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HUNGER STRIKES B-135 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HUNGER STRIKES NO: B-135 FILE: HUNGER STRIKES EFFECTIVE DATE: 08-01-11 REVISED: AUTHORITY: Sheriff M. Mims APPROVED BY: Assistant Sheriff T. Gattie REFERENCE: 28 Code of Federal Regulations 549.60; Fresno County Department of Public Health Policy and Procedure No. CAR 22.29; and Fresno County Sheriff's Office Policy and Procedure Manual Section 102. PURPOSE: The purpose of this policy is to provide for the management of an inmate on a self-imposed hunger strike in a manner that maintains the safety and security of the inmate and facility. POLICY: It is the policy of the Fresno County Sheriff's Office to monitor the health and welfare of individual inmates, and to ensure that procedures are pursued to preserve life. It is the policy of the Fresno County Sheriff's Office that mass hunger strikes will be managed both as an overall security management concern and a health status concern. PROCEDURES: I. DEFINITION HUNGER STRIKE: an inmate is considered to be on a hunger strike when he or she communicates that fact to staff and is observed by staff to be refraining from eating for a period of time, ordinarily in excess of 72 hours; or when staff observes the inmate to be refraining from eating for a period in excess of 72 hours. A hunger strike is the deliberate refusal of food or fluid and in a number of cases is used for the purpose of obtaining a desired outcome. An inmate who chooses not to eat a meal for any other reason (feeling unwell, religious fast, medically-imposed fast, or a dislike forwhat is being offered) is not classed as being on a hunger strike. Page 1 of 3 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HUNGER STRIKES NO: B-135 FILE: HUNGER STRIKES II. INITIAL REFERRAL A. When an inmate has made a clear statement not to eat or has been observed not to have eaten food for 72 hours, the discovering officer shall: 1. Interview the inmate and attempt to determine the reason for the hunger strike. 2. Notify the Facility Sergeant. 3. Notify Medical (i.e., the on-duty charge nurse) and Mental Health staff for evaluation. 4. Notify Population Management for reassessment of the inmate's housing location. Depending on the circumstances, the inmate may be removed from the general population or reassigned to medical housing. 5. Log an entry in OffenderTrak under BOOKING/FOOD REFUSAL. Indicate any information available, as well as the names of all persons notified in the COMMENTS section. 6. Print the log entry and post in a conspicuous location in the security station. Ensure that relieving staff members are made aware of the situation. 7. Prepare a written incident report, if so directed. B. When staff considers it prudent to do so, a referral for medical evaluation may be made without waiting 72 hours. III. VERIFICATION OF INTENT A. The Facility Sergeant shall attempt to verify information about the inmate's everyday behavior indicating that the inmate's eating behavior is consistent with a declared hunger strike. Such verification shall include a review of commissary purchases. At times, an inmate may not actually engage in a hunger strike, but merely make a bid to gain attention. B. The inmate shall be assessed by medical staff within twenty-four (24) hours following notification. Page 2 of 3 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HUNGER STRIKES NO: B-135 FILE: HUNGER STRIKES C. JPS shall evaluate the inmate to determine if the inmate suffers from a mental disorder that renders him/her incapable of making a rational, reasonable decision concerning the hunger strike. III. MONITORING A. The health and welfare of any inmate on a hunger strike shall be monitored. The frequency of checks shall be determined by a Watch Commander, in consultation with a physician (e.g., routine,twice every 30 minutes, continuous). B. Correctional staff shall ensure that food and drink are offered to the inmate at each meal, or as otherwise authorized by the physician. 1. All offerings and refusals shall be documented in the OffenderTrak log. 2. Acceptance of liquids alone should not be documented as accepting a meal. C. If the inmate is housed in segregation, officers shall monitor and document the inmate's intake of food and drink. A verbal offer of a meal will not suffice. Food from the food tray may be left in the inmate's cell. Ordinarily, when the food tray is left in the inmate's cell, perishable food items will not be left for more than two (2) hours. D. Medical staff may recommend that the inmate be transferred to medical housing for closer observation, or order the inmate admitted to a hospital for treatment. E. Under no circumstances will other inmates be used to monitor hunger strike inmates. IV. RELEASE FROM TREATMENT Medical staff shall be notified if reliable evidence indicates that the inmate has ended the hunger strike. Only a physician may order that an inmate be released from hunger strike evaluation and treatment. Page 3 of 3