MENTAL HEALTH G-130 FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: MENTAL HEALTH SERVICES NO: G-130
FILE: MENTAL HEALTH
EFFECTIVE DATE: 12-25-94 REVISED: 05-05-95, 05-01-98, 06-15-18, 01-24-23
AUTHORITY: Sheriff J. Zanoni APPROVED BY: Assistant Sheriff S. McComas
REFERENCE: Penal Code Sections 4011, 4011.6, 4011.8 and 4023. Welfare and
Institutions Code Section 5150; California Code of Regulations, Title 15,
Sections 1052, 1203, 1205, 1207, 1207.5, 1208, 1209, 1210, 1211, and 1216;
45 CFR 164.512; Prison Rape Elimination Act of 2003 (42 USC 15601) 28 CFR
115; 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 establish guidelines for the mental health care of
incarcerated people housed in the Fresno County Sheriff's Office Detention Facilities.
POLICY:
It is the policy of the Fresno County Sheriffs Office Jail Division that adequate and timely
mental health care shall be provided to any incarcerated person in custody who
demonstrates the need, or is determined to need, mental health care. This care shall be
in a manner consistent with all applicable standards of mental health care and in
compliance with all applicable Federal, State, and local laws, codes, regulations,
directives, and all applicable State and Federal court orders.
The Fresno Sheriff's Office is responsible for the on-site and off-site mental health care
services for the incarcerated people at the Fresno County Jail. With the approval of the
Fresno County Board of Supervisors, such services may be contracted to a private
service provider. The service provider shall operate a mental health care program that
meets the local community standards of care, and supply all services under the terms of
the negotiated contract.
PROCEDURES:
I. MENTAL HEALTH STAFF
A. Clinical decisions, diagnoses, and treatment plans shall only be made
by licensed mental health clinicians (psychiatrists, psychologists,
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therapists, clinical social workers, psychiatric nurses). Licensed mental
health clinicians shall review and cosign record entries made by
Licensed Psychiatric Technicians (LPTs) and Licensed Vocational
Nurses (LVNs) when LVNs and LPTs are providing behavioral health
services.
B. Mental health staff shall be appropriately credentialed according to the
licensure, certification, and registration requirements for the State of
California.
C. Mental health staff shall be assigned to work in the jail and to evaluate,
monitor, and treat incarcerated people who show signs of mental,
rather than physical problems. Mental health staff shall assist
correctional officers in dealing with incarcerated people who show
signs of emotional or mental problems.
II. MENTAL HEALTH SERVICES
A. Mental health staff shall be responsible to provide the following
services-
1. Mental health evaluations and assessment of treatment needs of
incarcerated people who require (or appear to require) mental
health services (e.g., incarcerated people with suicidal ideations,
incarcerated people in behavioral crisis, incarcerated people who
currently participate in a methadone treatment program,
incarcerated people who reported alcohol and drug abuse, or who
disclosed prior sexual victimization, etc.).
2. Mental health treatment programs provided by qualified staff,
including the use of telehealth.
3. Crisis intervention services.
4. Basic mental health services as clinically indicated.
5. Psychiatric medication support services (e.g., access to
medications, monitoring the effects of the medications prescribed
by the psychiatrist, etc.).
6. Suicide prevention services (completing suicide risk assessments
and monitoring incarcerated people assessed to be low, moderate,
and high risk).
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7. Safety cell checks, evaluations, and follow-up.
8. Short-term individual and/or psycho-educational or
psychotherapy group sessions.
9. Monitoring of SMI incarcerated people housed in
administrative separation lockdown and disciplinary housing.
Development and implementation of individualized treatment plans
(e.g., Behavioral Management Plans [BMP's] to modify problematic
behaviors).
10. Evaluations for and documentation of the need for involuntary
acute hospitalization pursuant to Welfare and Institutions Code
5150.
11. Continuity of care from admission to transfer or discharge from the
facility, including referral to community-based providers, when
indicated.
B. Mental health staff may make recommendations to Population
Management staff regarding incarcerated person housing assignment
locations and/or changes, as appropriate. Mental health staff will
provide a reason for such recommendation.
