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WEATHER RISKS B-190 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS EFFECTIVE DATE: 07-01-01 REVISED: 08-01-03, 08-11-16, 06-01-19 AUTHORITY: Sheriff J. Zanoni APPROVED BY: Assistant Sheriff T. Gattie REFERENCE: California Code of Regulations, Title 15, Section 1012. Occupational Safety and Health Administration Technical Manual, Section III, Chapter 4 (Heat Stress); Environmental Protection Agency Pamphlet Air Quality Index: A Guide to Air Quality and Your Health (EPA-456 2014); County of Fresno Heat Emergency Contingency Plan (2012); Fresno County Sheriff's Office Jail Division policy E-180/Inmate Exercise and Recreation; and Hall v. County of Fresno, E.D. Cal. No. 1:11-CV-02047-LJO-BAM (2015). PURPOSE: The purpose of this policy is to minimize health problems or risks for inmates caused by air pollutants and extremely high temperatures. POLICY: It is the policy of the Fresno County Sheriffs Office Jail Division to protect both staff and inmates from excessively high temperatures through awareness of the effects of heat, and to implement specific procedures to manage inmate exposure to extremely high temperatures and air pollutants. It is the policy of the Fresno County Sheriffs Office to ensure adequate identification of inmates who are at risk of developing heat-related illness due to their prescribed medications, in order that they be protected from excessive heat conditions. It is the policy of the Fresno County Sheriffs Office Jail Division to provide all inmates with informational material concerning air quality and heat-related disorders. It is the policy of the Fresno County Sheriffs Office Jail Division to inform inmates of the daily Air Quality Index (AQI) so that they can make informed decisions concerning their outdoor physical exertion based upon the level of contaminants in the air. Page 1 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS PROCEDURES: I. AIR QUALITY FORECAST A. The Air Quality Index (AQI) is the number used by government agencies to communicate to the public the daily air quality. The Environmental Protection Agency (EPA) uses the AQI for five major air pollutants regulated by the Clean Air Act: ground-level ozone, particulate matter, carbon monoxide, sulfur dioxide and nitrogen dioxide. For each of these pollutants, the EPA has established national air quality standards to protect against harmful health effects. The AQI rating can range from 0 to 500; the higher the AQI value, the greater the level of air pollution and the greater the health danger. (Refer to Addendum A.) B. The AQI shall be reviewed by the B-Platoon Watch Commanders, or their designee, each morning. The AQI can be obtained from the local news, newspaper, or San Joaquin Valley Air Pollution Control District's website (www.vaIlevair.orq/aginfo/forecast.htm). The AQI shall be posted on the A-Platoon's Daily Schedules and announced during the morning briefing. C. The Main Jail Yard, South Annex Yard, and North Annex Security Officers shall be responsible to post the appropriate colored placard so that the inmates can make informed decisions concerning their outdoor physical exertion based upon the reported level of contaminants in the air. (Refer to Addendum B.) D. At any time the AQI is expected to reach or exceed 201 (i.e., very unhealthy), the Sheriff Inmate Labor Crews (SILC) shall be assigned tasks indoors. E. At any time the AQI is expected to reach or exceed 301, all outdoor recreation and work assignments will be canceled due to the hazardous health conditions. (Refer to Section X for reporting requirements.) II. HEAT STRESS — CAUSAL FACTORS A. High air temperatures, radiant heat sources, high humidity, and strenuous physical activities have a high potential for inducing heat stress, thus causing the body's core temperature to rise and the heart rate to increase. Possibly even more important are personal characteristics such as age, weight, degree of physical fitness, degree of Page 2 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS acclimatization, metabolism, use of alcohol or drugs, previous heat stroke and a variety of medical conditions which can all affect a person's sensitivity to heat. B. Outdoor labor (such as performed by the SILC/Graffiti Abatement crews) and strenuous physical activity (e.g., running and playing basketball during outdoor recreation) performed in hot weather conditions have a high potential to cause heat stress among exposed persons. III. HEAT INDEX A. The Heat Index or the "Apparent Temperature" is an accurate measure of