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GUARDING PSYCH INMATES D-239. FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES EFFECTIVE DATE: 02-01-02 REVISED: 03-01-04, 07-01-12 AUTHORITY: Sheriff M. Mims APPROVED BY: Assistant Sheriff T. Gattie REFERENCE: Welfare & Institutions Code Sections 5325 and 5325.1;and California Code of Regulations, Title IX, Section 865.2. PURPOSE: The purpose of this policy is to establish and maintain a consistent and legal method of guarding inmates who are transported and/or admitted to an off-site mental health facility. POLICY: It is the policy of the Fresno County Sheriffs Office Jail Division that all inmates transported to an off-site mental health facility shall have a Correctional Officer, Deputy or Reserve Deputy assigned to guard them. It is the policy of the Fresno County Sheriffs Office Jail Division to ensure that all officers assigned to guard inmates at off-site facilities have received training and orientation as required by the hospital, prior to their assignment to guard duty. It is the policy of the Fresno County Sheriffs Office Jail Division that the number of officers guarding the inmate and any other appropriate security measures put into place shall be determined by the Watch Commander. PROCEDURES: I. OFFICER/GUARD RESPONSIBILITIES IN PSYCHIATRIC FACILITIES A. The primary responsibility of the officer on guard duty is to prevent the escape of the inmate under their custody. All persons under guard are to be considered high escape risks. Therefore, officers shall not walk away from the immediate presence of the custody patient, engage in any unnecessary visiting with friends, staff or patients, or participate in any activity that detracts their attention from the inmate. Page 1 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES B. Officers are not expected to intervene when an inmate is "acting out" or become involved in behavior intervention, unless necessary to prevent serious bodily injury. C. The routine shackling and handcuffing of patients is not permitted in the psychiatric units. Handcuffs shall be carried, but are not to be dangled from the belt. The handcuffs are to be concealed from sight and only used in the case of an emergency, or when transporting the inmate to and from the psychiatric facility. D. Officers shall be in close attendance with the inmate at all times. 1. Depending on the circumstances, the officer will most likely be allowed to attend consults and therapy sessions with the inmate. If a doctor wants privacy, the officer may be asked to step outside of the room, but should be able to maintain visual contact (e.g., the door can remain open if there are no windows). The officer should remain directly outside the room for as long as necessary. If this creates a problem with the mental health staff, notify the Central Control Sergeant so they can decide what should be done. 2. Direct visual contact shall be maintained as much as possible. If the inmate is inside their room, the door shall remain open (unless in seclusion or restraints). A visual documented check shall be conducted at least once every fifteen (15) minutes whenever the inmate is not in the direct line of supervision. E. Remain alert to the activities of other persons in the room, as well as the person being guarded. F. Officers are not to fraternize with patients in the unit. Remember, the patients are there for a reason. Do not laugh at them, believe, or support any of their stories. G. Officers may, at their discretion, engage in activities (e.g., checkers, cards, ping pong, etc.)with the inmate being guarded. Reading shall be limited to work-related materials. H. Officers should not expect to be relieved for a rest or meal break while assigned to guard duty. If absolutely necessary, Security services can briefly relieve officers while they use the restroom. Page 2 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES 1. Community Medical Center Security offers assistance throughout the hospitals, including the Law Enforcement Room in the Behavior Control Unit (LER/BCU) in Community Regional Medical Center (CRMC). Their dispatch number is XXX-XXX. 2. Internal Services (County)Security offers assistance in the parking lots and outer buildings, including the Crestwood Fresno Psychiatric Health Facility (formerly PHF). Their after-hours radio paging number is XXX-XXX. II. ASSIGNMENT TO A PSYCHIATRIC UNIT A. Uniforms are not to be worn when working in the psychiatric housing units. Officers shall wear neat, clean, conservative civilian clothes and display their Sheriff's Office identification card. No T-shirts with logos, sweatpants or sweatshirts, shorts, or any clothing that would attract attention. Female officers shall not wear high heels or dresses. B. 1. 