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Correctional Managed Health Care

Policy Manual


Correctional Managed Health Care Policy Manual
Policy # Effective Date Title Format
       
  10/05/2017 Table of Contents PDF
    Disclaimer PDF
    Policy Manual Updates:  
  11/01/2013      Transmittal Memo PDF
  08/07/2013      Transmittal Memo PDF
  05/09/2013      Transmittal Memo PDF
  05/03/2013      Transmittal Memo PDF
  03/11/2013      Transmittal Memo PDF
  02/14/2013      Transmittal Memo PDF
  02/12/2014      Transmittal Memo PDF
  05/12/2014      Transmittal Memo PDF
  05/19/2014      Transmittal Memo PDF
  08/08/2014      Transmittal Memo PDF
  08/21/2014      Transmittal Memo PDF
  09/24/2014      Transmittal Memo PDF
  10/15/2014      Transmittal Memo PDF
  12/11/2014      Transmittal Memo PDF
  07/08/2015      Transmittal Memo PDF
  07/30/2015      Transmittal Memo PDF
  08/26/2015      Transmittal Memo PDF
  09/24/2015      Transmittal Memo PDF
  11/10/2015      Transmittal Memo PDF
  01/08/2016      Transmittal Memo PDF
  02/17/2016      Transmittal Memo PDF
  03/17/2016      Transmittal Memo PDF
  04/22/2016      Transmittal Memo PDF
  04/29/2016      Transmittal Memo PDF
  05/25/2016      Transmittal Memo PDF
  06/17/2016      Transmittal Memo PDF
  08/23/2016      Transmittal Memo PDF
  09/28/2016      Transmittal Memo PDF
  12/12/2016      Transmittal Memo PDF
  01/10/2017      Transmittal Memo PDF
  03/07/2017      Transmittal Memo PDF
  04/07/2017      Transmittal Memo PDF
  05/02/2017      Transmittal Memo PDF
  05/25/2017      Transmittal Memo PDF
  08/16/2017      Transmittal Memo PDF
  10/02/2017      Transmittal Memo PDF
  10/05/2017      Transmittal Memo PDF
    Policy Review Schedules:  
         Policy Review for January PDF
         Policy Review for April PDF
         Policy Review for July PDF
         Policy Review for October PDF
  04/2014 Signature Page PDF
  08/2015 Signature Page PDF
  06/2016 Signature Page PDF
       
SECTION A:  GOVERNANCE AND ADMINISTRATION
A-01.1 03/07/2017 Access to Care PDF
A-02.1 03/17/2016 Responsible Health Authority PDF
A-02.2 03/17/2016 Treatment of Injuries Incurred in the Line of Duty PDF
A-03.1 03/17/2016 Medical Autonomy PDF
A-04.1 03/17/2016 Administrative Meetings PDF
A-04.2 07/08/2015 Health Services Statistical Report PDF
A-05.1 05/20/2016 Health Services Policies PDF
A-06.1 01/04/2012 Quality Improvement/Quality Management Program PDF
A-06.2 05/20/2016 Professional and Vocational Nurse Peer Review Process PDF
A-07.1 05/25/2017 Emergency Plans and Drills PDF
  05/25/2017      Attachment A: Disaster Drill Evaluation Form PDF
A-08.1 05/20/2016 Decision Making – Mental Health Patients PDF
  01/04/2012      Attachment A: Mental Health Disciplinary Review Form PDF
A-08.2 05/25/2017 Transfers of Offenders with Acute Conditions PDF
A-08.3 08/23/2016 Referral of Offenders to the Development Disabilities Program (DDP) PDF
A-08.4 08/16/2017 Offender Medical and Mental Health Classification PDF
  08/16/2017      Attachment A: Guidelines for Completing the Health Summary for Classification Form PDF
A-08.5 08/23/2016 Coordination with Windham School System PDF
A-08.6 03/07/2017 Medically Recommended Intensive Supervision Screening PDF
  05/02/2013      Attachment A: MRIS Medical Summary PDF
  03/07/2017      Attachment B: MRIS - Standard Operating Procedure for Completing Medical Summary PDF
A-08.7 08/16/2017 PULHES System of Offender Medical and Mental Health Classification PDF
  09/22/2014      Attachment A: PULHES Background and Information PDF
  08/23/2016      Attachment B: Guidelines For Coding PUHLES PDF
A-08.8 03/07/2017 Medical Pass PDF
  03/07/2017      Attachment A: Examples of Approved Medical Passes PDF
  03/07/2017      Attachment B: Examples of Items for which a Medical Pass is Not Necessary PDF
A-08.9 9/28/2016 The Chronic Mentally Ill Treatment Program (CMI-TP) PDF
  9/28/2016      Attachment A Chronic Mentally Ill Treatment Program (CMI-TP) - Referral Form PDF
A-08.10 12/12/2016 The Program for Aggressive Mentally Ill Offender (PAMIO) PDF
  12/12/2016      Attachment A: Admission Referral Application to Clements Unit PAMIO Psychiatric Center PDF
A-09.1 04/2007 Privacy of Care PDF
A-10.1 03/17/2016 Notification Requirements Regarding Critically Ill Offenders PDF
A-11.1 05/20/2016 Procedure to be Followed in Cases of Offender Death PDF
  05/20/2016      Attachment A: Initial Notification to Health Services of Offender Death PDF
  05/20/2016      Attachment B: Deaths in Custody – Death Report for Bureau of Justice Statistics PDF
  05/20/2016      Attachment C: Offender Death Summary PDF
A-11.2 05/12/2014 Pronouncement of Death by Licensed Nurses PDF
A-12.1 03/07/2017 Grievance Mechanism PDF
  04/24/2012      Attachment A: Getting Medical Treatment – English PDF
  04/24/2012      Attachment B: Getting Medical Treatment – Spanish PDF
  01/08/2016      Attachment C: Informal Resolution Process PDF
A-12.2 06/01/2009 Patient Liaison Program PDF
A-13.1 12/11/2014 Provider Peer Review PDF
       