how hot it really feels when the Relative Humidity is added to the actual air temperature. The following chart indicates the likelihood of heat disorders with prolonged exposure or strenuous activity. Rehtfive ltuuunliifUoda ('N.,) 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 '5 80 85 90 95 100 122 ,G f 13:5 143 119 136 116 104 7 /�, -�=130 JA 1,4f6 113 102 l J37 14.5 110 99 102 '130, 137;143 ,1.52; 107 96 99 101 104 I � ��.134, M 104 94 96 99 101 1044 '132, 138, 144„ 101 92 94 97 98 lOq lq2 1'�Q, 155 98 89 91 93 94 95 98 100 103 � � 1341 157i 95 87 88 90 91 92 93 95 98 99 103 1 / 150 ;156i 92 85 85 87 88 88 89 90 92 94 97 99 102 13 ' 89 82 83 84 84 85 86 87 88 89 91 93 95 97 100 103 86 79 80 82 82 83 83 185 85 87 88 90 92 94 96 97 100 10-3 83 76 77 78 79 80 81 81 82 82 83 84 85 86 88 89 91 94 95 96 99 103 80 73 74 75 76 77 77 78 79 79 80 81 81 82 83 85 86 86 87 88 89 91 71 71 72 73 74 74 75 1 75 76 77 77 78 79 79 80 81 82 83 84 84 85 Possible heat disorders for people in higher risk groups Heat index 90 to 104(Hot)—sunstroke,heat cramps,or heat exhaustion POSSIBLE with prolonged exposure and/or physical activity. ® Heat index 105 to 129(Very Hot)-sunstroke,heat cramps,or heat exhaustion LIKELY,and heat stroke POSSIBLE with prolonged exposure and/or physical activity ® Heat index 130 or higher(Extremely Hot)—heat stroke or sunstroke LIKELY with continued exposure. Note: Heat Index values were devised for shady,light wind conditions. Exposure to full sunshine can increase the Heat Index values by up to 15°F. Strong winds,particularly with very hot,dry air,can be extremely hazardous. B. The daily temperature, humidity, and heat index forecast shall be reviewed by the B-Platoon Watch Commanders, or their designee, each morning. The information can be obtained from the local news, newspaper, or the National Weather Service website (www.wrh.noaa.gov/hnx - click on Fresno on the map). The temperature and heat index forecast shall be posted on the A-Platoon Daily Schedules and announced during briefing when the forecast meets or exceeds 900. Page 3 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS NOTE: The heat index can also be calculated by entering the temperature and relative humidity into the National Weather Service's Heat Index Calculator (www.wpc.ncep.noaa.gov/html/heatindex.shtml). IV. HEAT-RISK MEDICATIONS Heat alert medications can pose a serious health risk during times of extreme heat by impairing the body's ability to regulate temperature. The Jail Division takes special precautions to prevent heat-related illness in inmates taking medication which has the potential to impair thermoregulation. A. Inmates prescribed with heat-risk medications will be counseled regarding the adverse effects of the medication by the prescribing physician. B. As a means of governing the inmates who are prescribed with medicines specifically identified as heat-risk medications, a computer tracking event shall be created for each inmate. The prescribing clinician (or their designee) shall initiate an ALERT event (i.e., Heat Medication Warning) via OffenderTrak. The ALERT will not include the name of the prescribed heat alert medication to protect the inmate's privacy. C. The A-Platoon Facility Sergeants shall be responsible to print a list of all inmates with ALERTs for Heat Medication Warnings each morning. The log will list the names and locations of the inmates who are taking heat- risk medications. D. On days that the projected heat index forecast is expected to meet or exceed 900, the Sergeants shall provide a copy of the list to the Main Jail Yard, South Annex Jail Yard, and North Annex Security Officers. When the heat index reaches 900, the Facility Sergeant shall be notified, and the procedures in Section VII shall be implemented. V. MONITORING CELL TEMPERATURES A. Temperature control inside the housing units will vary between the seasons, but reasonable ranges should be maintained between 630 and 78°F. Page 4 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS B. Officers are expected to monitor their assignment areas for temperatures that exceed the acceptable range. If an officer believes the temperature to be excessively warm or cold, or an inmate complains, the temperature in the affected area shall be checked. 1. Officers are to use the infrared thermometers which are available in each security station. 