C. Mental health staff will coordinate with medical staff to ensure that care
is appropriately integrated, medical and mental health needs are met,
and the impact of any condition on each other is adequately
addressed.
D. Mental health staff will collaborate with the Department of Behavioral
Health (DBH) to provide continuity of care with psychiatric medications
and referrals to DBH services. Mental health staff shall have access
to the DBH computerized information database to facilitate such care.
III. INITIAL HEALTH CARE SCREENING FOR ARRESTEES
A. All arrestees shall be screened by the Booking Nurse (i.e., registered
nurse or nurse practioner) prior to acceptance for booking.
B. Health care intake screening shall include, but not be limited to,
medical and mental health problems, developmental disabilities,
tuberculosis and other communicable diseases.
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1. The Intake/Receiving Screening Form includes questions
regarding history of mental health problems or treatment,
hospitalizations, and/or current or previous thoughts of self-harm.
2. Incarcerated people identified as having developmental disabilities,
mental retardation, and/or learning disabilities will be referred to
mental health staff for assessment. Mental health staff shall
contact the Central Valley Regional Center for the purposes of
diagnosis and/or treatment within 24 hours of such determination,
excluding holidays and weekends.
3. Incarcerated people displaying signs of suicide risk at intake
screening will be referred for an immediate mental health
evaluation.
C. The Booking Nurse may recommend that any arrestee who is in need of
obvious acute medical attention not be accepted into custody. (The
screening shall be fully completed, so that all detectable medical needs
can be addressed prior to acceptance.)
1. The recommendation will be reviewed and approved by the Watch
Commander.
2. The arresting/transporting officer shall be responsible to transport the
arrestee to Community Regional Medical Center (CRMC) or other
medical facility so that his or her medical needs can be addressed
prior to booking into the Jail. The transporting officer will be required
to provide a copy of the CRMC medical clearance paperwork, upon
return.
3. If the Booking Nurse again finds the arrestee not fit for confinement,
the nurse shall consult with the on-duty (or on-call) physician (or
psychiatrist, as applicable).
4. If the physician/psychiatrist concurs with the Booking Nurse and
rejects the arrestee, the Watch Commander will "override" the
decision and accept the arrestee into custody.
5. The Watch Commander will coordinate with Medical/Mental Health to
transport the incarcerated person back to CRMC via the site
Emergency Room transfer process to address the incarcerated
person's medical care and fitness for confinement needs.
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6. The contracted medical provider will be responsible to coordinate with
CRMC regarding subsequent care of the incarcerated person, to
ensure their fitness for confinement upon discharge from the
Emergency Room, as necessary. [See flowchart on Addendum A.]
D. If the arrestee is found fit for incarceration but requires further medical
attention, he/she shall be treated by jail medical staff. If the arrestee
requires psychiatric treatment, he/she shall be provided a mental
health evaluation by health services stafft, who shall consult with
Population Management staff regarding appropriate housing for the
incarcerated person.
IV. SPECIAL MENTAL DISORDER ASSESSMENT
An additional mental health screening will be performed on women who
have given birth within the past year and are charged with murder or
attempted murder of their infants. Such screening will be performed at
intake and, if the assessment indicates postpartum psychosis, a referral for
further evaluation will be made.
V. ACCESS TO MENTAL HEALTH TREATMENT
A. Mental health service requests are to be made in writing, utilizing a
Health Services Request Form. Incarcerated people are to place the
completed forms in the locked boxes located inside each pod. Health
Services Request Forms will be collected by health care staff during
medication passes at least twice a day. Health care staff will pick up
completed health service request forms directly from incarcerated
people in Iockdown units during medication passes twice a day. The
Charge Nurse will review and triage each request prior to placement
of the incarcerated person's name on the sick call list and/or
scheduling an appointment.
B. Mental health staff may receive referrals for mental health evaluations
from correctional and medical staff.
1. Population Management Unit staff may refer incarcerated people
with documented mental health history (e.g., safety cell
placements), incarcerated people who report prior sexual
victimization, incarcerated people who are exhibiting mental
impairments during classification interviews, and incarcerated
people returning from State Hospitals.