SECTION B:  MANAGING A SAFE AND HEALTHY ENVIRONMENT
B-14.01 02/09/2017 Infection Control Program PDF
B-14.02 02/09/2017 Correctional Managed Health Care Infection Control Committee PDF
B-14.03 02/09/2017 Employee TB Testing PDF
B-14.04 02/09/2017 Prevention of Hepatitis B Virus (HBV) Infection in TDCJ Facilities PDF
  02/2017   Attachments A-D: Hepatitis B Immunization PDF
B-14.05 02/09/2017 Occupational Exposure Counseling and Testing for TDCJ and Correctional Managed Health Care Employees PDF
  06/2017      Attachments A-M PDF
B-14.06 02/09/2017 Management of Offender Bloodborne Exposures PDF
B-14.07 04/26/2017 Immunization PDF
  02/2017      Attachments A-E PDF
         Attachment F: Vaccine Adverse Event Reporting System PDF
         Attachment: HPV Vaccine Gardasil® What You Need to Know - English PDF
         Attachment: HPV Vaccine Gardasil® What You Need to Know - Spanish PDF
         Attachment: Tetanus & Diphtheria Vaccine (Td) – English PDF
         Attachment: Tetanus & Diphtheria Vaccine (Td) – Spanish PDF
B-14.10 02/11/2016 Tuberculosis PDF
         Attachment G: Tuberculosis Elimination Division Report Contacts PDF
         Attachment H Page 1: TB Program Evaluation PDF
         Attachment H Page 2: Continuation of Report of Contacts PDF
B-14.11 ** 02/09/2017 Human Immunodeficiency Virus (HIV) Infection PDF
B-14.11 ** 02/09/2017 HIV Disease Management Link
B-15.1 10/10/2013 Environmental Inspections PDF
B-16.1 10/10/2013 Kitchen Sanitation and Food Handlers PDF
B-17.1 10/10/2013 Ectoparasite Control PDF
       
SECTION C:  PERSONNEL AND TRAINING
C-18.1 03/17/2016 Licensure and Credential Verification PDF
C-19.1 03/17/2016 Continuing Education/Staff Development PDF
C-19.2 07/2015 Correctional Managed Health Care Reference Materials PDF
  05/20/2016      Attachment A: Sample Correctional Managed Health Care Bookshelf PDF
C-20.1 07/08/2015 Training for Correctional Officers PDF
C-22.1 08/07/2013 Offender Workers PDF
C-23.1 08/23/2016 Position Descriptions PDF
C-24.1 12/11/2014 Staffing Levels PDF
C-25.1 10/30/2013 Orientation Training for Health Services Staff PDF
       