2. To ensure consistency in the readings, two (2) temperature readings are to be taken for each area, as follows: a. Individual cell temperatures will be measured by directing the infrared beam at the cell floor. b. Dayroom temperatures in the Main and North Annex Jails will be measured on the concrete area between the upper and lower tiers. c. The temperature should also be taken by aiming the infrared beam "inside" the air vent in the targeted area. C. Findings that are outside of the reasonable range are to be reported to the Jail Services Unit. As with any needed repair, the request for service shall be documented and sent via email to "Jail Services." [Refer also to policy F-210/Maintenance Reporting and Repairs(FILE: MAINTENANCE)] 1. When documenting the temperatures, the location where each temperature was taken is to be noted (i.e., cell, floor or vent). 2. Any variance in the location of the temperature reading needs to be noted. D. If an exigent circumstance exists that causes the temperature in a housing unit to be excessively warm or cold, the Fire/Life Safety Officer (in cooperative efforts with Jail Services) shall be responsible to obtain the temperatures in the affected housing areas and complete a Temperature Log form. The log shall be completed each day until the temperature inside the housing area returns to the acceptable range (630 -780F). Examples of circumstances that require daily monitoring include: 1. HVAC system malfunction 2. Boiler malfunction 3. Extreme outdoor weather when the temperature meets/exceeds 1000 Page 5 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS VI. INDOOR TEMPERATURES EXCESSIVELY WARM A. If the temperature inside a housing unit meets or exceeds 90°F, correctional staff shall immediately notify the Facility Sergeant and the Jail Services Unit. Any problem with the cooling system shall be reported and handled as an emergency repair order. As with any needed repair, the request for service shall be documented and sent via email to "Jail Services." B. Correctional staff shall encourage the inmates to drink cool water, shower, and/or cool their skin with a wet towel. 1. Special attention shall be given to providing hydrating liquids and showers to inmates prescribed with heat-risk medications who are housed in administrative segregation units. Shower lengths shall be increased, when feasible. 2. All inmates housed in administrative segregation units shall be offered additional opportunities to shower (after all scheduled showers have taken place). C. Jail Services shall assist in attaining the appropriate temperature range and assuring the availability of ice/water and fans. D. The Facility Sergeant shall: 1. Notify the Watch Commander. 2. Ensure proper placement of the fans. E. The Watch Commander shall ensure that the Charge Nurse is alerted and Medical staff is prepared to provide any necessary medical support to inmates adversely affected by the extreme temperature. F. If at all possible, the affected inmates will be temporarily transferred to a cooler area of the facility. G. If the temperature inside a housing unit which houses a heat-risk inmate reaches 95°F, Medical staff shall be requested to observe each heat-risk inmate at least once every two (2) hours. Page 6 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS VI I. HEAT-RISK MEDICATIONS AND OUTDOOR RECREATION A. The Main Jail Yard, South Annex Jail Yard, and North Annex Security Officers shall monitor the outside temperature (the North Annex Officers shall monitor the gym temperature). When the heat index reaches 90°F, the Facility Sergeant shall be notified. 1. All inmates who have a Heat Medication Warning ALERT, who are outside or in an affected gym at the time, shall be directed to return to their respective housing unit. 2. Any inmate with a Heat Medication Warning ALERT who has pending recreation time scheduled, will have their outdoor recreation canceled for the day (unless the recreation time is scheduled for the evening, and the temperature has cooled). 3. All affected inmates will remain indoors until the heat crisis has subsided. 4. Any denial or restriction of an inmate's participation in recreation outside the housing unit shall be documented via OffenderTrak under Miscellaneous/Scheduling. Cancellation due to prescribed heat medications shall be documented via a "Heat Rec Cancellation" Event. The heat index should be indicated in the Description field. 5. Cancellation of an entire housing unit or facility (e.g., when the heat index meets or exceeds 110°F) shall be documented via an incident report. B. In an effort to minimize the cancellation of recreation time and as a preventative measure to reduce the risk of heat stress, inmates housed in administrative segregation single cells will be scheduled for outdoor recreation in the cooler morning and evening hours (i.e., before noon and after 6.00 pm). 