Correctional Managed Health Care
Policy Manual
| Policy # | Effective Date | Title | Format |
|---|---|---|---|
| 09/08/2022 | Table of Contents | ||
| Disclaimer | |||
| Transmittal Memos and Signature Pages | HTML | ||
| Policy Review Schedules: | |||
| Policy Review for January | |||
| Policy Review for April | |||
| Policy Review for July | |||
| Policy Review for October | |||
| SECTION A: GOVERNANCE AND ADMINISTRATION | |||
| A-01.1 | 03/07/2017 | Access to Care | |
| A-02.1 | 03/17/2016 | Responsible Health Authority | |
| A-02.2 | 03/17/2016 | Treatment of Injuries Incurred in the Line of Duty | |
| A-03.1 | 03/17/2016 | Medical Autonomy | |
| A-04.1 | 3/17/2016 | Administrative Meetings | |
| A-04.2 | 02/15/2019 | Health Services Statistical Report | |
| A-05.1 | 04/2022 | Correctional Managed Health Care Policies | |
| A-06.1 | 04/2022 | Quality Improvement/Quality Management Program | |
| A-06.2 | 04/2022 | Professional and Vocational Nurse Peer Review Process | |
| A-07.1 | 04/2022 | Emergency Plans and Drills | |
| 04/2022 | Attachment A: Disaster Drill Evaluation Form | ||
| A-08.1 | 04/2022 | Decision Making for Serious Mentally Ill Patients | |
| 04/2022 | Attachment A: Mental Health Disciplinary Review Form | ||
| A-08.2 | 04/2022 | Transfers of Offenders with Acute Conditions | |
| 04/2022 | Attachment A: Approved Medical Transportation Criteria | ||
| A-08.3 | 09/08/2022 | Referral of Offenders to the Development Disabilities Program (DDP) | |
| A-08.4 | 09/08/2022 | Offender Medical and Mental Health Classification | |
| 11/05/2019 | Attachment A: Guidelines for Completing the Health Summary for Classification Form | ||
| A-08.5 | 08/23/2016 | Coordination with Windham School System | |
| A-08.6 | 08/23/2018 | Medically Recommended Intensive Supervision Screening | |
| 05/02/2013 | Attachment A: MRIS Screening Form | ||
| 03/07/2017 | Attachment B: MRIS Medical Summary | ||
| A-08.7 | 07/2022 | PULHES System of Offender Medical and Mental Health Classification | |
| 07/2022 | Attachment A: PULHES Background and Information | ||
| 07/2022 | Attachment B: Guidelines For Coding PUHLES | ||
| A-08.8 | 08/17/2021 | Medical Pass | |
| A-08.9 | 02/24/2022 | The Chronic Mentally Ill Treatment Program (CMI-TP) | |
| A-08.10 | 02/25/2019 | The Program for Aggressive Mentally Ill Offender (PAMIO) | |
| A-09.1 | 10/2022 | Privacy of Care | |
| A-10.1 | 10/2022 | Notification Requirements Regarding Critically Ill Offenders | |
| A-11.1 | 10/2022 | Procedure to be Followed in Cases of Offender Death | |
| 10/2021 | Attachment A: Initial Notification to Health Services of Offender Death | ||
| 10/2021 | Attachment B: Deaths in Custody – Death Report for Bureau of Justice Statistics | ||
| 10/2021 | Attachment C: Offender Death Summary | ||
| A-11.2 | 10/2022 | Pronouncement of Death by Licensed Nurses | |
| A-12.1 | 10/2022 | Grievance Mechanism | |
| 10/2021 | Attachment A: Getting Medical Treatment – English | ||
| 10/2021 | Attachment B: Getting Medical Treatment – Spanish | ||
| 10/2021 | Attachment C: Informal Resolution Process | ||
| A-12.2 | 10/2022 | Patient Liaison Program | |
| A-13.1 | 10/2022 | Provider Peer Review | |