SECTION D:  HEALTH CARE SERVICES SUPPORT
D-27.1 03/17/2016 Pharmaceuticals PDF
D-27.2 07/08/2015 Heat Stress PDF
  03/2015      Attachment A: Drugs Associated With Heat Stress PDF
  03/18/2015      Attachment B: Comorbidities That May Affect Heat Tolerance PDF
  10/30/2013      Attachment C: Heat-Related Illness Reporting Form PDF
D-27.3 03/18/2015 Photosensitivity PDF
D-28.1 08/23/2016 Clinic Space, Equipment, and Supplies PDF
D-28.2 07/2015 Sharp, Needle and Syringe Control PDF
D-28.3 07/08/2015 Facility Repairs and Renovations PDF
D-28.4 01/04/2012 First Aid Kits PDF
D-28.5 08/23/2016 Equipment, Supplies and Inventory PDF
D-29.1 10/1995 Access to Diagnostic Services PDF
D-30.1 03/07/2017 Hospital and Specialized Ambulatory Care PDF
D-30.2 10/1995 Scheduling Approved Consultations to Specialty Health Services PDF
       
SECTION E:  INMATE CARE AND TREATMENT
E-31.1 03/17/2016 Information on Health Care Services PDF
E-31.2 08/16/2017 Organ or Tissue Donation PDF
  02/12/2014      Attachment A: Donor Information Sheet PDF
  05/02/2013      Attachment B: Retraction of Tissue and Organ Donor Status PDF
E-31.3 04/07/2017 Obtaining Community Hospital Offender Information PDF
E-31.4 05/20/2016 Management of Offenders Who Have Received Solid Organ Transplants PDF
E-32.1 05/02/2017 Receiving, Transfer and Continuity of Care Screening PDF
  04/2017      Attachment A: CMC Intake History & Health Screening Form PDF
  06/2015      Attachment B: SAFPF Detoxification Medications List PDF
E-34.1 03/17/2016 Health Appraisal of Incoming Offenders PDF
E-34.2 05/20/2016 Periodic Physical Examinations PDF
E-34.3 03/17/2016 Use of Force Procedures PDF
E-34.4 07/08/2015 Reporting Suspected Abuse PDF
E-34.5 10/02/2017 Chemical Agents and the Use of Force Contraindication List PDF
E-35.1 05/25/2017 Mental Health Appraisal for Incoming Offenders PDF
E-35.2 05/25/2017 Mental Health Evaluation PDF
E-36.1 06/01/2017 Dental Treatment Levels of Care and Appendix I, II, and Dental Sealants PDF
E-36.2 01/04/2012 Inprocessing Offenders – Dental Examination, Classification, Education and Treatment PDF
E-36.3 01/04/2012 Recording and Scheduling Dental Patient Visits PDF
E-36.4 05/25/2017 Dental Prosthodontic Services PDF
  01/04/2012      Attachment A: Medically Necessary Dental Prosthetics Referral Form PDF
  01/04/2012      Attachment B: Completed Dental Prosthesis Requisition Form PDF
E-36.5 01/04/2012 Dental Utilization/Quality Review Committee PDF
E-36.6 01/04/2012 Periodontal Disease Program PDF
E-36.7 10/30/2013 Dental Clinic Operations Reporting PDF
  01/08/2016      Attachment A: Private Non-EMR Facilities Dental Clinic Operations Monthly Report Form PDF
E-37.1 05/25/2017 Daily Processing of Health Complaints and Sick Call PDF
  05/25/2017      Attachment A: Sick Call Procedure For Offenders Unable To Write PDF
E-37.2 01/04/2012 Guidelines for Clipper Shave Pass PDF
E-37.3 05/20/2016 Medical Lay-Ins PDF
E-37.4 05/20/2016 Lockdown Procedures PDF
E-37.5 05/20/2016 Interpreter Services – Monolingual Spanish-Speaking Offenders PDF
E-37.6 01/04/2012 Cosmetic Surgery PDF
E-39.1 04/07/2017 Health Evaluation and Documentation Offenders in Segregation – Restrictive Housing PDF
E-40.1 08/23/2016 Direct Medical Orders PDF
E-41.1 08/23/2016 Emergency Services PDF
E-41.2 08/23/2016 Emergency Response During Hours of Operation PDF
  08/23/2016      Attachment A: Inventory List PDF
E-42.1 03/18/2015 Offender Transport and Transfer PDF
E-42.2 09/24/2015 Missed Clinic Appointment PDF
  01/2012      Attachment A: SLC Missed Appointment Audit/Survey PDF
E-42.3 06/17/2016 Transportation of Infirmary and Inpatient Mental Health Offenders PDF
  06/17/2016      Attachment A: Authorization to Leave the Inpatient or Sheltered Housing Setting PDF
E-42.4 03/18/2015 Medical Holds PDF
E-43.1 10/30/2013 Delegation to Advanced Practice Registered Nurses and Physician Assistants PDF
  10/30/2013      Attachment A: Prescriptive Authority Agreement PDF
  10/30/2013      Attachment B: Alternative Physician Supervision Log PDF
E-44.1 10/30/2013 Continuity of Care PDF
E-44.2 01/08/2016 Examination of Offenders by Private Practitioners PDF
  01/08/2016      Attachment A: Request and Consent for Examination by Private Practitioner PDF
       
