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Administrative Code

Virginia Administrative Code
10/3/2024

Part XIII. Health Care Services

Article 1
General Policies

6VAC15-45-1190. Medical unit operated in accordance with applicable laws.

Written policy, procedure, and practice shall ensure inmates are provided with health care services and that the facility's medical unit is operated in accordance with applicable laws and the Department of Corrections Office of Health Services policies and procedures. Any departure from these policies and procedures shall be subject to Department of Corrections review and approval.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.1; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1200. Access to health care.

Written policy, procedure, and practice shall provide access to basic health care, and for a system for processing complaints about health care, and that these policies are communicated orally and in writing to inmates upon arrival at the facility in language which can be clearly understood by inmates.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.2; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1210. Continuity of health care.

Written policy, procedure, and practice shall provide for continuity of health care from admission to discharge or transfer.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.3; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1220. Health care evaluation.

Written policy, procedure, and practice shall require that, in order to ensure quality assurance, the facility shall have documentation that a health care evaluation by the Department of Corrections Office of Health Services has been performed at least once every other year, and that action plans are written and implemented for all areas of deficiency.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.4; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1230. Use of restraints.

Written policy, procedure, and practice shall govern the use of restraints for medical and psychiatric purposes; identifying the authorization needed; and when, where and how restraints may be used and for how long.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.5; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 2
Responsible Health Authority

6VAC15-45-1240. Responsibility of medical authority.

Written policy, procedure, and practice shall require that a designated medical authority, who may be a physician or a health administrator, is responsible for the health care of the inmates pursuant to a written agreement or contract or job description.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.6; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1250. Physician, dentist, and nurse responsibilities.

Written policy, procedure, and practice shall require that all medical, psychiatric, dental, and nursing matters involving medical judgment are the sole province of the responsible physician, psychiatrist, dentist, and nurse, respectively.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.7; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1260. Morbidity and mortality reports.

Written policy, procedure, and practice shall provide that the medical authority submits monthly morbidity and mortality reports and annual summaries to the Department of Corrections.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.8; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1270. Reporting of threatening conditions.

Written policy, procedure, and practice shall provide that the medical authority reports immediately to the contractor conditions that pose a serious health threat to staff and inmate health and safety. The contractor shall immediately report such conditions to the Department of Corrections.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.9; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1280. Review of health care program.

Written policy, procedure, and practice shall provide that the medical authority review each health care policy, procedure and program at least every 12 months, and revise them as needed. Each review and revision shall bear the date and signature of the reviewer.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.10; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 3
Facilities and Equipment

6VAC15-45-1290. Space for health care delivery.

Written policy, procedure, and practice shall ensure that the contractor provide adequate space, equipment, supplies, and materials for the delivery of health care as determined by the medical authority in accordance with the level of care provided by the facility.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.11; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1300. First aid kits and emergency medical supplies.

Written policy, procedure, and practice shall provide that first aid kits and emergency medical supplies are available in areas determined by the medical authority in conjunction with the contractor.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.12; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1310. Checking and testing of medical equipment.

Written policy, procedure, and practice shall require that medical staff are responsible for checking and testing all medical equipment according to manufacturer's recommendations and that the equipment is safeguarded from inmate access.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.13; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1320. Ambulances.

Written policy, procedure, and practice shall provide that ambulances utilized by the facility are certified by the Department of Emergency Medical Services, operated by certified drivers, and that a certified emergency medical technician accompanies an inmate being transported for medical reasons.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.14; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 4
Personnel

6VAC15-45-1330. Licensure, certification, and registration requirements.

Written policy, procedure, and practice shall require that all medical personnel who provide health care services to inmates meet applicable licensure, certification, and registration requirements and that verification of current credentials are on file in the facility.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.15; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1340. Job descriptions.

Written policy, procedure, and practice shall require that the duties and responsibilities of medical personnel are governed by written job descriptions approved by the medical authority, kept on file at the facility, and a copy be given to the employee.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.16; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1350. Written protocols.

Written policy, procedure, and practice shall provide that all health care shall be performed pursuant to written protocols by personnel authorized by law to give such orders.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.17; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1360. Nursing practices.