| SECTION B: MANAGING A SAFE AND HEALTHY ENVIRONMENT | |||
PLEASE REFER TO THE INFECTION CONTROL POLICY MANUAL |
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| SECTION C: PERSONNEL AND TRAINING | |||
| C-18.1 | 03/17/2016 | Licensure and Credential Verification | |
| C-19.1 | 03/17/2016 | Continuing Education/Staff Development | |
| C-19.2 | 04/2022 | Correctional Managed Health Care Reference Materials | |
| 04/2022 | Attachment A: Sample Correctional Managed Health Care Bookshelf | ||
| C-20.1 | 04/2022 | Training for Correctional Officers | |
| C-22.1 | 08/17/2021 | Offender Workers | |
| C-23.1 | 08/23/2016 | Position Descriptions | |
| C-24.1 | 10/2022 | Staffing Levels | |
| C-25.1 | 10/2022 | Orientation Training for Health Services Staff | |
| SECTION D: HEALTH CARE SERVICES SUPPORT | |||
| D-27.1 | 03/17/2016 | Pharmaceuticals | |
| D-27.2 | 01/2022 | Heat Stress (formerly B-15.2) | |
| 01/2022 | Attachment A: Drugs Associated With Heat Stress | ||
| 01/2022 | Attachment B: Comorbidities That May Affect Heat Tolerance | ||
| D-27.3 | 01/2022 | Photosensitivity | |
| D-28.1 | 08/23/2016 | Clinic Space, Equipment, and Supplies | |
| D-28.2 | 04/2022 | Sharp, Needle and Syringe Control | |
| D-28.3 | 04/2022 | Facility Repairs and Renovations | |
| D-28.4 | 04/2022 | First Aid Kits | |
| D-28.5 | 08/23/2016 | Equipment, Supplies and Inventory | |
| D-29.1 | 10/1995 | Access to Diagnostic Services | |
| D-30.1 | 10/2022 | Hospital and Specialized Ambulatory Care | |
| D-30.2 | 10/2022 | Scheduling Approved Consultations to Specialty Health Services | |
| SECTION E: INMATE CARE AND TREATMENT | |||
| E-31.1 | 03/17/2016 | Information on Health Care Services | |
| E-31.2 | 04/2022 | Organ or Tissue Donation | |
| 04/2022 | Attachment A: Donor Information Sheet | ||
| 04/2022 | Attachment B: Retraction of Tissue and Organ Donor Status | ||
| E-31.3 | 03/18/2018 | Obtaining Community Hospital Offender Information | |
| E-31.4 | 04/2022 | Management of Offenders Who Have Received Solid Organ Transplants | |
| E-32.1 | 06/28/2022 | Receiving, Transfer and Continuity of Care Screening | |
| 06/28/2022 | Attachment A: CMC Intake History & Health Screening Form | ||
| 06/2015 | Attachment B: SAFPF Detoxification Medications List | ||
| E-34.1 | 05/28/2019 | Health Appraisal of Incoming Inmates | |
| E-34.2 | 08/28/2019 | Periodic Physical Examinations | |
| E-34.3 | 03/17/2016 | Use of Force Procedures | |
| E-34.4 | 04/2022 | Reporting Suspected Abuse | |
| E-34.5 | 04/2022 | Chemical Agents and the Use of Force Contraindication List | |
| E-35.1 | 04/2022 | Mental Health Appraisal for Incoming Offenders | |
| E-35.2 | 04/2022 | Mental Health Evaluation | |
| E-36.1 | 08/17/2021 | Dental Treatment Levels of Care and Appendix I, II, and Dental Sealants | |
| E-36.2 | 04/03/2018 | Inprocessing Offenders – Dental Examination, Classification, Education and Treatment | |
| E-36.3 | 04/2022 | Recording and Scheduling Dental Patient Visits | |
| E-36.4 | 08/2023 | Dental Prosthodontic Services | |
| 04/2022 | Attachment A: Medically Necessary Dental Prosthetics Referral Form | ||