2. Correctional and medical staff may refer incarcerated people who
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display signs of suicide risk or require other crisis intervention
services. (Refer to policies D-260/Suicide Prevention [FILE: SUICIDE] and D-360/ Sexual
Misconduct and Abuse[FILE: SEXUAL ABUSE].)
3. If at any time, medical or custody staff is made aware of a mental
condition that was not conveyed or detected at the time of
booking/screening, the discovering staff member should report that
information to the appropriate mental health staff.
VI. PSYCHIATRIC MEDICATIONS
A. Psychiatric medications, including but not limited to antipsychotic
medications, shall be prescribed to incarcerated people with mental
illness in accord with nationally accepted professional standards for
the treatment of serious mental illness. Prescription medications shall
only be prescribed by licensed physicians, physician's assistants,
psychiatrists, or nurse practitioners, within the scope of their
licensures.
B. Physicians shall "bridge" all verified, valid prescriptions for
incarcerated people who enter the facility currently on psychiatric
medications.
1. Incarcerated people who receive such bridge medications shall
receive a face-to-face evaluation with a psychiatrist within seven
(7) days of initiation of the medication.
2. Follow-up face-to-face evaluations shall occur as needed, but
within thirty (30) days following the initial visit.
3. Subsequent face-to-face evaluations by the psychiatrist shall occur
as needed, but at intervals of no more than ninety (90) days.
C. Incarcerated people who are prescribed psychiatric medications by the
psychiatrist (i.e., not"bridge" medications) shall receive follow-up face-
to-face evaluations with a psychiatrist as needed depending on their
clinical status, but no later than thirty (30) days following the initial visit.
Subsequent visits shall occur as needed, but at intervals of no more
than ninety (90) days.
D. Medication shall be distributed to the incarcerated people each day at
designated times by designated medical staff. Psychotropic
medications are excluded from self-administration.
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E. Some psychotropic medications can pose a serious health risk during
times of extreme heat by impairing the body's ability to regulate
temperature. Temperatures in all jail facilities are monitored for the
purpose of ensuring that incarcerated people prescribed psychotropic
medications are not at risk of heat-related illness from extremely hot
conditions (i.e., when the heat index reaches or exceeds 900).
Conversely, incarcerated people are provided with extra blankets
and/or thermal underclothing as needed in extremely cold conditions
(i.e., when the temperature of a housing unit drops below 630F).
(Refer to policy B-190/Air Pollutants, Extreme Temperatures and Heat-Risk Medications [FILE:
WEATHER RISKS].)
VI I. SEXUAL ABUSE VICTIMS
A. If an incarcerated person indicates during intake screening that they
have experienced prior sexual victimization, whether it occurred in an
institutional setting or in the community, the incarcerated person shall
be offered a follow-up meeting with a medical or mental health
practitioner within fourteen (14) days of the intake screening.
B. If an incarcerated person is a victim of sexual assault that occurs while
in-custody, the incarcerated person/victim must be provided with
appropriate mental health services, confidentially, and at no cost, in a
manner consistent with the level of care in the community.
1. The incarcerated person will be referred for an urgent suicide risk
assessment, and shall be evaluated within one (1) hour of referral.
2. The incarcerated person shall be monitored for suicidal impulses,
post-traumatic stress disorder, depression, and other mental health
consequences.
3. The incarcerated person shall be offered crisis intervention
counseling, appropriate to the needs of the victim.
c. The ongoing evaluation and treatment of such victims shall include, as
appropriate, follow-up services, treatment plans, and when necessary,
referrals for continued care. (Refer to Section xVl/continuity of care.)
Vill. SUICIDE PREVENTION AND RISK ASSESSMENT
A. All arrestees and incarcerated people shall be medically screened at
the time of intake by a medical staff member for possible signs and
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symptoms of suicidal behavior.
B. Incarcerated people displaying signs of suicide risk shall be referred to
a mental health clinician for an evaluation.
C. Incarcerated people who have been sexually assaulted while in-
custody shall be referred for an urgent suicide risk assessment.