Written policy, procedure, and practice shall provide that nurses, nurse practitioners, and physician's assistants practice within the limits of applicable laws and regulations.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.18; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1370. Distribution of medications.

Written policy, procedure, and practice shall provide that nonmedical personnel involved in the distribution, administration, or both, of non-over-the-counter medications or in providing other medical services are trained according to Department of Corrections, Office of Health Services' procedures.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.19; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1380. First aid and crisis intervention.

Written policy, procedure, and practice shall provide for on-site emergency first aid, CPR and crisis intervention. In addition, direct care and custodial staff shall be trained to recognize signs and symptoms of mental disorder, suicidality, and chemical dependency.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.20; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1390. Inmate jobs.

Written policy, procedure, and practice shall provide that inmates are not used for the following duties:

1. Performing direct patient care services.

2. Scheduling health care appointments.

3. Determining access of other inmates to health care services.

4. Handling or having access to surgical instruments, needles, medications, and medical records.

5. Operating diagnostic and therapeutic instruments.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.21; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1400. Training of health care personnel.

Written policy, procedure, and practice shall provide that health care personnel are provided opportunities for orientation and training.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.22; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 5
Health Screenings and Examinations

6VAC15-45-1410. Transfers.

Written policy, procedure, and practice shall provide that all inmates undergoing transfers undergo a health screening by qualified medical personnel upon arrival at the facility and no later than one working day thereafter if the facility does not have 24-hour medical coverage.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.23; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1420. Communicable diseases.

Written policy, procedure, and practice shall provide for the identification and management of tuberculosis and other communicable diseases and that these policies and procedures are updated as new information becomes available.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.24; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 6
Mental Health Services

6VAC15-45-1430. Provision of mental health services.

Written policy, procedure, and practice shall specify the provision of mental health services for inmates. These services include, but are not limited to, those provided by qualified mental health professionals who meet the educational and licensure/certification criteria specified by their respective professional discipline (i.e. psychiatry, psychology, psychiatric nursing, and social work).

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.25; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1440. Access to mental health services.

Written policy, procedure, and practice shall provide that all inmates have access to mental health services. These services shall include a system for mental health screening and mental health evaluation of inmates, a system of referral to the services of qualified mental health professionals, a system for transfer or commitment of inmates in need of mental health services beyond the facility resources, and a system for continuity of care and follow-up procedures.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.26; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1450. Mental health status information.

Written policy, procedure, and practice shall provide for the initial and ongoing assessment and determination of the mental health status and needs of inmates.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.27; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1460. Special needs inmates.

Written policy, procedure, and practice shall provide for identification of special needs inmates. Special needs inmates shall include, but are not limited to, inmates who are mentally ill, emotionally or behaviorally disturbed, or mentally retarded. Programs shall be instituted for these inmates' appropriate management and treatment.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.28; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1470. Inmates with acute mental health needs.

Inmates who are acutely mentally ill, severely emotionally or behaviorally disturbed, or severely mentally retarded shall be referred for placement in units appropriate for their treatment and management needs.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.29; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1480. Suicide and intervention plan.

There shall be a written suicide prevention and intervention plan that is reviewed and approved by a qualified mental health professional. Staff with responsibility for inmate supervision shall be familiar with the plan.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.30; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1490. Mental health training program.

There shall be a written mental health training program which is provided to employees whose duties require direct contact with special needs inmates. This training program shall be developed and reviewed by qualified mental health professionals.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.31; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 7
Levels of Care

6VAC15-45-1500. Treatment of health problems.

Written policy, procedure, and practice shall provide that treatment of an inmate's health problems are not limited by the resources available within the facility and that hospital care is available for acute illness or surgery at a facility outside the facility.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.32; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1510. Provision of all levels of health care.

Written policy, procedure, and practice shall provide that the contractor, in conjunction with the medical authority, makes available all levels of health care to include self-care, first aid, 24-hour emergency care, 24-hour infirmary care, hospital care, and chronic and convalescent care, as required by the contract.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.33; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1520. Sick call.

Written policy, procedure, and practice shall require that regularly scheduled sick call is conducted by qualified health care personnel and is available to all inmates.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.34; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1530. Contracted health services.

