Health Care Department Operations Manual

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Chapter 3 – Health Care Operations

Article 8 – Public Health

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3.8.5 Coccidioidomycosis Waiver

  • Policy

    • Patients who are medically restricted from the Coccidioidomycosis (Cocci) 2 area, who are not medical high risk and do not have a negative cocci skin test are permitted to waive the medical restriction from residence in the Cocci 2 area.  Patients meeting these criteria may waive their medical restriction at any time and may do so regardless of their current housing location.  Prior to waiving their medical restriction, patients must be fully informed of the morbidity and mortality risks of waiving the medical restriction.

      • Patients may rescind the waiver of the medical restriction at any time.  Within 60 business days of rescinding of the waiver, patients with waivers who reside in the Cocci 2 area shall be transferred out of the Cocci 2 area.

      • Invalid Waivers of Medical Restriction from the Cocci 2 area

        • Waivers for medical restrictions from the Cocci 2 area shall become invalid when a patient:

          • Has a negative cocci skin test.

          • Becomes medical high risk (e.g., when a patient turns 65 years of age).

          • Has changes in their medical condition resulting in a change to their Cocci status.

    • Patients with an invalid waiver shall be transferred out of the Cocci 2 area within 60 business days.

    • Patients with a history of cocci are not restricted from residing in the Cocci 2 area and thus do not need to sign waivers to reside in the Cocci 2 area.

  • Purpose

    • To formalize a process that permits certain patients with medical restrictions for the Cocci 2 area to waive the medical restrictions and permit these patients to reside in Cocci 2 institutions despite the medical restriction in the medical classification system.  This policy stipulates that those who test negative and those with high risk medical conditions may not waive their medical restriction and cannot reside in an institution in the Cocci 2 area.

  • Responsibility

    • The Chief Executive Officer, or designee, is responsible for developing a local operating procedure to ensure the policy and procedure are followed.

  • Procedure Overview

    • The procedure outlines a process for patients who are medically restricted from the Cocci 2 area, who are not medical high risk, and do not have a negative cocci skin test to waive the medical restriction from residence in a Cocci 2 area. Patients may rescind the waiver of the medical restriction at any time.

  • Procedure

    • Waiving of the Medical Restriction from the Cocci 2 Area

      • Patients requesting a waiver of the medical restriction shall be scheduled for an evaluation by a health care provider.

      • At the encounter, patient education and information regarding the health care risks of waiving the medical restriction, including the risk of morbidity and mortality from cocci exposure, shall be discussed.

      • If the patient still wishes to waive the medical restriction at the conclusion of the encounter, the provider shall complete the following:

        • Progress Notes, documenting the chrono discussion,

        • CDC 7225, Refusal of Examination and/or Treatment.

        • CDCR 128-C ASP and PVSP, Coccidioidomycosis Waiver.

      • One copy of the waiver shall be forwarded to the Classification and Parole Representative for inclusion in the patient’s central file; a second copy shall be scanned into the health record; and a third copy shall be provided to the patient.

    • Rescinding of the Waiver Of Medical Restriction from the Cocci 2 Area

      • The staff member shall make contact with the assigned counselor or the counselor’s supervisor within three business days informing them of the patient’s request.

      • The staff member shall document the patient’s request, date and time of the request, and the name of the counselor informed of the request on a CDC 128-B, General Chrono.

      • Patients must be transferred to an appropriate intermediate institution within 60 business days from the date the patient rescinds the waiver; therefore, case work, Unit or Institution Classification Committee appearances, and transfers must be accomplished within that timeframe.

  • Resource:

  • References

    • Plata v. Newsom, Order Granting Plaintiffs’ Motion for Relief Re: Valley Fever at Pleasant Valley and Avenal State Prisons, June 24, 2013

    • Health Care Department Operations Manual, Chapter 1, Article 2, Section 1.2.14, Medical Classification System

  • Revision History

    • Effective: 01/2016
      Revised: 05/2019