Section 3999.303 - Scheduling and Access to Care(a) The Department shall maintain an effective and efficient scheduling system to ensure timely patient access to health care services.(b) Access to health care services. (1) All California Department of Corrections and Rehabilitation (CDCR) incarcerated persons shall have access to medically necessary health care services 7 days per week, 24 hours per day. (A) Registered Nurses (RN) shall be onsite at the institution 7 days per week, 24 hours per day.(B) Each institution shall establish hours of operation for Primary Care Clinics.(2) At any time, patients with health care needs may submit a CDCR 7362, Health Care Services Request Form. Patients with urgent health care needs may complete a CDCR 7362 or notify any institutional staff, including correctional staff for assistance. Patients with life-threatening conditions shall receive immediate medical attention.(3) If a patient is unable to complete a CDCR 7362, health care staff shall complete the form on behalf of the patient.(4) Institutions shall ensure the CDCR 7362 is available to patients in the housing units, clinics, and Reception Centers. Housing unit staff and health care staff shall make the CDCR 7362 available upon request. Each institution shall have at least one locked box on each yard designated for patients to deposit the CDCR 7362.(5) Initial review and triage of a CDCR 7362 on normal business days.(A) Patients who submit CDCR 7362s that describe symptoms shall be seen by the Primary Care RN within one business day.(B) If the Primary Care RN determines a PCP referral is necessary, the patient shall be seen based on the following timeframes:1. Emergency: immediately.2. Urgent: within 24 hours.3. Routine: within 14 calendar days.(6) Initial review and triage of a CDCR 7362 on non-business days.(A) All CDCR 7362s shall be sent to the Triage and Treatment Area (TTA) RN for triage.(B) The TTA RN shall determine whether the patient requires emergency, urgent, or routine care and shall take direct action to coordinate care for patients with emergency or urgent conditions.(7) Patients with life-threatening medical symptoms shall receive immediate medical attention pursuant to section 3999.400.(8) Patients with urgent medical symptoms shall be scheduled for a same day face-to-face encounter with the Primary Care RN and other members of the care team as indicated by symptoms.(c) Scheduling. (1) Health care staff shall ensure that lists for scheduled appointments are communicated to custody staff no later than one business day prior to the scheduled encounter.(2) Custody staff shall ensure delivery of priority health care ducats to patients prior to their scheduled appointment.(3) Failure to report for a medical or dental appointment.(A) If the patient, including patients who are in the Mental Health Services Delivery System, fails to report to a scheduled medical or dental appointment, the assigned health care access clinic officer shall immediately contact the designated housing unit or work/program assignment to locate the patient and have the patient escorted or have the patient report to the scheduled medical or dental appointment.(B) Custody staff shall locate the patient and escort the patient to the appointment or direct the patient to report to the scheduled medical or dental appointment. 1. If the reason the patient did not report as ducated was due to the patient refusing to report as directed, custody staff shall escort the patient to the health care area. Licensed health care staff shall counsel the patient and have the patient sign the CDCR 7225, Refusal of Examination and/or Treatment, if the patient continues to refuse treatment after the counseling.2. Patients who are insistent in their refusal to report shall not be subject to cell extraction or use of force to gain compliance with the priority health care ducat. In these instances, licensed health care staff must respond to the patient's housing unit to provide the necessary patient education regarding the refusal. Custody staff cannot accept refusals on behalf of the patient, nor can refusals be taken over the phone.3. Custody staff shall be responsible to document the patient's refusal to report to the priority health care ducat on a CDC 115, Rules Violation Report.(4) If a patient in the Mental Health Services Delivery System refuses to report for a mental health appointment in person, custody staff shall not complete a CDC 115 or a Counseling Only Rules Violation Report.(5) When scheduling patients, health care staff shall consider patient preferences regarding access, such as providing appointment times that do not interfere with the patient's work shifts or classes.(6) Primary Care Clinics shall designate specific times each day as open access times for the care team.(7) An additional health care staff shall be present during all examinations of patients involving genital, rectal, or breast examinations.(A) Upon patient request, an additional health care staff shall be present during other examinations, if staff availability permits.(d) Security concerns and precautions. (1) Health care services shall continue to be provided during alarms/incidents not occurring on the clinic yard.(2) During a lockdown, health care staff shall coordinate with custody staff to facilitate continuity of care. Custody staff shall escort patients to scheduled clinic appointments; lockdown shall not prevent the completion of scheduled medical appointments.(3) In restricted housing units and housing units on lockdown status, a system shall be maintained to provide patient access to health care services. Access to health care services shall be accomplished via daily cell front rounds by health care staff for the collection of the CDCR 7362.(4) During health care encounters.(A) Health care encounters shall be provided in a manner that affords both auditory and visual confidentiality consistent with security and safety concerns of patients and health care providers.(B) Health care screenings, evaluations, interviews, and treatment shall be held in a private setting unless the security of the institution or safety of staff will be compromised, or unless health care staff in the presence of the patient requests the presence of custody staff. Custody staff is not required during a health care encounter with a patient who is not maximum custody or whose current behavior does not present a threat to the safety of staff or other patients.1. A patient shall not be placed in mechanical restraints during a health care encounter unless they are a safety concern for staff or others as determined by custody staff.(C) A treatment module shall be utilized for the duration of encounters with patients who are a safety and security risk. If it is necessary to perform a procedure, the patient shall be removed from the treatment module and placed in waist restraints while being treated outside the module.(D) When health care staff are in housing units or on the tiers, custody staff shall maintain visual surveillance.Cal. Code Regs. Tit. 15, § 3999.303
Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.
Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.
1. New section filed 7-1-2019 as an emergency; operative 7/1/2019 (Register 2019, No. 27). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 12-5-2019 as an emergency; operative 12/10/2019 (Register 2019, No. 49). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-9-2020 as an emergency; operative 3/10/2020 (Register 2020, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 3-9-2020 order, including amendment of subsection (c)(7)(A), transmitted to OAL 6-8-2020 and filed 7-20-2020; amendments operative 7/20/2020 pursuant to Government Code section 11343.4(b)(3) (Register 2020, No. 30).
5. Change without regulatory effect amending subsection (b)(1) filed 7-1-2024 pursuant to section 100, title 1, California Code of Regulations (Register 2024, No. 27).