JULIE L. JONES
SECRETARY
PROCEDURE NUMBER: 401.011
PROCEDURE TITLE:
HEALTH SERVICES ADMINISTRATION
RESPONSIBLE AUTHORITY: OFFICE OF HEALTH SERVICES
EFFECTIVE DATE:
APRIL 15, 2015
INITIAL ISSUE DATE:
MAY 1, 2001
SUPERSEDES:
HSB 15.06.05
RELEVANT DC FORMS:
NONE
________________________________________________________________________________
ACA/CAC STANDARDS: 4-4361, 4-4380, 4-4381, 4-4384, 4-4382, 4-4383, 4-4348, 4-4408, 4ACRS-4C-18, AND 4-ACRS-4C-02
STATE/FEDERAL STATUTES: CHAPTERS 458 AND 459, AND SECTION 945.6034, F.S.
FLORIDA ADMINISTRATIVE CODE: CHAPTER 33-401 AND RULE 33-601.901, F.A.C.
Procedure 401.011
PURPOSE: To establish guidelines for the administration of health care delivery systems to
inmates under the custody or supervision of the Department.
DEFINITIONS:
(1) Chief Health Officer/Institutional Medical Director, where used herein, refers to the
designated health authority with which final clinical judgment rests on medical issues
concerning inmates at assigned institutions and any satellite facilities. The Chief Health
Officer/Institutional Medical Director is a Physician licensed in accordance with either chapter
458 or 459, F.S.
(2) Comprehensive Health Care Contractor (CHCC) refers to contracted staff that have been
designated by the Department to provide medical, dental, and mental health services at
designated institutions within a particular region.
(3) Health Care Practitioner, where used herein, refers to individuals with authority to order,
direct, or administer treatment including a Physician, Advanced Registered Nurse Practitioner
(ARNP), Physician Assistant (PA), Dentist, Optometrist, or licensed Psychologist; however, a
licensed Psychologist does not have prescriptive authority.
(4) Health Care Provider refers to a Dental Hygienist, Dental Assistant, Pharmacist, Registered
Nurse, Licensed Practical Nurse, Correctional Medical Technician-Certified, Unit Treatment
and Rehabilitation Specialist, Behavioral Specialist, Health Support Technician, Health
Support Worker, or other person involved in direct patient care.
(5) Health Services Administrator, where used herein, refers to the CHCC employee who is the
administrative and operational lead for the health services unit. This employee may be a Nurse
Manager, subject to approval by the Department.
(6) Health-trained Individual refers to Correctional Officers or other correctional personnel
trained and appropriately supervised to carry out specific duties with regard to the
administration of health care.
(7) Nurse Manager refers to the person designated by the CHCC who is in charge of nursing and
administration of the health services unit at smaller institutions that do not have complex
medical and/or mental health missions. The Department has final approval in determining
appropriate sites for the use of Nurse Managers.
(8) Protected Health Information refers to inmate or offender information that is created or
received by the Department of Corrections, whether oral, recorded, transmitted, or maintained
in any form or medium, that relates to the past, present, or future physical or mental health or
condition of an inmate or offender, the provision of health care to an inmate or offender, or the
past, present, or future payment for the provision of health care to an inmate or offender and
identifies an inmate or offender or there is a reasonable basis to believe the information can be
used to identify an inmate or offender. Protected health information is health information that
contains some or all of the following elements: name, address information, including the name
of an inmate’s institution and dorm, social security number, DC number, facial photograph, etc.
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Procedure 401.011
(9) Regional Director refers to the CHCC employee who is responsible for administrative
processes within the designated region.
(10) Regional Medical Director refers to the CHCC employee who is responsible for the delivery
of health services within the designated region.
________________________________________________________________________________
SPECIFIC PROCEDURES:
These standards and responsibilities apply to both Department staff and Comprehensive Health
Care Contractor (CHCC) staff.
(1) The CHCC shall designate a Health Services Administrator to provide oversight of daily
operations of the health services delivery system. The Health Services Administrator will be
responsible for ensuring that health care systems and processes at the institution support an
efficient and effective health care delivery system.
