GEORGIA STANDARDS
FOR ADULT
PRETRIAL DETENTION
FACILITIES

GEORGIA SHERIFFS' ASSOCIATION
JAIL ASSISTANCE DIVISION

Revised June 2008
(

TABLE OF CONTENTS
FOREWORD
INTRODUCTION TO STANDARDS

ADMINISTRATION AND MANAGEMENT
Chapter
1.
2.
3.
4.
5.
6.

Administration
Fiscal Management
Personnel
Training
Staffing
Records

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Page
1-1
2-1
3-1
4-1
5-1
6-1

FACILITY PLANNING AND ARCHITECTURE
7.
8.

9.

Planning of New Facilities
Physical Plant
Design/Flow
Secnrity Conditions
Sanitary Conditions
Space Provisions /Reqnirements
Fire Safely

7-1
8-1
8-1
8-6
8-10
8-13
9-1

CLASSIFICATION SCREENING
10.
11.
12.
13.

Admissions, Orientation and Release
Classification
Trusties
Special Honsing

10-1
11-1
12-1
13-1

SERVICES, PROGRAMS AND ACTIVITIES
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.

Medical and Health Services
Sanitation and Hygiene
Inmate Commnnications
Legal Access
Food Service
Volunteers
Inmate Programs
Disciplinary Procedures
Grievance Procedures
Security, Supervision and Surveillance
Emergeucy Procedures

GLOSSARy
INDEX
JAIL STANDARUS 1~1·:VISION
FACILITY SELF-AlIUI1'

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15-1
16-1
17-1
18-1
19-1
20-1
21-1
22-1
23-1
24-1
A
B
C
D

Chapter Fourteen
Medical and Health Care
Principle: The sheriff and the facility administrator have the responsibility for obtaining medical
care for inmates in the facility. The kind and amount of medicai services provided will depend on
the number of "special" inmates the facility receives. In assessing this responsibility, many
courts have ordered sweeping provisions for medical and health care. Although these orders
differ in detail, the common elements are that reasonable care and adequate medical attention
be readily availabie to the inmate population.

Designation of Responsible Physician
14.01

The provision of medical services for the facility shall be the responsibility of a
designated medical doctor pursuant to a written agreement between the
governmental funding agency responsible for the facility, the sheriff, and the
responsible qualified medical authority.

Comment:
None

Designation of Receiving Medical Facility
14.02

The provision of medical services for the facility shall be the responsibility of a
designated medical doctor pursuant to a written agreement between the
governmental funding agency responsible for the facility, the sheriff, and the
responsible qualified medical authority.

Comment:
None

Licensing of Medical Personnel
14.03

,J

State licensors and/or certification requirements and restrictions shall apply to
health care personnel working in the facility, which are the same as those working
in the community.

Comment:
None

14-1

Prohibition Against Restrictions
14.04

The responsible physician shall have no restrictions imposed upon him I her by
the facility administration regarding the practice of medicine.

Comment:
None

Conformance to Security Regulations
14.05

Appropriate facility security regulations shall be followed by medical personnel.

Comment:
None

Operating Procedures
14.06

Written policy and procedures, approved by the responsible physician shall be
followed to include:
•
•
•
•
•
•
•

Sick cell
Receiving screening
Health appraisal data collection
Non-emergency medical services
Emergency medIcal and dental services
Management of inmates with transmittable, medically documented,
communicable diseases
Job descriptions for medical personnel

...........

_. __ .__ _-------_....:......_--'--------_. __ .~._------~~

Comment:
None

14-2

Delivery Plan
14.07

The facility shall provide 24-hour emergency medical and dental care, as outlined
in a plan approved by the responsible physician. This shall include arrangements
for:
•
•
•
•

Emergency evacuation of the inmate from the facility
Use of an emergency medical vehicle
Use of one or more designated hospital emergency rooms or other
appropriate health facilities
Emergency on-call physician and dental services when the
emergency facility is not located in a nearby community

Comment:
None

Preparation of Medical Records
14.08

There shall be a quarterly report prepared by the physician and/or his designee
for the physicians comments and approval on the health delivery system and the
health environment of the facility, and an annual statistical summary made.
These documents shall be submitted to the sheriff.

Comment:
None

Treatment by Other Individuals
14.09

Treatment by medical personnel other than the responsible physician shall be
performed pursuant to standing or direct orders from the physician.

Comment:
None

Provision of Treatment Space
14.10

If medical services are delivered in the facility, adequate equipment, supplies and
materials, as determined by the responsible physician, shall be provided for the
delivery of primary health care.

Comment:
None

14-3

Notification of Availability of Services

14.11

At the time of admission to the facility, inmates shall receive written/oral
orientation information on the procedures for gaining access to medical services.
Such information shall also be posted conspicuously within the facility.

Comment:
None

Medical Screening at Time of Booking

14.12

Receiving screening shall be performed by the booking officer or designee on all
inmates upon admission to the facility and before their placement in the general
population or housing area. The find ings shall be recorded on a printed screen ing
form approved by the responsible physician. The screening shall be reviewed by
medical personnel upon completion of inquiry into:
•
•
•
•

•

Current illnesses and health problems
Medications taken and special health requirements
Behavior observation, including state of consciousness and mental
status to include risk of suicide
Notation of body deformities, tattoos, trauma marking, bruises,
lesions. jaundice, ease of movement, condition of skin, including
rashes and infestations
Disposition/referral of· inmates to qualified medical personnel on an
emergency basis

._----~-

--------------------------------

Comment:
None

Completion of Health Appraisal

14.13

A health appraisal data collection shall be completed for each inmate who
remains in the detention facility for more than fourteen (14) days and shall include:
•
•
•

•
•

Review of the earlier receiving sCreening
Additional data to complete the medical and psychiatric history
Laboratory and diagnostic tests to detect communicable diseases,
including venereal diseases and tuberculosis as approved by the
facility physician
Height, weight, pulse, blood pressure and temperature
A standardized medical examination with appropriate comments
about medical and dental status

14-4

Further, qualified medical personnel may collect inmate health histories, vital
signs and other he.alth appraisal data. All health appraisal data shall be recorded
on the health data forms approved by the responsible physician. The responsible
physician or designated medical personnel shall review the results of the medical
examination, tests and problem identification.