| 04/2022 | Attachment B: Completed Dental Prosthesis Requisition Form | ||
| E-36.5 | 01/04/2012 | Dental Utilization/Quality Review Committee | |
| E-36.6 | 01/04/2012 | Periodontal Disease Program | |
| E-36.7 | 10/2022 | Dental Clinic Operations Reporting | |
| E-36.8 | 08/23/2018 | Dental Comprehensive Treatment Plan (DCTP) | |
| E-37.1 | 09/08/2022 | Daily Processing of Health Complaints and Sick Call | |
| 04/2022 | Attachment A: Sick Call Procedure For Offenders Unable To Write | ||
| E-37.2 | 04/2022 | Guidelines for Clipper Shave Pass | |
| E-37.3 | 04/2022 | Medical Lay-Ins | |
| E-37.4 | 04/2022 | Lockdown Procedures | |
| E-37.5 | 04/2022 | Interpreter Services – Monolingual Spanish-Speaking Offenders | |
| E-37.6 | 01/04/2012 | Cosmetic Surgery | |
| E-39.1 | 09/08/2022 | Health Evaluation and Documentation Offenders in Segregation – Restrictive Housing | |
| E-39.2 | 10/2022 | Alternative Meal Service | |
| E-40.1 | 08/28/2019 | Direct Medical Orders | |
| E-41.1 | 08/23/2016 | Emergency Services | |
| E-41.2 | 08/23/2016 | Emergency Response During Hours of Operation | |
| 02/25/2019 | Attachment A: Inventory List | ||
| E-42.1 | 08/23/2018 | Offender Transport and Transfer | |
| E-42.2 | 10/2022 | Missed Clinic Appointment | |
| 10/2021 | Attachment A: SLC Missed Appointment Audit/Survey | ||
| E-42.3 | 10/2022 | Transportation of Infirmary and Inpatient Mental Health Offenders | |
| 10/2021 | Attachment A: Authorization to Leave the Inpatient or Sheltered Housing Setting | ||
| E-42.4 | 03/18/2015 | Medical Holds | |
| E-43.1 | 10/2022 | Delegation to Advanced Practice Registered Nurses and Physician Assistants | |
| 10/2021 | Attachment A: Prescriptive Authority Agreement | ||
| 10/2021 | Attachment B: Alternative Physician Supervision Log | ||
| E-44.1 | 10/2022 | Continuity of Care | |
| E-44.2 | 10/2022 | Examination of Offenders by Private Practitioners | |
| 10/2021 | Attachment A: Request and Consent for Examination by Private Practitioner | ||
| SECTION F: HEALTH PROMOTION AND DISEASE PREVENTION | |||
| F-46.1 | 03/17/2016 | Health Education and Promotion | |
| F-47.1 | 09/08/2022 | Therapeutic Diets and Food Allergies | |
| 04/2022 | Attachment A: Counseling Sheet for Therapeutic Diet Refusal | ||
| F-48.1 | 04/2022 | Exercise Program | |
| F-49.1 | 09/22/2014 | Personal Hygiene | |
| F-50.1 | 10/2022 | Tobacco Free Environment | |
| SECTION G: SPECIAL NEEDS AND SERVICES | |||
| G-51.1 | 03/07/2017 | Offenders with Special Needs | |
| G-51.3 | 03/08/2018 | Admission Health Appraisals for Offenders with Physical Disabilities | |
| 01/2022 | Attachment A: Speech Pathology Referral Criteria for TDCJ and Speech Pathology Referral Process | ||
| 01/2022 | Attachment B: Level of Care Assessment | ||
| G-51.4 | 03/17/2016 | Wheelchair Repair and Maintenance | |
| G-51.5 | 03/08/2018 | Certified American Sign Language (ASL) Interpreter Services | |
| G-51.6 | 04/2022 | Referral of an Offender for Admission Into a Behavioral Health Facility | |
| G-51.7 | 04/2022 | Behavioral Health Treatment for Substance Abuse Felony Punishment Facility Offenders | |
| G-51.8 | 04/2022 | Care of Offenders With Terminal Conditions | |