(2) Each institution that operates under the auspices of the Department and the CHCC will have a
designated Chief Health Officer/Institutional Medical Director.
(a) The CHCC shall designate an Institutional Medical Director who will serve as the health
authority and be responsible for the final medical judgment for all inmate patients within
the institutions to which s/he is assigned.
(b) The Chief Health Officer/Institutional Medical Director of the institution will also be the
health authority for that institution’s satellite sites, unless otherwise designated in section
(3) below.
(c) The position description or contract for the Chief Health Officer/Institutional Medical
Director will delineate clinical duties and responsibilities to include but not be limited to
the following:
1. development of systems and processes, including continuous quality review, and
quality management initiatives to deliver health care services; and
2. determination of staff resources, deployment and disciplines of health care providers
and practitioners with coordination of care through a multidisciplinary approach.
(3) The Chief Health Officer/Institutional Medical Director may designate a qualified health care
provider to act in her/his clinical behalf only when such delegation of authority does not violate
state laws or the Department’s rules.
(4) Security and other operations of the institution will not dictate practices that contradict or
otherwise compromise decisions that are in the sole province of a licensed clinician.
(5) Dental, medical, mental health, nursing, and pharmacy staff will make all health services
decisions for their discipline with consideration to the overall operations and security
provisions of the institution. Health services staff will advise and consult with the Warden and
other institutional security as necessary about any decisions that may have a significant and/or
adverse effect on security operations.
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Procedure 401.011
(6) The Health Services Administrator will meet at least quarterly with the Warden (or
designee[s]) concerning health care issues and needed corrective action. The Health Services
Administrator will ensure that the Warden receives any positive or negative reports about the
health care delivery system and health environment on a timely basis.
(7) QUALIFICATIONS:
(a) Each person who provides direct health care services to inmates will possess the
appropriate licensure, certification(s), or registration requirements.
(b) The Health Services Administrator will develop and/or maintain a records system for the
credentials in accordance with “Credentialing and Privileging Procedures,” HSB 15.09.05,
and job descriptions for each health care provider at the institution. The Health Services
Administrator will ensure that the credentialing files of health care providers are kept
current, confidential, and readily available.
(c) The Health Services Administrator will ensure that staff receives appropriate orientation
and training. The Health Services Administrator or will ensure contract providers receive
the training appropriate to their position. Employees and contracted providers will be
required to complete the Department’s new employee orientation program and health
services orientation.
(8) ADMINISTRATION OF TREATMENT:
(a) In accordance with state law, only health care practitioners may order, direct, or administer
treatment to inmate patients without direct or written orders.
1. All other health care personnel will perform their duties within the health care delivery
system in accordance with the lawful orders of the health care practitioners at the
institution.
2. No direct or written order by a health care practitioner will violate any directive
established by the Chief Health Officer/Institutional Medical Director at the
institution.
3. No institutional policy or directive by a health care practitioner will violate any
directive or policy established by the Assistant Secretary of Health Services.
(b) Nurse Practitioners and Physician Assistants may practice within the limits of applicable
state laws and rules, the Department’s rules, and the protocols established by the
supervising Physician.
(9) HEALTH EDUCATION: The Health Services Administrator will coordinate with the
Warden to ensure inmates have the opportunity to participate regularly in programs of health
education with topics specific to the needs of the inmate population at the institution.
(10) ALTERNATIVE HEALTH CARE DELIVERY:
(a) Whenever an institution does not have one (1) or more full-time health care providers, the
responsible Chief Health Officer/Institutional Medical Director will coordinate with the
Warden and the Health Services Administrator to establish a means to provide necessary
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Procedure 401.011
health services to inmates. The Warden or her/his designee will designate one (1) healthtrained individual on site to coordinate health services issues with the Chief Health
Officer/Institutional Medical Director.
(b) The Health Services Administrator will make arrangements in advance with the Warden
when:
1. services are not available on site to meet an inmate’s health care needs, and
2. the inmate must go to another Department of Corrections’ institution or in the
community to receive treatment from a health care specialist with appropriate and
necessary secure transportation.
(c) The Health Services Administrator will provide resources for emergency and routine care
and maintain a list of referral locations.
_/S/_______________________________
Chief of Staff
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