mental Health Evaluation PDF
E-36.1 10/12/2023 Dental Treatment Levels of Care PDF
E-36.2 04/03/2018 Inprocessing Inmates – Dental Examination, Classification, Education and Treatment PDF
E-36.3 04/2022 Recording and Scheduling Dental Patient Visits PDF
E-36.4 08/2023 Dental Prosthodontic Services PDF
  04/2022      Attachment A: Medically Necessary Dental Prosthetics Referral Form PDF
  04/2022      Attachment B: Completed Dental Prosthesis Requisition Form PDF
E-36.5 01/04/2012 Dental Utilization/Quality Review Committee PDF
E-36.6 01/04/2012 Periodontal Disease Program PDF
E-36.7 10/2022 Dental Clinic Operations Reporting PDF
E-36.8 08/23/2018 Dental Comprehensive Treatment Plan (DCTP) PDF
E-37.1 09/08/2022 Daily Processing of Health Complaints and Sick Call PDF
  04/2022      Attachment A: Sick Call Procedure For Inmates Unable To Write PDF
E-37.2 04/2022 Guidelines for Clipper Shave Pass PDF
E-37.3 04/2022 Medical Lay-Ins PDF
E-37.4 04/2022 Lockdown Procedures PDF
E-37.5 04/2022 Interpreter Services – Monolingual Spanish-Speaking Offenders PDF
E-37.6 01/04/2012 Cosmetic Surgery PDF
E-39.1 09/08/2022 Health Evaluation and Documentation Inmates in Segregation – Restrictive Housing PDF
E-39.2 10/2022 Alternative Meal Service PDF
E-40.1 08/28/2019 Direct Medical Orders PDF
E-41.1 08/23/2016 Emergency Services PDF
E-41.2 08/23/2016 Emergency Response During Hours of Operation PDF
  02/25/2019      Attachment A: Inventory List PDF
E-42.1 10/2023 Offender Transport and Transfer PDF
E-42.2 10/2022 Missed Clinic Appointment PDF
  10/2021      Attachment A: SLC Missed Appointment Audit/Survey PDF
E-42.3 10/2023 Transportation of Infirmary and Inpatient Mental Health Inmates PDF
  10/2021      Attachment A: Authorization to Leave the Inpatient or Sheltered Housing Setting PDF
E-42.4 03/18/2015 Medical Holds PDF
E-43.1 10/2022 Delegation to Advanced Practice Registered Nurses and Physician Assistants PDF
  10/2021      Attachment A: Prescriptive Authority Agreement PDF
  10/2021      Attachment B: Alternative Physician Supervision Log PDF
E-44.1 10/2023 Continuity of Care PDF
E-44.2 10/2023 Examination of Inmates by Private Practitioners PDF
  10/2021      Attachment A: Request and Consent for Examination by Private Practitioner PDF
F-46.1 03/17/2016 Health Education and Promotion PDF
F-47.1 09/08/2022 Therapeutic Diets and Food Allergies PDF
  04/2022      Attachment A: Counseling Sheet for Therapeutic Diet Refusal PDF
F-48.1 04/2022 Exercise Program PDF
F-49.1 09/22/2014 Personal Hygiene PDF
F-50.1 10/12/2023 Tobacco Free Environment PDF
G-51.1 03/07/2017 Inmates with Special Needs PDF
G-51.3 01/2023 Admission Health Appraisals for Inmates with Physical Disabilities PDF
  01/2022      Attachment A: Speech Pathology Referral Criteria for TDCJ and Speech Pathology Referral Process PDF
  01/2022      Attachment B: Level of Care Assessment PDF
G-51.4 03/17/2016 Wheelchair Repair and Maintenance PDF
G-51.5 03/08/2018 Certified American Sign Language (ASL) Interpreter Services PDF
G-51.6 04/2022 Referral of an Inmate for Admission Into a Behavioral Health Facility PDF
G-51.7 04/2022 Behavioral Health Treatment for Substance Abuse Felony Punishment Facility Offenders PDF
G-51.8 04/2022 Care of Inmates With Terminal Conditions PDF
  04/2022      Attachment A: Consent to Hospice Care PDF
  04/2022      Attachment B: Hospice Guidelines PDF
G-51.9 04/2022 Wheelchair Use PDF
  04/2022      Attachment A: Special Wheelchair Committee - Treatment Plan of Inmate Refusing to Walk PDF
  04/2022      Attachment B: Special Wheelchair Committee Treatment Plan Form PDF
G-51.10 04/2022 Chronic Care Program PDF
G-51.11 10/2023 Treatment of Inmates With Intersex Conditions, Gender Identity Disorder or Gender Dysphoria, Formerly Known as Gender Identity Disorder PDF
  08/05/2014 G-51.11 Revision Explanation PDF
  01/10/2017      Attachment A: Consent Form for Therapy with Male Hormones PDF
  01/10/2017      Attachment B: Consent Form for Therapy with Female Hormones PDF
G-51.12 04/11/2019 Inmates with Special Needs who are Releasing from TDCJ PDF
G-51.13 09/08/2022 Admission to a Sheltered Housing PDF
G-52.1 08/23/2016 Infirmary Care PDF
G-52.2 07/13/2023 Chronic Mentally Ill - Sheltered Housing (CMI-SH) PDF
G-52.3 09/08/2022 Admission to the TDCJ Mental Health Therapeutic Diversion Program (MHTDP) PDF
G-52.4 04/2023 Seriously Mentally Ill – Sheltered Housing (SMI-SH) PDF
  04/2022      Attachment A - Seriously Mentally Ill – (SMI-SH) Referral Form PDF
G-53.1 07/13/2023 Suicide Prevention Plan PDF
  08/23/2018      Attachment A - Health Services Policy Facility Addendum PDF