Written policy, procedure, and practice shall provide for the contractor to contract the services of medical, dental, or mental health specialists.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.35; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1540. Access to health care by nongeneral population inmates.

Written policy, procedure, and practice shall require that inmates in categories of custody other than general population have access to regularly scheduled sick call and emergency medical care. The care shall be provided on-site or in the medical area depending on security and medical considerations.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.36; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1550. Refusal to accept treatment.

Written policy, procedure, and practice shall prohibit inmates from choosing their own health care provider, and require procedures for documentation of refusal to accept treatment.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.37; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 8
Informed Consent and Medical Research

6VAC15-45-1560. Informed consent.

Written policy, procedure, and practice shall provide that written informed consent for inmate health care is obtained where required and documented. When health care is rendered against the patient's will, it shall be in accord with applicable laws and regulations.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.38; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1570. Medical research.

Written policy, procedure, and practice shall prohibit the use of inmates for medical, pharmaceutical, or cosmetic experiments. This policy does not preclude individual treatment of an inmate based on his need for a specific medical procedure that is not generally available.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.39; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 9
Specialized Programs

6VAC15-45-1580. Health education program.

Written policy, procedure, and practice shall provide that a program of health education is available to all inmates of a facility.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.40; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1590. Special treatment programs.

Written policy, procedure, and practice shall provide for special treatment programs for inmates requiring close medical supervision as determined by the responsible physician, dentist or qualified mental health professional, and as required by the contract.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.41; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1600. Chemically dependent inmates.

Written policy, procedure, and practice shall guide the management of chemically dependent inmates under the supervision of a qualified health care practitioner.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.42; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1610. Medical and dental prostheses.

Written policy, procedure, and practice shall provide that medical and dental prostheses are provided when the health of the inmate would otherwise be affected, as determined by the responsible physician or dentist.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.43; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1620. Pregnant inmates.

Written policy, procedure, and practice shall provide for a system whereby pregnant inmates may obtain obstetrical medical and social services, and as required by the contract.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.44; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1630. Special diets.

Written policy, procedure, and practice shall provide that special diets are prescribed as needed and monitored by the responsible physician or dentist.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.45; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 10
Health Records

6VAC15-45-1640. Transfer of health records.

Written policy, procedure, and practice shall provide that copies of the medical records of all inmates transferred are transferred to the custody of medical personnel at the receiving facility and that the confidentiality of the records shall be preserved during the transfer.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.46; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1650. Complete health record.

Written policy, procedure, and practice shall govern the creation, organization, maintenance, and storage of a complete health record for each inmate, which documents all the health services rendered during the entire period of incarceration, as required by applicable Department of Corrections procedures.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.47; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1660. Confidentiality.

Written policy, procedure, and practice shall uphold the principle of confidentiality of the health record and support the following requirements:

1. The health record shall be maintained separately from the facility record.

2. Access to the health record shall be controlled by the medical authority and is granted only to those who require it under departmental policy.

3. The medical authority shall share with the contractor information regarding security and the inmates' medical management, transfer, and ability to participate in programs.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.48; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1670. Health record for transfers and consultations.

Written policy, procedure, and practice shall provide that the health record accompanies the inmate to all Department of Corrections facilities whether for transfers or for medical consultations and that the confidentiality of the health record is strictly maintained during such transfer.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.49; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

6VAC15-45-1680. Inactive health record files.

Written policy, procedure, and practice shall require that inactive health record files are sent to the Department of Corrections. Records shall be maintained in accordance with Library of Virginia guidelines. Microfilm records shall be sent to the Department of Corrections.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.50; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 11
Pharmacy Services

6VAC15-45-1690. Pharmaceutical services.

Written policy, procedure, and practice shall require that pharmaceutical services at the facility are in strict compliance with state and federal laws and applicable pharmaceutical regulations.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.51; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

Article 12
Serious Illness and Death

6VAC15-45-1700. Notification of inmate death, injury, or illness.

Written policy, procedure, and practice shall specify and govern the process by which those individuals designated by the inmate are notified in case of serious illness, injury, or death.

Statutory Authority

§ 53.1-266 of the Code of Virginia.

Historical Notes

Derived from VR230-01-006 § 13.52; Virginia Register Volume 12, Issue 4, eff. December 13, 1995.

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