2. C. Officers may carry their issued OC-spray, Monadnock expandable baton, and/or Taser. These items must be concealed from view at all times and may only be used in circumstances serious in nature, calling for extreme measures necessary to protect against serious bodily injury. D. Officers shall not engage in any activity that may distract them from the performance of their duties. No personal electronic devices, radios, portable TVs, electronic games, or card games are allowed while on d uty. E. The patient phones are for the patients' use only, as required by law. The phones in the Nurses' Station are business phones and are not to be used for personal phone calls. Officers may make and receive brief Page 3 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES phone calls to and from the Sergeants. F. County-issued laptop computers and cell phones may be utilized to conduct Sheriff's Office business, but only in the dining (i.e., "common") area, or in the dayroom (i.e., "secured")area during sleeping hours(i.e., 2200 — 0500 hours). 1. Phone calls shall be kept to a minimum and computers may only be used to complete reports. 2. At no time should the use of these items detract the officer's attention from the inmate. G. Personal belongings (e.g., backpacks, purses, clothing, etc.)should be stored in a secure location. There are very few secure storage areas within the facilities. If possible, store personal belongings with the weapons, or ask the charge nurse to assist in locating a secure storage area in which to place personal belongings. Backpacks holding work- related items may be taken into the dining/common area, but may not be taken into the dayroom/secure area except during sleeping hours (i.e., 2200 — 0500 hours). H. Officers will not be relieved to leave for lunch and should either bring a sack lunch with them, or wait for the Transportation Officer to deliver a meal. 1. When two or more officers are on duty, they may not leave the area for lunch at the same time. 2. Food and beverages shall only be consumed in the dining/common area (or in the dayroom/secure area between 2200—0500 hours). III. DAILY OCCURRENCE LOG A. The Central Control Sergeant will create a Hospital Log Book specific for each inmate, which will accompany the inmate to the mental health facility. Inmate Daily Occurrence Log sheets shall be used to record the dates and times of the following activities: 1. The full names of visitors and the time and duration of visits. 2. If the inmate is to be denied one of their Patient Rights (refer to Section IV). Page 4 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES 3. Any unusual occurrences. 4. Any other information that needs to be conveyed to relief officers. B. If additional Inmate Daily Occurrence Log sheets are needed, contact the Central Control Sergeant or Transportation. C. When the inmate is released or returned to custody, the Log Book shall be returned to the Jail along with the inmate's medical paperwork. 1. The Inmate Daily Occurrence Log sheets shall be taken to Jail Records to be scanned into the inmate's records. 2. Return the Hospital Log Book to the Central Control Sergeant. IV. PATIENT RIGHTS Inmates admitted for psychiatric treatment or evaluation are afforded additional rights that cannot be taken away without "good cause". All psychiatric patients have the right to: A. Wear their own clothing. Although they will most likely be transported wearing a jumpsuit, they will be issued alternative clothing at the facility. Personal clothing may be brought in by visitors, but is limited to two outfits (the acceptance of large amounts of clothing and luggage is to be discouraged due to limited storage space). B. To have reasonable access to telephones, both to make and receive confidential calls or to have such calls made for them. C. To be free from harm, including unnecessary or excessive physical restraint, isolation, medication, abuse, or neglect. D. To see visitors each day. Visiting will be in accordance with the psychiatric facility's visiting policies. Snacks may be brought in by visitors, but must be consumed during visiting hours. Any extra items not eaten must be returned to the visitors. To maintain compliance with infection control policies, no extra food, candy or drinks are to be stored in the living areas. The officer shall thoroughly search all items for contraband prior to giving them to the inmate. Visitors may NOT bring cigarettes, matches, lighters, glass objects, razor blades medications or Page 5 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES other objects deemed potentially dangerous. 1. The guarding officer shall be responsible to obtain the visitor's name and verify the visitor's identification. The officer shall announce the arrival of the visitor and confirm that the inmate wishes to accept the visit. The names of the visitors shall be noted on the inmate's log, along with the time and duration of the visit. 2. During visits, the assigned officer shall place themselves inside of the room in a position to constantly observe the visitor(s) and the inmate. Officers will remain alert to the activities of other persons in the room, as well as the person being guarded. 