SECTION F:  HEALTH PROMOTION AND DISEASE PREVENTION
F-46.1 03/17/2016 Health Education and Promotion PDF
F-47.1 08/16/2017 Therapeutic Diets and Food Allergies PDF
  10/2012      Attachment A: Counseling Sheet for Therapeutic Diet Refusal PDF
F-48.1 05/20/2016 Exercise Program PDF
F-49.1 09/22/2014 Personal Hygiene PDF
F-50.1 12/11/2014 Tobacco Free Environment PDF
       
SECTION G:  SPECIAL NEEDS AND SERVICES
G-51.1 03/07/2017 Offenders with Special Needs PDF
G-51.2 03/07/2017 Admission to A Geriatric Center PDF
G-51.3 03/07/2017 Admission Health Appraisals for Offenders With Physical Disabilities PDF
  03/18/2015      Attachment A: Speech Pathology Referral Criteria for TDCJ and Speech Pathology Referral Process PDF
  03/18/2015      Attachment B: Level of Care Assessment PDF
G-51.4 03/17/2016 Wheelchair Repair and Maintenance PDF
G-51.5 12/11/2014 Certified American Sign Language (ASL) Interpreter Services PDF
G-51.6 05/20/2016 Referral of an Offender for Admission into a Mental Health Inpatient Treatment Facility PDF
G-51.7 05/20/2016 Psychiatric Inpatient Treatment for Substance Abuse Felony Punishment Facility Offenders PDF
G-51.8 03/17/2016 Care of Offenders With Terminal Conditions PDF
  09/22/2014      Attachment A: Consent to Hospice Care PDF
  09/22/2014      Attachment B: Hospice Guidelines PDF
G-51.9 05/20/2016 Wheelchair Use PDF
  05/20/2016      Attachment A: Special Wheelchair Committee - Treatment Plan of Offender Refusing to Walk PDF
  05/20/2016      Attachment B: Special Wheelchair Committee Treatment Plan Form PDF
G-51.10 08/15/2012 Chronic Care Program PDF
G-51.11 01/10/2017 Treatment of Offenders With Intersex Conditions, Gender Identity Disorder or Gender Dysphoria PDF
  08/05/2014 G-51.11 Revision Explanation PDF
  01/10/2017      Attachment A: Consent Form for Therapy with Male Hormones PDF
  01/10/2017      Attachment B: Consent Form for Therapy with Female Hormones PDF
G-51.12 10/02/2017 Offenders with Special Needs who are Releasing from TDCJ PDF
  04/24/2012      Attachment A: Continuity of Care Information Form PDF
G-51.13 10/05/2017 Admission to a Sheltered Housing PDF
G-52.1 08/23/2016 Infirmary Care PDF
G-52.2 9/28/2016 Chronic Mentally Ill - Sheltered Housing (CMI-SH) PDF
G-52.3 05/25/2017      Admission to the TDCJ Mental Health Therapeutic Diversion Program (MHTDP) PDF
  05/25/2017      Attachment A: MHTDP Referral Form PDF
  04/29/2016      Attachment B: MHTDP Eligibility Diagnoses PDF
G-53.1 08/16/2017 Suicide Prevention Plan PDF
G-53.3 12/12/2016 Management of Offenders Hunger-Strikes PDF
G-54.1 01/04/2012 Detoxification PDF
G-55.1 01/08/2016 Pregnant Offenders PDF
G-56.1 12/11/2014 Offenders with Substance Abuse Disorders PDF
G-57.1 12/11/2014 Sexual Assault/Sexual Abuse PDF
  09/01/2005      Attachment A: Penal Code, Chapter 22. – Assaultive Offenses PDF
  09/01/2005      Attachment B: Code of Criminal Procedure, Chapter 56. – Rights of Crime Victims, Subchapter A. – Crime Victims’ Rights PDF
G-59.2 03/07/2017 Optical Prostheses and Appliances PDF
G-59.3 09/22/2014 Medical Prostheses and Orthotic Devices PDF
  09/2014      Attachment A: Medical Conditions Not Suitable for B&L Referral PDF
       