D. Mental health clinicians shall complete a comprehensive suicide risk
assessment form for all incarcerated people who display signs of
suicide risk to determine if the incarcerated person presents a low,
moderate, or high risk of suicide. Mental health clinicians shall
complete a new form if there are indications of any modification of risk
factors, including but not limited to any suicide attempts or expressions
of suicidal ideation. A comprehensive suicide risk assessment form will
also be completed for incarcerated people who appear to be a danger
to themselves or others and/or incarcerated people who may be in
behavioral crisis.
1. Upon completion of the suicide risk assessment form, mental
health staff shall create a corresponding Alert in Offendertrak
indicating the suicide risk level (i.e., L-Suicide, M-Suicide, or H-
Suicide).
2. Low-risk (L-Suicide) incarcerated people shall be monitored at
least monthly by mental health staff and shall be housed with other
incarcerated people or, if they cannot be housed with other
incarcerated people, in housing where they can be frequently
monitored by correctional staff.
3. Moderate-risk (M-Suicide) incarcerated people shall be monitored
at least weekly by mental health staff and shall be housed with
other incarcerated people unless they pose a safety and security
threat to other incarcerated people. Moderate-risk incarcerated
people shall be housed in locations that allow custody staff to
observe and communicate with these incarcerated people on a
daily basis.
4. High-risk (H-Suicide) incarcerated people shall be monitored at
least every twenty-four (24) hours by mental health staff.
5. Incarcerated people who are determined to be "low low-risk" do not
require follow-up (unless determined necessary based on a
subsequent assessment).
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E. If an incarcerated person is at moderate risk of attempting self-
injurious behavior, but is not in immediate danger, a mental health
clinician may recommend that the incarcerated person be placed on
Suicide Precaution/"no sharps."
1. The clinician will also complete a Crisis Management Plan that
documents their recommendation, and indicates the possessions
and clothing items that should be removed or kept.
2. The clinician will be responsible to create an Alert ("Restriction -
Mental Health") in Offendertrak.
F. Sentenced incarcerated people who have been identified as a
moderate or high level of suicide risk shall receive an evaluation by a
mental health clinician prior to their release. (Refer to section xvl/Continuity of
Care for the complete/detailed requirement.)
IX. SERIOUS MENTAL ILLNESS or SEVERE MENTAL ILLNESS (SMI)
Serious mental illness is defined as any mental disorder that results in
comparatively severe impairment in major areas of functioning, such as
cognitive capabilities or disruption in normal developmental processes and
requires significant mental health treatment. The term is synonymous with
"severe mental illness."
A. Mental health staff shall create an "SMI" Alert in Offendertrak for all
SMI incarcerated people.
B. Mental health staff, with the assistance of correctional staff, shall
develop and implement Behavior Management Plans for incarcerated
people with serious mental illness who engage in repeated acts of
misconduct with the goal of reducing their placements, or shortening
the length of time they spend in Iockdown administrative separation
housing.
1. Correctional staff assigned to Population Management who are
familiar with the housing of incarcerated people with serious mental
illness shall be included in administrative meetings where Behavior
Management Plans are developed and reviewed.
2. Behavior Management Plan forms shall be scanned into the
Incarcerated person Management Plans folder
(G/RefM at/Custody/I nm ate Management Plans) by the designated
Population Management Sergeant.
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C. SMI incarcerated people may be assigned to all levels of classification.
Population Management works in conjunction with mental health staff
to assess the best housing environment that will aid the SMI
incarcerated person in maintaining optimum mental health without
compromising the safety and security of other incarcerated people and
jail staff.
D. Incarcerated people with serious mental illness are not housed in any
locked down administrative separation or discipline housing unit in the
jail system unless those incarcerated people demonstrate a current
threat to jail security, incarcerated person and/or officer safety, as
documented by correctional staff, that prevents them from being safely
housed in less restrictive locations.
E. In the event any SMI incarcerated person must be housed in a locked
down administrative separation or discipline housing unit, correctional
and mental health staff shall ensure those incarcerated people are
offered mental health treatments three (3) times per week.