Comment:
None

Method of Identifying Medical Complaints
14.14

Inmates medical complaints shall be collected daily and responded to by
medically trained personnel in a timely fashion.

Comment:
Inmates should not be used to collect complaints.

Sick Call
14.15

Sick call, conducted by a physician and/or other qualified medical personnel, shall
be available to each inmate as follows:
•
•
•

Small facilities of less than fifty (50) inmates shall hold sick call
once per week, at a minimum
Medium-sized facilities of fifty (50) to two-hundred (200) inmates
shall hold sick call at least three (3) times per week
Large-size facilities of over two-hundred (200) inmates shall hold
sick Gall a minimum of five (5) times per week.

Comment:
None

Medical Training for Facility Staff
14.16

Facility personnel shall be satisfactorily trained in emergency care procedures.
Such training shall incorporate the following steps:
•
•
•
•
•

Awareness of potential emergency situations
Notification or observation in determinillg that an emergency is in
progress
Transfer to the appropriate medical provider
ReGognition of systems of illness most common to the facility
Look at 14.21

14-5

Comment:
Policy shall be written to provide for proper monitoring referral and follow up on
inmates at risk for suicide.

First Aid Training and Preparation
14.17

All personnel shall have current training in basic first aid equivalent to that defined
by the American Red Cross. First a'id kits shall be available with the responsible
physician approving the number, content, location and procedure for periodic
inspection of the kit(s),

Comment:
None

Cardiopulmonary Resuscitation (CPR)
Training and Certification
14.18

At least one (1) person per shift shall have current training in receiving screening,
in recognition of symptoms of the conditions most common to the facility, and in
basic life support, cardiopulmonary resuscitation (CPR) certification,

Comment:
None

Provision of Prostheses
14.19

As determined by the responsible physician, medical and dental prostheses shall
be provided when the health of the inmate would otherwise be adversely affected,

Comment:
None

Provision of Dental Care
14.20

Dental care shall be provided to each inmate upon the commendation of the
responsible physician,

Comment:
None

14-6

Screening of Mentally Disordered Inmates
14.21

Screening, evaluation and referral for care shall be provided to mentally
disordered or retarded inmates whose adaptation to the detention environment is
significantly impaired.
The responsibie physician shall have designated in
advance specific referral sources.

Comment:
Go to 14.16. Staff should be trained to identify the signs of suicide risk in inmates.

Actions Regarding Mentally Disordered Inmates
14.22

Written policy and procedures shall require consultation between the facility
administrator and the responsible physician or designated mental health
professional prior to the following actions taken regarding inmates who reasonably
appear to be mentally disordered or retarded.
•
•
•
•

Housing assignments (see Chapter 11.07)
Program assignments
Disciplinary measures
Transfer in and out of institution

Comment:
None

Provision of Detoxification Services
14.23

When not provided in a community health facility, detoxification from alcohol,
opiates, barbiturates and other drugs shall be performed at the facility under close
supervision as approved by the responsible physician.

Comment:
None

14-7

Procedures for Use of Pharmaceuticals
14.24

The facility's policy and procedures, as approved by the responsible physician, for
the proper management of pharmaceuticals shall include:
•
•

•
•

•
•

A formulary
Policy regarding the prescription of all medications with particular
attention to behavior modifying medications and those subject to
abuse
Policy regarding medication dispensing and administration
Policy regarding the maximum security storage and weekly
inventory of all controlled substances, syringes, needles and
surgical instruments
Policy excluding the use of inmates to dispense medication
Policy that inmates shall not have access to medications

Comment:
None

Procedures for the Administration of Medication
14.25

The person administering medication shall receive training from the responsible
physician or appropriate facility. The facility administrator shall be accountable for
administering medications according to orders and shall record the administration
of medications in a manner and on a form approved by the responsible physician.

Comment:
None

Components of Medical Record File
14.26

The medical record file shall contain:
•
•
•
•
•

The completed receiving screening form
Health appraisal data collection form
A record of all findings, diagnosis, treatments, dispositions,
prescriptions and administration of medications
Notes concerning patient education and notations of place, date
and time of medical encounters
Discharge from medical treatment

The method of recording entries in the medical record, and the form and format of
the record shall be approved by the responsibie physician.

Comment:
None

14-8

Maintenance and Security of Medical I Mental Health Records
14.27

Access to the medical/mental health record shall be controlled by the responsible
physician. The physician-patient privilege applies to these records which shall not
be in any way a part of the confinement record. Summaries or copies of
summaries or copies of the medical/mental health record file shall be routinely
sent to the facility to which the inmate is transferred.

Comment:
Inmates shall be excluded from access to all medical/ mental health fiies.

Consent for Treatment
14.28

Informed written consent shall be obtained for all examinations, treatments and
procedures. In the case of minors, the informed written consent of parents,
guardian or legal custodian is necessary.

Comment:
None

Prohibition Against Medical
Experimentation
14.29

The conduct of medical or pharmaceutical testing or treating for experimental or
research purposes shall be prohibited.

Comment:
None

14-9