3. If an officer feels that a visit should be denied for violation of a visiting rule, they must notify the charge nurse. Any time a visitor is asked to leave, it is considered to be a denial of the visitation right and the charge nurse must ensure that specific procedures are complied with, as specified under Title IX, Section 865.2. Violation of the following rules may be grounds for terminating a visit: a. If the visitor displays behaviors that might be the result of drug or alcohol consumption. b. If the visitor becomes disruptive or is agitating the inmate. c. To ensure protection of confidentiality, cameras and recording equipment are not allowed. d. Physical contact between the inmate and visitor(s) shall be limited to a brief hug upon greeting and/or leaving. V. GOOD CAUSE FOR DENIAL OF RIGHTS A. The rights listed in Section IV may be denied only for "good cause". Good cause for denying a patient the exercise of a right exists when the professional person in charge of the facility has good reason to believe- 1. That the exercise of the specific right would be injurious to the patient; or 2. That there is evidence that the specific right, if exercised, would seriously infringe on the rights of others; or 3. That the institution or facility would suffer serious damage if the Page 6 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES specific right is not denied; or 4. That there is no less restrictive way of protecting the interests specified in 1, 2, or 3 (above). B. The reason used to justify the denial of the right must be related to the specific right denied, and the cause has to have occurred in the hospital facility. The right shall not be withheld or denied as a punitive measure, nor shall a right be considered a privilege to be earned. If a staff member believes that "good cause" exists to deprive the inmate of one of their rights (e.g., telephone access), that information shall be passed on to the Watch Commander, who will contact the Facility Case Manager and discuss the situation. The Case Manager will then advise if the right may be denied as outlined in Title IX. C. The charge nurse shall be responsible to obtain an order from a psychiatrist. The order is only effective for twenty-four (24) hours. The denial of the right will be re-evaluated on a daily basis. A new order must be written if the denial is to be continued for longer than twenty- four hours. The order shall be recorded in the inmate's medical record. It is the nursing staff's responsibility to notify the Patients' Rights Advocate and complete the Denial of Rights form. D. Once the good cause for denial is no longer present, the right must be restored. VI. SERGEANT NOTIFICATION The hospital facilities fall under the realm of responsibility of the Central Control Sergeant. The Sergeant shall be notified when any of the following events occur: A. Anytime the inmate is removed or transferred from their assigned location. B. When the inmate is ready to be released back to the jail (after the doctor has signed their release and their medication is ready). C. If there are any unusual incidents or problems that occur, to include, but not limited to the following: 1. Anytime force is used to help restrain an inmate or another patient. Page 7 of 8 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: GUARDING INMATES AT OFF-SITE MENTAL HEALTH FACILITIES NO: D-239 FILE: GUARDING PSYCH INMATES 2. If any problem occurs which might constitute good cause to revoke one of the inmate's rights (e.g., if the inmate is making threatening calls, or there is reason to believe the inmate is planning an escape attempt, etc.). 3. If there are any problems or unusual occurrences with visitors. 4. If any problems occur with the mental health staff. 5. If the inmate attempts or affects an escape. VI I. ESCAPE ATTEMPTS When guarding inmates, the primary responsibility of the officer is to prevent the escape of the inmate under their custody. Officers must remain alert and take preventative steps to avert any escape attempts. Should an inmate attempt an escape, the response of the officer will vary greatly, dependent upon the circumstances. A. If possible, capture and restrain the inmate. This course of action may not always be prudent or advisable (e.g., if guarding more than one inmate; if a vehicle pursuit is necessary; if a "break-out" involving weapons and outside help is involved, etc.). Use officer discretion and prudence as required. B. Depending on the circumstances, immediately advise both the Central Control Sergeant and Community Medical Center Security and/or Internal Services (County) Security, depending on the facility in which the inmate is being treated. Again, officer discretion is required (e.g., if the immediate recapture of the inmate can be facilitated and would be impeded by the time necessary to contact others, notification to the Sergeant will come secondary, but as soon as feasibly possible). C. Under no circumstances is an officer to assume the role of a patrol officer or detective (e.g., do not try to entrap the inmate at their home, conduct an investigation, etc.). The Watch Commander will be responsible to notify the Patrol Watch Commander to deploy resources and conduct an investigation, as appropriate. D. Refer also to Policies and Procedures Section B-120 — Escape/ Intrusion (FILE: ESCAPE). Page 8 of 8