| 04/2022 | Attachment A: Consent to Hospice Care | ||
| 04/2022 | Attachment B: Hospice Guidelines | ||
| G-51.9 | 04/2022 | Wheelchair Use | |
| 04/2022 | Attachment A: Special Wheelchair Committee - Treatment Plan of Offender Refusing to Walk | ||
| 04/2022 | Attachment B: Special Wheelchair Committee Treatment Plan Form | ||
| G-51.10 | 04/2022 | Chronic Care Program | |
| G-51.11 | 07/2022 | Treatment of Offenders With Intersex Conditions, Gender Identity Disorder or Gender Dysphoria, Formerly Known as Gender Identity Disorder | |
| 08/05/2014 | G-51.11 Revision Explanation | ||
| 01/10/2017 | Attachment A: Consent Form for Therapy with Male Hormones | ||
| 01/10/2017 | Attachment B: Consent Form for Therapy with Female Hormones | ||
| G-51.12 | 04/11/2019 | Offenders with Special Needs who are Releasing from TDCJ | |
| G-51.13 | 09/08/2022 | Admission to a Sheltered Housing | |
| G-52.1 | 08/23/2016 | Infirmary Care | |
| G-52.2 | 08/17/2021 | Chronic Mentally Ill - Sheltered Housing (CMI-SH) | |
| G-52.3 | 09/08/2022 | Admission to the TDCJ Mental Health Therapeutic Diversion Program (MHTDP) | |
| G-52.4 | 04/2022 | Seriously Mentally Ill – Sheltered Housing (SMI-SH) | |
| 04/2022 | Attachment A - Seriously Mentally Ill – (SMI-SH) Referral Form | ||
| G-53.1 | 09/08/2022 | Suicide Prevention Plan | |
| 08/23/2018 | Attachment A - Health Services Policy Facility Addendum | ||
| G-53.3 | 09/08/2022 | Management of Offenders Hunger Strikes | |
| G-54.1 | 01/04/2012 | Detoxification | |
| G-55.1 | 10/2022 | Pregnant Offenders | |
| G-56.1 | 10/2022 | Offenders with Substance Abuse Disorders | |
| G-57.1 | 10/2021 | Sexual Assault/Sexual Abuse | |
| 10/2021 | Attachment A: Penal Code, Chapter 22. – Assaultive Offenses | ||
| 10/2021 | Attachment B: Code of Criminal Procedure, Chapter 56. – Rights of Crime Victims, Subchapter A. – Crime Victims’ Rights | ||
| G-59.2 | 10/2022 | Optical Prostheses and Appliances | |
| 10/2021 | Attachment A: CMHC Dispensing of Prescription Eyewear | ||
| G-59.3 | 10/2022 | Medical Prostheses and Orthotic Devices | |
| 10/2021 | Attachment A: Medical Conditions Not Suitable for B&L Referral | ||
| SECTION H: HEALTH RECORDS | |||
| H-60.1 | 02/25/2019 | Health Records – Organization, Maintenance and Governance | |
| 01/2022 | Attachment A: Outpatient Health Record Format | ||
| 01/2022 | Attachment B: List of EHR Chart Sections | ||
| 01/2022 | Attachment C: Approved Abbreviations | ||
| 01/2022 | Attachment D: CMHC EHR Standard Operating Procedure – Change Sign User for Email | ||
| 01/2022 | Attachment E: CMC Document Clarification | ||
| 01/2022 | Attachment F: CMHC EHR Standard Operating Procedure – Creating an Addendum Note | ||
| 01/2022 | Attachment G: Incomplete Chart Review | ||
| H-60.2 | 09/08/2022 | Inpatient Health Records | |
| 04/2022 | Attachment A: History and Physical Examination | ||
| 04/2022 | Attachment B: Discharge Summary | ||
| 04/2022 | Attachment C: Approval To File an Incomplete Medical Record | ||
| H-60.3 | 08/23/2016 | Health Services Forms Control and Design | |
| H-60.4 | 04/07/2017 | Utilization of Electronic Health Record | |