1. SMI incarcerated people who are housed in any lockdown cell for
more than 48 hours are to have their cases reviewed by a
multidisciplinary team consisting of corrections and mental health
staff every two (2) weeks. Decisions for an individual's continued
housing in a single cell includes input from a licensed mental health
clinician.
2. Out-of-cell structured behavioral health services for SMI
incarcerated people housed in any lockdown cell will be offered:
a. A minimum of three (3) out-of-cell mental health contacts per
week consisting of structured individual or group therapeutic/
educational treatment and programming, each lasting
approximately one (1) hour with appropriate duration to be
determined by a mental health clinician (or incarcerated person,
if the incarcerated person ends the session before the hour is
up).
b. At a minimum, one (1) one-to-one structured therapeutic
contact session will be offered by a mental health clinician. The
remaining two (2) contacts per week may either be additional
one-to-one structured therapeutic contacts or group
therapeutic/ educational contact sessions.
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F. Mental health contacts shall be documented indicating type and
duration of activity.
G. The Sheriff's Office shall review the status of incarcerated people with
serious mental illness housed in administrative separation lockdown
cells at least once every 30 days to determine if the incarcerated
person can be moved to less restrictive housing. Jail mental health
staff shall assess SMI incarcerated people' housing requirements,
which shall be discussed at monthly administrative meetings with
custody and health care staff.
H. Sentenced SMI incarcerated people will receive discharge planning
from health care staff(i.e., an LMFT or RN) prior to their release to the
community. (Refer to SectionXVI/Continuity of Care.)
X. SAFETY CELLS
A. A mental health opinion/consultation with responsible health care staff
on placement and retention shall be secured within two (2) hours of
placement in a safety cell to determine the incarcerated person's need
for mental health services and suitability for retention in the safety cell.
This evaluation may be performed by any qualified, licensed health
care staff. Licensed mental health staff will evaluate the incarcerated
person and perform a clinical assessment within the first twelve (12)
hours of placement. (Refer to policy D-210/Safety Cell[FILE: SAFETY CELL].)
B. Mental health clinicians shall complete a comprehensive suicide risk
assessment form for all incarcerated people who display signs of
suicide risk to determine if the incarcerated person presents a low,
moderate, or high risk of suicide. This assessment will be indicated on
the Crisis Management Plan form. The clinician will be responsible to
create a corresponding Alert in Offendertrak.
C. The incarcerated person must be reviewed for continued retention in
the safety cell a minimum of every four (4) hours by the on-duty Watch
Commander. However, nothing shall preclude correctional, medical,
or mental health staff from recommending removal prior to that time.
D. Whenever health care staff members wish to recommend either the
placement of an incarcerated person into a safety cell, or the removal
of an incarcerated person from a safety cell, they shall contact the
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Watch Commander. Health care staff utilize Crisis Management Plan
forms (commonly referred to as "Restriction forms") to document
incarcerated person safety cell placement and removal and to indicate
their recommendation that an incarcerated person be placed on any
restrictions (e.g., "no sharps").
1. The Crisis Management Plan form is submitted to the Watch
Commander for approval and signature. The Watch Commander
will then approve or deny safety cell placement, removal, or
restrictions, and ensure all subsequent custody notifications are
made.
2. The signed form is delivered to Population Management staff by
the health care staff member.
E. Whenever an incarcerated person's placement in a safety cell is to
exceed thirty-six (36) hours, mental health staff shall submit written
justification (i.e., a Crisis Management Plan) to the Watch
Commander, to recommend one of the following actions:
1. The reasonable extension and temporary continuance of the safety
cell housing.
2. Discontinuance of the safety cell placement, and/or:
a. Evaluate for a transfer to a medical or behavioral health facility
for 72-hour treatment and evaluation pursuant to Section 5150
of the Welfare and Institutions Code.
b. Recommend direct supervision (managed within the Jail
facility).
F. Any confinement lasting more than thirty-six (36) hours shall require
the written approval of a Bureau Commander or their designee. No
incarcerated person shall remain in a safety cell for more than forty-
eight (48) continuous hours.