SECTION H:  HEALTH RECORDS
H-60.1 03/07/2017 Health Records – Organization, Maintenance and Governance PDF
  03/17/2016      H-60.1 Attachment A Outpatient Health Record Format PDF
  03/17/2016      H-60.1 Attachment B List of EHR Chart Sections PDF
  03/07/2017      H-60.1 Attachment C: Abbreviated Job Titles PDF
  08/23/2016      H-60.1 Attachment D: CMHC EHR Standard Operating Procedure – Change Sign User for Email PDF
  08/23/2016      H-60.1 Attachment E: CMC Document Clarification PDF
  08/23/2016      H-60.1 Attachment F: CMHC EHR Standard Operating Procedure – Creating an Addendum Note PDF
  08/23/2016      H-60.1 Attachment G: Incomplete Chart Review PDF
H-60.2 05/25/2017 Inpatient Health Records PDF
  04/2013      Attachment A: History and Physical Examination PDF
  04/2013      Attachment B: Discharge Summary PDF
  04/2013      Attachment C: Approval To File an Incomplete Medical Record PDF
H-60.3 08/23/2016 Health Services Forms Control and Design PDF
H-60.4 04/07/217 Utilization of Electronic Health Record PDF
H-61.1 05/20/2016 Confidentiality and Release of Information PDF
  07/2012      Attachment A: Affidavit of Personal Representative PDF
  11/19/2008      Attachment B: Calculation of Costs for Patient Health Information (2/2005) Facilities PDF
  07/2012      Attachment C: Calculation of Costs for Patient Health Information (2/2005) Health Services Archives PDF
         Authorization for the Use and Disclosure of Protected Health Information (PHI) - English Version PDF
         Authorization to Release Protected Health Information - Spanish Version PDF
H-64.1 12/11/2014 Transfer of Health Records PDF
  02/2013      Attachment A: Breach of Confidentiality Incident Log PDF
  02/2013      Attachment B: Breach of Confidentiality Form PDF
H-65.1 03/07/2017 Retention/Destruction of Health Records PDF
       
SECTION I:  MEDICAL-LEGAL ISSUES
I-66.1 08/23/2016 Medical Therapeutic Restraints PDF
  08/23/2016      Attachment A: Medical Therapeutic Restraint Flow Sheet PDF
I-66.2 03/17/2016 Therapeutic Restraint of Mental Health Patients PDF
I-66.3 03/17/2016 Psychiatric Inpatient Seclusion PDF
I-67.1 05/20/2016 Compelled Psychoactive Medication for Mental Illness PDF
  10/2012      Attachment A: Correctional Managed Health Care - Mental Health Services Certificate of Emergency Compelled Psychoactive Medication In A Mentally Ill Person PDF
  05/20/2016      Attachment B: Certificate of Non-Emergency Compelled Psychoactive Medication in a Mentally Ill Person PDF
I-68.1 03/17/2016 Blood and Urine Testing for Forensic Purposes PDF
I-68.2 03/07/2017 DNA Specimen Collection PDF
I-68.3 03/17/2016 Forensic Information PDF
I-68.4 01/04/2012 Medical Consultation for the Offender Drug Testing Program PDF
  01/04/2012      Attachment A: Offender Controlled Substance Testing Information Form PDF
  07/08/2015      Attachment B: Prescription Drugs Giving Positive Results for the Sure-Screen Test PDF
I-69.1 01/04/2012 Participation in Executions PDF
I-70.1 08/23/2016 Informed Consent PDF
  09/24/2015      Attachment A: Request/Consent for Treatment or Services PDF
I-70.2 03/07/2017 Consent For Admission to Inpatient Psychiatric Care PDF
  01/08/2016      Attachment A: Voluntary Consent for Admission to an Inpatient Psychiatric Facility PDF
  01/08/2016      Attachment B: Psychiatric Involuntary Admission Review PDF
  01/08/2016      Attachment C: Involuntary Admission to Inpatient Facility PDF
I-71.1 08/16/2017 Offender’s Right to Refuse Treatment, Department’s Right to Compel Treatment PDF
  08/07/2013      Attachment A: Request for Compelled Medical Treatment PDF
  08/07/2013      Attachment B: Refusal of Treatment or Services PDF
  08/07/2013      Attachment C: Instructions For Completing The Refusal Of Treatment Form PDF
I-71.2 07/08/2015 Patient Self-Determination Act, Natural Death Act, Advance Directives Act PDF
  01/04/2012      Attachment A: Directive To Physicians PDF
  07/01/2009      Attachment B: Standard Out-Of-Hospital Do-Not-Resuscitate Order PDF
  02/2012      Attachment C: Patient Information About Advance Directives PDF
I-72.1 01/08/2016 Biomedical Research PDF