| H-61.1 | 08/17/2021 | Confidentiality and Release of Protected Health Information | |
| 07/2012 | Attachment A: Affidavit of Personal Representative | ||
| 01/2021 | Attachment B: Authorization for the Use and Disclosure of Protected Health Information (PHI) - English | ||
| 01/2021 | Attachment C: Authorization for the Use and Disclosure of Protected Health Information (PHI) - Spanish | ||
| 11/19/2008 | Attachment D: Calculation of Costs for Patient Health Information (2/2005) Facilities | ||
| 07/2012 | Attachment E: Calculation of Costs for Patient Health Information (2/2005) Health Services Archives | ||
| H-64.1 | 10/2022 | Transfer of Health Records | |
| 10/2021 | Attachment A: Breach of Confidentiality Incident Log | ||
| 10/2021 | Attachment B: Breach of Confidentiality Form | ||
| H-65.1 | 11/22/2021 | Retention/Destruction of Health Records | |
| SECTION I: MEDICAL-LEGAL ISSUES | |||
| I-66.1 | 11/04/2017 | Medical Therapeutic Restraints | |
| 08/23/2016 | Attachment A: Medical Therapeutic Restraint Flow Sheet | ||
| I-66.2 | 10/2022 | Therapeutic Restraint of Mental Health Patients | |
| I-66.3 | 10/2022 | Therapeutic Seclusion of Mental Health Patients | |
| I-67.1 | 10/2022 | Compelled Psychoactive Medication for Mental Illness | |
| 10/2021 | Attachment A: Correctional Managed Health Care - Mental Health Services Certificate of Emergency Compelled Psychoactive Medication In A Mentally Ill Person | ||
| 10/2021 | Attachment B: Certificate of Non-Emergency Compelled Psychoactive Medication in a Mentally Ill Person | ||
| I-68.1 | 03/17/2016 | Blood and Urine Testing for Forensic Purposes | |
| I-68.2 | 03/07/2017 | DNA Specimen Collection | |
| I-68.3 | 03/07/2016 | Forensic Information | |
| I-68.4 | 04/2022 | Medical Consultation for the Offender Drug Testing Program | |
| 04/2022 | Attachment A: Offender Controlled Substance Testing Information Form | ||
| 04/2022 | Attachment B: Prescription Drugs Giving Positive Results for the T-cup Test | ||
| I-69.1 | 04/2022 | Participation in Executions | |
| I-70.1 | 08/28/2019 | Informed Consent | |
| 09/24/2015 | Attachment A: Request/Consent for Treatment or Services | ||
| I-70.2 | 10/2022 | Consent for Admission to a Behavioral Health Facility | |
| 10/2021 | Attachment A: Voluntary Consent for Admission to a Behavioral Health Facility | ||
| 10/2021 | Attachment B: Psychiatric Involuntary Admission Review | ||
| 10/2021 | Attachment C: Involuntary Admission to a Behavioral Health Facility | ||
| I-71.1 | 01/04/2012 | Offender’s Right to Refuse Treatment, Department’s Right to Compel Treatment | |
| 08/07/2013 | Attachment A: Request for Compelled Medical Treatment | ||
| 08/07/2013 | Attachment B: Refusal of Treatment or Services | ||
| 08/16/2017 | Attachment C: Instructions For Completing The Refusal Of Treatment Form | ||
| I-71.2 | 10/2022 | Patient Self-Determination Act, Natural Death Act, Advance Directives Act | |
| 10/2021 | Attachment A: Directive To Physicians | ||
| 10/2021 | Attachment B: Standard Out-Of-Hospital Do-Not-Resuscitate Order | ||
| 10/2021 | Attachment C: Patient Information About Advance Directives | ||
| I-72.1 | 01/08/2016 | Biomedical Research | |