1. If it is necessary to cancel recreation time for an inmate housed in a single cell, notify the Facility Sergeant. All efforts will be made to provide the inmate with alternative out-of-cell time. 2. If the inmate has an SMI ALERT, a housing officer shall send an email to "Jail Compliance Unit" via email. A Compliance Sergeant will be responsible to ensure that a makeup session is rescheduled. Page 7 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS C. The Facility Sergeant shall be responsible to ensure: 1. The Watch Commander is notified of any recreation area closure. 2. A report is written regarding the closure of the recreation area(s). a. The report shall include identification of the heat index tool that was used to determine the heat index, as well as the heat index temperature that caused the closure. b. A separate incident report shall be written at the time that the affected recreation area is reopened. c. If all yards are to be closed, one report will suffice. Vill. ELEVATED TEMPERATURES — NON-HEAT-RISK MEDICATIONS A. When the heat index reaches 900, the inmates in the yards (and North Annex Jail gyms) should be encouraged to consume additional liquids to facilitate fluid replacement. The inmates should be cautioned to use common sense and good judgment and be advised not to engage in overly strenuous activity. B. When the heat index reaches 1050 or higher, the inmates shall be notified and advised to limit their outdoor exertion to low impact physical activities. C. When the heat index reaches 1100 or higher, outdoor recreation will be canceled until the heat index drops below 1100. IX. INMATE WORKERS AND ELEVATED TEMPERATURES A. The SILC Officers shall monitor the inmates on days when the heat index is expected to reach 900. Anytime the heat index reaches or exceeds 900. 1. The officers shall be especially alert for inmates who display the signs and symptoms of heat stress. 2. The inmates shall be provided with frequent rest breaks. Page 8 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS 3. Cool water shall be made available to the workers and they should be encouraged to drink small amounts frequently. Mandatory water breaks should occur every thirty (30) minutes for ten (10) minutes in duration. B. When the heat index is expected to reach or exceed 1050, the outdoor SILC/Graffiti Abatement crews will be limited to work only until noon, then return to the Jail for alternative indoor work assignments. C. At any time that the heat index reaches or exceeds 1100, the outdoor work assignment will be immediately reassigned indoors. X. EMERGENCY SUSPENSION OF RECREATION Emergency suspension of recreation may be discharged under the authority of Section 1012 (Emergency Suspensions of Standards or Requirements) of Title 15 of the California Code of Regulations. When the heat index reaches 1100 or higher, outdoor recreation will be canceled until the heat index drops below 1100. A. The Watch Commander shall ensure that a report is written regarding the cancellation of the activity and take the appropriate action (if practical), to have inmate recreation rescheduled. B. The Watch Commander shall notify the Jail Operations Bureau Commander. If the Bureau Commander is not available, he/she shall be notified on his/her next scheduled workday, via memo. C. If the suspension of recreation lasts longer than three (3) consecutive days, the Bureau Commander shall notify the Board of State and Community Corrections (BSCC) in writing. In no event shall the suspension continue more than fifteen (15) consecutive days without the approval of the chairperson of the BSCC. XI. SYMPTOMS OF HEAT STRESS A. All staff is to be alert for heat stress symptoms. If an inmate exhibits any of the following signs of heat stress, they shall immediately be removed from the heat source as much as is practically possible and referred to Medical staff for medical assessment and/or treatment as soon as practical. Page 9 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS 1. Blurring of vision or spots before the eyes 2. Dizziness, light-headedness, headaches or spinning of the room 3. Nausea or vomiting 4. Feeling extremely hot with little or no sweating 5. Extreme thirst, even after drinking 6. Muscle cramps, stomach cramps or weakness 7. Sleepiness or confusion 8. Lack of coordination or balance 9. Shortness of breath or chest pain B. Amore complete listing of heat disorders, their symptoms and treatments can be found in Section