Correctional Health Services : Clinics And Processes
The first interaction with CHS employees that an individual has is in our pre-booking and intake work units. Correctional Health Services provides initial health screening prior to booking to all persons presented to the jails by the dozens of arresting agencies for incarceration. In the year ending June 30, 2009, over 11,000 individuals were processed each month through pre-booking. Every individual must have a pre-booking health screening and receive medical approval for the booking process to begin. If an individual has a significant or life-threatening injury, the person is sent to the hospital.
The CHS employees in the Pre-booking/Intake unit spend time with each individual reviewing a series of questions to assess medical condition and to learn if the patient has chronic illnesses including mental illness and/or medications. This information allows CHS to provide the patient with continuity of care while housed in jail. Individuals are also asked about their alcohol or drug use so that appropriate care can be given if they experience withdrawals. CHS data documents that 12,876 patient visits for “Clinical Institute Withdrawal Assessment” were provided in the year ending June 30, 2009. The monthly average for referrals to mental health staff during the intake process was 1350 patients.
CHS has outpatient clinics located in each of the six jails in Maricopa County. Each clinic provides nurse and doctor sick call, chronic care visits, wound care, and other daily and acute medical and mental health care. The majority of the Outpatient clinics are 24/7 facilities. Additionally, two of the clinics have dental and x-ray facilities.
The CHS Infirmary provides the setting for acute patient care observation and post hospital stay. The Infirmary has 60 beds with 19 negative air flow rooms in case of a need for airborne contagious disease containment. In the year ending June 30, 2009, 949 patients were cared for in the Infirmary with a total of more than 13,000 patient days.
Mental Health Housing Unit
Another CHS care facility operating 24 hours a day, 7 days per week is the Mental Health Housing Unit allowing for those needing acute mental health care with more individualized support. The Unit has six housing pods; one pod is for females. Of the other five pods, one is used for admission of males, one for acute/sub-acute males, and two for those adjusting before returning to general population. Although the unit has 264 beds, use is restricted due to the custody levels of the patients. More than 2,500 patients received care in this facility during the year ending June 30, 2009.
Medication administration within a jail is challenging and unique. The population moves, often without advance notice. Considering approximately 130,000 individuals were booked last year with approximately 350 entering and 350 leaving the jail daily, it is easily imagined how complex the prescription, pharmacy, distribution, and administration of medications might be. On any given day last year, approximately 9000 individuals were in the County jails. Typically almost half the population is on medication and many have more than one prescription. CHS Licensed Practical Nurses (LPNs) administer medications twice daily by visiting every housing facility!