G. Within twenty-four (24) hours of safety cell removal, the incarcerated
person will be evaluated by mental health staff. The evaluation will be
documented via a "24-hr Safety Cell Follow Up" event in Offendertrak.
The incarcerated person will receive subsequent mental health
evaluations at designated intervals (e.g., 7-days, 14-days, etc.). All
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events will be documented via the appropriate entries in Offendertrak
(e.g., 7-Day Safety Cell Follow Up," 14-Day Safety Cell Follow Up,"
etc.).
XI. OBSERVATION CELL
The observation cell is to be used to separate and protect those
incarcerated people who display behavior that indicates they are in a crisis
or a danger to themselves or others and require close observation.
(Refer to policy D-375/Safety Cell[FILE: OBSERVATION CELL].)
A. Placement into an observation cell requires recommendation from a
licensed mental health clinician (or in their absence, a registered
nurse who has been trained in mental health issues) and approval of
the Watch Commander. If an RN performed the initial evaluation,
licensed Mental Health staff shall evaluate the incarcerated person
and perform a clinical assessment within the first twelve (12) hours of
placement
B. Any deprivation of rights or privileges withheld from an incarcerated
person in an observation cell shall require written documentation by a
licensed mental health clinician and the prior approval of the Watch
Commander.
C. The incarcerated person shall be medically cleared by qualified
Medical staff(i.e., RN or provider) for retention every twenty-four (24)
hours thereafter.
D. The incarcerated person shall be reevaluated for removal or
continued retention in the observation cell a minimum of every twenty-
four (24) hours by a licensed mental health clinician and the Watch
Commander. However, nothing shall preclude correctional, Medical,
or Mental Health staff from recommending removal prior to that time.
E. Whenever an incarcerated person's placement in an observation cell
is to exceed ten (10) days, a mental health assessment from the
facility Psychiatrist or facility Medical Director shall be conducted and
a written recommendation shall be forwarded to the Watch
Commander for the reasonable extension and temporary continuance
of the observation cell housing. No incarcerated person shall remain
in an observation cell for more than fourteen (14) continuous days.
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XII. INDIVIDUAL MENTAL HEALTH TREATMENT PLANS
F. For each incarcerated person treated for mental health conditions,
custody staff shall be informed of the treatment plan when necessary,
to ensure coordination and cooperation in the ongoing care of the
incarcerated person. This treatment plan shall include referral to
treatment after release from the facility when recommended by mental
health staff. [Refer to Section XVI/Continuity of Care.]
G. All Behavior Management Plans are scanned into the Inmate
Management Plans folder in the G-drive (G/RefMat/Custody/Inmate
Management Plans) by a designated Population Management
Sergeant. Crisis Management Plans are also accessible in the Inmate
Management Plans folder.
H. The Watch Commander will ensure that an email is sent to all
Sergeants and Lieutenants, notifying them of any newly effected plan.
The affected Facility Sergeant is responsible to-
1. Print all newly enacted Crisis Management Plans, Behavior
Management Plans, and Administrative Action Reports, as
applicable. Copies of all current/applicable forms are placed into
the "Inmate Management Plan" binder located in the security
station of the affectecd housing floor. The only exception is the
South Annex 2D housing unit, where the plans are immediately
accessible outside of each individual cell door.
2. Ensure the affected housing floor officers are notified and aware of
any newly effected incarcerated person management plans.
3. Purge the binder of expired forms, as necessary.
XIII. TRANSFER TO A MENTAL HEALTH TREATMENT FACILITY
A. A mentally disordered incarcerated person who appears to be a
danger to himself or others, or to be gravely disabled, and is unable to
be cared for adequately within the jail facilities, shall be transferred to
an off-site Lanterman Petris Short treatment facility (e.g., Exodus) for
diagnosis and treatment of such apparent mental disorder pursuant to
Penal Code 4011.6, Penal Code 4011.8, and/or Welfare & Institutions
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Code 5150.
B. In the event an incarcerated person is housed off-site, but remains in
custody, the mental health lead clinician/supervisor will have regular
communication with the off-site care provider to assess the
incarcerated person's status and ensure continuity of care upon return
to the jail facility. The mental health lead clinician/supervisor will also
have regular communication with appropriate custody staff regarding
the incarcerated person's status.