XI I. XII. HEAT DISORDERS A. HEAT STROKE is caused by the failure of the body's internal mechanism to regulate its core temperature. Sweating stops and the body can no longer rid itself of excess heat. Victims of heat stroke will die unless treated promptly. While awaiting medical help, the victim must be removed to a cool area and their clothing soaked with cool water. They should be fanned vigorously to increase cooling. Prompt first aid can prevent permanent injury to the brain and other vital organs. Have the person drink some cool water (a small cup every 15 minutes) if they are alert enough to drink anything and not feeling sick to their stomach. If ice is available, place ice packs under the arm pits and groin area. Signs of heat stroke include: 1. Mental confusion, throbbing headache, rapid pulse, nausea, delirium, loss of consciousness, convulsions or coma 2. A body temperature of 1060F or higher 3. Hot dry skin which may be red, mottled or bluish Page 10 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS B. HEAT EXHAUSTION results from loss of fluid through sweating when the individual has failed to drink enough fluids or take in enough salt or both. The person with heat exhaustion still sweats but experiences extreme weakness or fatigue, giddiness, nausea, or headache. If heat exhaustion is not treated, the illness may advance to heat stroke. Treatment is usually simple: the victim should rest in a cool place and drink an electrolyte solution, if available (a beverage used by athletes to quickly restore potassium, calcium, and magnesium salts). If unavailable, have the person drink some cool water (a small cup every 15 minutes) if they are not feeling sick to their stomach. Try to cool the person by fanning them. Cool the skin with a cool spray mist of water or wet cloth. If the person does not feel better in a few minutes, call for emergency help. Severe cases involving victims who vomit or lose consciousness may require longer treatment under medical supervision. Signs and symptoms of heat exhaustion include- 1. Heavy sweating, muscle cramps, headache, dizziness/light headedness, extreme weakness or fatigue, mood changes (irritable or confused), nausea, thirst, giddiness, vomiting, fainting, or decreased and dark colored urine. 2. The body temperature is normal or slightly higher. 3. The skin is clammy and moist, the complexion pale or flushed. C. HEAT CRAMPS are painful spasms of the muscles, usually caused by performing hard physical labor in a hot environment. These cramps have been attributed to an electrolyte imbalance caused by sweating. Cramps can be caused by both too much and too little salt. Tired muscles are usually the ones most susceptible to cramps. Cramps may occur during or after heat exposure and may be relieved by taking liquids by mouth or saline solutions intravenously for quicker relief, if medically determined to be required. D. HEAT COLLAPSE (fainting) the brain does not receive enough oxygen because blood pools in the extremities. As a result, the individual may lose consciousness. The onset of heat collapse is rapid and unpredictable. Moving around, rather than standing still, will usually reduce the possibility of fainting. Victims usually recover quickly after a brief period of lying down. To prevent heat collapse, the person should gradually become acclimatized to the hot environment. Page 11 of 12 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: AIR POLLUTANTS, EXTREME TEMPERATURES AND HEAT-RISK MEDICATIONS NO: B-190 FILE: WEATHER RISKS E. HEAT RASH, also known as prickly heat, may occur in hot and humid environments where sweat is not easily removed from the surface of the skin by evaporation. When extensive or complicated by infection, heat rash can be so uncomfortable that it inhibits sleep. It can be prevented by resting in a cool place and allowing the skin to dry. XIII. FRIGID CONDITIONS A. When a condition exists that causes the inside temperature to be exceptionally cold (i.e., the temperature of a housing unit drops below 630F), the Facility Sergeant and Jail Services Unit shall be notified. B. The Facility Sergeant shall: 1. Notify the Watch Commander. 2. Ascertain the cause and anticipated duration. Depending on the circumstances, the affected inmates will be issued an extra blanket and/or thermal underclothing to keep them from being uncomfortably cold. C. The Watch Commander shall ensure that the Charge Nurse is alerted and Medical staff is prepared to provide any necessary medical support to inmates adversely affected by the extreme temperature. Page 12 of 12