Health Care Department Operations Manual

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Chapter 3 – Health Care Operations

Article 3.2 – Dental Care: Scope of Services

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3.3.2.2 Dental Care – Reception Center

  • Policy

    • All California Department of Corrections and Rehabilitation (CDCR), Reception Center (RC) patients who qualify, as defined in Sections (c)(1)(A) and (B) below, shall receive a dental screening by a dentist as part of the RC classification process.  A dentist shall assign a Dental Priority Classification (DPC) and identify urgent dental needs.  Timely treatment of Emergency and/or DPC 1 dental conditions shall be provided.

  • Purpose

    • To provide patients with continuity of health care and to identify and provide timely treatment for those patients with Emergency and/or DPC 1 dental conditions.

  • Procedure

    • Dental Screening in Reception Centers

      • Within 60 calendar days of a patient’s arrival at an RC:

        • A dentist shall perform a dental screening on each newly arriving patient, including new commitments and parole violators.

        • The patient shall receive education on oral hygiene which is included in the Patient Orientation to Health Care Services Handbook.

      • Patients who received a dental screening at an RC or a comprehensive dental examination at a Mainline Facility within the past six months need not receive a new RC dental screening except as determined by the attending dentist.  This includes patients who have paroled and are rearrested as well as those who transfer from one RC to another.

        • When, in the professional judgment of a CDCR dentist, a patient does not need to receive a new RC dental screening, the patient shall retain the most recently assigned DPC.

        • The dentist shall document the patient’s DPC in a clinical note in the Electronic Dental Record System (EDRS), in accordance with EDRS Workflow 1-2 and associated Back Office Job Aid. The dentist shall select the “Skip DPC” option when signing the clinical note in accordance with EDRS Workflow 1-1.1 / 1-1.2 and associated Back Office Job Aid.

        • Patients who do not receive an RC dental screening according to the process described above do not need to complete and sign a CDCR 7423, Notification of Reception Center Dental Screening.

      • Dental screenings shall be documented on the EDRS odontogram, in accordance with EDRS Workflow 1-1.1/1-1.2 and associated Back Office Job Aid, and shall include, but not be limited to:

        • A panoramic radiograph unless one has been taken by CDCR within the past 12 months.

        • A screening of the head and neck as well as the hard and soft tissues of the oral cavity with a mouth mirror and adequate illumination, which includes at least:

          • A cancer screening.

          • Charting of a patient’s existing DPC 1 conditions (e.g., dental decay or other oral pathology) then treatment planning and assigning a DPC code to the most urgent condition, or multiple conditions of equal urgency, that the dentist determines are the most urgent, in accordance with EDRS Workflow 1-3 and associated Back Office Job Aid.

        • Documenting in a clinical note in the EDRS the presence of prosthetic appliance(s) (Reference the Health Care Department Operations Manual [HCDOM], Section 3.3.6.4(c)(1)(B), Dental Chronos, for requirements concerning documenting a prosthetic appliance).

      • The dentist performing the RC screening shall:

        • Review the screening findings with the patient and advise them of any Emergency and/or DPC 1 conditions.

        • Inform the patient of any DPC 2, 3, or 5 dental needs and provide them with a CDCR 7423 to complete and sign if they could benefit from dental care.

        • Document in a clinical note in the EDRS:

          • Any radiograph(s) taken during the RC dental screening.

          • That an RC dental screening was completed and the results reviewed with the patient who was then advised of, as well as offered treatment for, any Emergency and/or DPC 1 conditions.

          • Abnormal conditions noted from the head and neck screening and any required follow-up.

          • Whether the patient elected to receive or refused treatment of any existing Emergency and/or DPC 1 conditions. (Reference the HCDOM, Section 3.3.5.6, Patient’s Right to Refuse Treatment, for requirements concerning a refusal).

          • The purpose of the next encounter if one is scheduled or needs to be scheduled.

          • A brief entry indicating that the process described in Section (c)(1)(D)2 was followed if the patient has DPC 2, 3, or 5 dental needs.

        • Follow the procedure outlined in the HCDOM, Section 3.3.5.2(c)(3)(A) if the patient requires and has requested treatment of any Emergency and/or DPC 1 conditions.

        • Follow the procedure outlined in the HCDOM, Section 3.3.5.2(c)(3)(B) if the patient does not wish to receive treatment of their Emergency and/or DPC 1 conditions.

        • Indicate the patient’s DPC upon signing the EDRS clinical note, in accordance with EDRS Workflow 1-1.1/1-1.2 and associated Back Office Job Aid.

        • Set the EDRS RC dental screening procedure code to completed status in the Appointment Book.

        • Ensure the RC dental screening treatment request is set to completed status in the EDRS, and the corresponding Electronic Health Record System (EHRS) RC dental screening order is set to completed status.

      • Dental staff shall:

        • Only perform screening duties within their scope of licensure.

        • Follow the procedure outlined in the HCDOM, Section 3.3.2.3(c)(3) if the patient refuses the:

          • RC screening.

          • Panoramic radiograph.

        • Follow the procedure outlined in the HCDOM, Section 3.3.6.1(c)(2)(B) regarding scanning forms into the EDRS Document Center.

        • Monitor the EDRS QM Reception Center Length of Stay Report to ensure RC dental screenings are performed timely and the EHRS RC dental screening order is completed. The Health Program Manager III or designee at each institution shall be responsible for tracking RC dental screenings.

      • The Office Technician (OT) or designated dental staff shall schedule an encounter for patients that qualified for but did not have a panoramic radiograph taken for any reason other than a “Refusal.”  Efforts shall be made to schedule the encounter within ten business days of discovering that the patient did not have a panoramic radiograph taken.

    • Dental Treatment in RCs

      • Dental treatment provided to RC patients shall be limited to the treatment of Emergency and DPC 1 dental conditions.

      • RC patients shall initiate access to dental services as outlined in the HCDOM, Sections 3.3.5.2(c)(3)(A); 3.3.5.13(c)(4)(A); and 3.3.5.13(d)(1)(C) and (D).

      • At the end of every treatment encounter for an RC patient, the dentist shall offer them a subsequent treatment encounter unless the patient’s DPC changes to a DPC 2, 3 or 4. (The procedure outlined in the HCDOM, Section 3.3.5.2(c)(2)(B) does not apply to most RC patients).

      • Patients who remain on RC status at an RC for 90 calendar days or longer may be eligible to receive DPC 2 care (excluding prosthetics) on a case by case basis.

      • Patients remaining on RC status at an RC for 180 calendar days or longer shall be notified within ten business days after completion of the 180 calendar days that they are eligible to receive an initial comprehensive dental examination performed by a dentist. (Reference the HCDOM, Section 3.3.2.3(c)(1)).

  • References

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.2.3, Comprehensive Dental Examinations

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.5.2, Recording and Scheduling Dental Encounters

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.5.6, Patient’s Right to Refuse Treatment

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.5.13, Access to Care

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.6.1, Health Records Organization and Maintenance

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.6.4, Dental Chronos

    • California Correctional Health Care Services, Patient Orientation to Health Care Services Handbook

  • Revision History

    • Effective: 04/2006
      Revised: 11/2017, 10/2020, 08/2021, 02/2022