XIV. PRIVATE MENTAL HEALTH TREATMENT
If an incarcerated person desires to be attended by their private physician
and/or at a hospital other than the one normally utilized by the Fresno
County Sheriffs Office Jail Division (i.e., CRMC), they may do so at their
own expense. (Refer to policy G-120/Medical Health Services[FILE: MEDICAL]).
XV. HEALTH CARE RECORDS
A. A confidential record shall be kept on each incarcerated person
assessed by mental health staff. The record shall include diagnostic
studies, individual treatment plan, and records of services provided by
the various mental health staff members in sufficient detail to make
possible an evaluation of services, and contain all the data necessary
in reporting to the State, including records of incarcerated person
interviews and progress notes. Mental health records shall be kept
separate from all other Jail Division and Sheriffs Office records.
B. Health care record and health information, both oral and documented,
is confidential protected health information. The minimum necessary
health information is to be disclosed to health care staff providing
health care or to jail authorities when necessary for the protection of
the welfare of the incarcerated person or others, management of the
jail, or maintenance of jail security and order.
C. All health care records must comply with State and Federal regulations
pertaining to access, disclosure, and/or use of health information.
(Refer to policy G-120/Medical Health Services[FILE: MEDICAL].)
XVI. CONTINUITY OF CARE
Inmates shall be provided with continuity of care from admission to transfer
or discharge from the facility, including referral to community-based
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providers, when indicated.
A. All incarcerated people are provided a Medical Discharge Summary.
If the incarcerated person is receiving medications at the time of
release, a seven (7) day supply of essential medications (including all
psychiatric medications) will be available at a nearby pharmacy. The
Medical Discharge Summary provides details concerning the
pharmacy, and additional community care services available to the
incarcerated person.
B. Sentenced incarcerated people who have been identified as a
moderate or high level of suicide risk shall receive an evaluation by a
mental health clinician prior to their release to the community (or
treatment program) for appropriate referrals or initiation of an
involuntary psychiatric hold pursuant to Welfare and Institutions Code
Section 5150. The same services will be provided to unsentenced
incarcerated people provided adequate time is available prior to a
legally mandated release. (Refer to policy C-210/Release from Custody [FILE:
RELEASES].)
C. As appropriate and when necessary, victims of in-custody sexual
assaults shall be referred for continued care following their transfer to,
or placement in, other facilities, or their release from custody.
D. All sentenced SMI incarcerated people shall be provided with
discharge planning by health care staff(i.e., LMFT or RN) prior to their
release to the community. Discharge planning includes connecting
such incarcerated people to community health care providers,
community social services, community-based housing, and/or
appropriate services per the individual's need. The same services will
be provided to unsentenced SMI incarcerated people provided
adequate time is available prior to a legally mandated release.
(Refer to policy C-210/Release from Custody [FILE: RELEASES].)
E. Transportation shall be provided, as necessary, in coordination with
outside agencies and applicable community resources for SMI
incarcerated people who are released from custody.
XVII. TRAINING
The training requirements listed below are specific to health care staff
working in a jail environment.
Refer also to policy A-310/Minimum Training Requirements for Correctional Staff Members[FILE: TRAINING].
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: MENTAL HEALTH SERVICES NO: G-130
FILE: MENTAL HEALTH
A. All health care staff shall receive structured orientation and training
specific to providing health services in a correctional setting.
B. All health care staff shall receive training regarding suicide prevention
during new employee orientation, and updated training annually. The
training shall be provided by a licensed clinician having expertise in
correctional suicide prevention and the use of a suicide risk
assessment form.
C. All full- and part-time mental health care staff shall be trained in how
to detect and assess signs, preserve physical evidence, respond
effectively, and report allegations or suspicions of sexual abuse and
sexual harassment.
D. Mock fire drills are conducted by the Jail Division at least twice a year
to ensure all staff members are familiar with safety procedures and
evacuation methods. Health care staff shall participate in one of the
fire drills at least once each year.
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