G-53.3 10/12/2023 Management of Inmates Hunger Strikes PDF
G-54.1 01/04/2012 Detoxification PDF
G-55.1 10/12/2023 Pregnant Inmates PDF
G-56.1 10/2022 Inmates with Substance Abuse Disorders PDF
G-57.1 07/13/2023 Sexual Assault/Sexual Abuse PDF
G-59.2 04/2023 Optical Prostheses and Appliances PDF
  10/2021      Attachment A: CMHC Dispensing of Prescription Eyewear PDF
G-59.3 10/2022 Medical Prostheses and Orthotic Devices PDF
  10/2021      Attachment A: Medical Conditions Not Suitable for B&L Referral PDF
G-60.1 10/2023 Tattoo Removal Program PDF
H-60.1 02/25/2019 Health Records – Organization, Maintenance and Governance PDF
  01/2022      Attachment A: Outpatient Health Record Format PDF
  01/2022      Attachment B: List of EHR Chart Sections PDF
  01/2022      Attachment C: Approved Abbreviations PDF
  01/2022      Attachment D: CMHC EHR Standard Operating Procedure – Change Sign User for Email PDF
  01/2022      Attachment E: CMC Document Clarification PDF
  01/2022      Attachment F: CMHC EHR Standard Operating Procedure – Creating an Addendum Note PDF
  01/2022      Attachment G: Incomplete Chart Review PDF
H-60.2 09/08/2022 Inpatient Health Records PDF
  04/2022      Attachment A: History and Physical Examination PDF
  04/2022      Attachment B: Discharge Summary PDF
  04/2022      Attachment C: Approval To File an Incomplete Medical Record PDF
H-60.3 08/23/2016 Health Services Forms Control and Design PDF
H-60.4 04/07/2017 Utilization of Electronic Health Record PDF
H-61.1 08/17/2021 Confidentiality and Release of Protected Health Information PDF
  07/2012      Attachment A: Affidavit of Personal Representative PDF
  01/2021      Attachment B: Authorization for the Use and Disclosure of Protected Health Information (PHI) - English PDF
  01/2021      Attachment C: Authorization for the Use and Disclosure of Protected Health Information (PHI) - Spanish PDF
  11/19/2008      Attachment D: Calculation of Costs for Patient Health Information (2/2005) Facilities PDF
  07/2012      Attachment E: Calculation of Costs for Patient Health Information (2/2005) Health Services Archives PDF
H-64.1 10/2022 Transfer of Health Records PDF
  10/2021      Attachment A: Breach of Confidentiality Incident Log PDF
  10/2021      Attachment B: Breach of Confidentiality Form PDF
H-65.1 11/22/2021 Retention/Destruction of Health Records PDF
I-66.1 11/04/2017 Medical Therapeutic Restraints PDF
  08/23/2016      Attachment A: Medical Therapeutic Restraint Flow Sheet PDF
I-66.2 10/2022 Therapeutic Restraint of Mental Health Patients PDF
I-66.3 10/2022 Therapeutic Seclusion of Mental Health Patients PDF
I-67.1 10/2022 Compelled Psychoactive Medication for Mental Illness PDF
  10/2021      Attachment A: Correctional Managed Health Care - Mental Health Services Certificate of Emergency Compelled Psychoactive Medication In A Mentally Ill Person PDF
  10/2021      Attachment B: Certificate of Non-Emergency Compelled Psychoactive Medication in a Mentally Ill Person PDF
I-68.1 03/17/2016 Blood and Urine Testing for Forensic Purposes PDF
I-68.2 03/07/2017 DNA Specimen Collection PDF
I-68.3 03/07/2016 Forensic Information PDF
I-68.4 04/2022 Medical Consultation for the Inmate Drug Testing Program PDF
  04/2022      Attachment A: Inmate Controlled Substance Testing Information Form PDF
  04/2022      Attachment B: Prescription Drugs Giving Positive Results for the T-cup Test PDF
I-69.1 04/2022 Participation in Executions PDF
I-70.1 07/13/2023 Informed Consent PDF
  09/24/2015      Attachment A: Request/Consent for Treatment or Services PDF
I-70.2 10/2022 Consent for Admission to a Behavioral Health Facility PDF
  10/2021      Attachment A: Voluntary Consent for Admission to a Behavioral Health Facility PDF
  10/2021      Attachment B: Psychiatric Involuntary Admission Review PDF
  10/2021      Attachment C: Involuntary Admission to a Behavioral Health Facility PDF
I-71.1 01/04/2012 Offender’s Right to Refuse Treatment, Department’s Right to Compel Treatment PDF
  08/07/2013      Attachment A: Request for Compelled Medical Treatment PDF
  08/07/2013      Attachment B: Refusal of Treatment or Services PDF
  08/16/2017      Attachment C: Instructions For Completing The Refusal Of Treatment Form PDF
I-71.2 10/2022 Patient Self-Determination Act, Natural Death Act, Advance Directives Act PDF
  10/2021      Attachment A: Directive To Physicians PDF
  10/2021      Attachment B: Standard Out-Of-Hospital Do-Not-Resuscitate Order PDF
  10/2021      Attachment C: Patient Information About Advance Directives PDF
I-72.1 01/08/2016 Biomedical Research PDF