Health Care Department Operations Manual

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Chapter 4 – Special Circumstances

Article 1 – Health Care

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4.1.5 Contraband Surveillance Watch

  • Policy

    • Incarcerated persons undergoing Contraband Surveillance Watch (CSW) pursuant to the California Department of Corrections and Rehabilitation (CDCR) Department Operations Manual, Section 52050.23, shall be provided appropriate clinical observation, assessment, and management.

  • Purpose

    • To ensure incarcerated person safety during CSW.

  • Applicability

    • This policy applies to CSW conducted within CDCR institutions.

  • Responsibility

    • The Chief Executive Officer (CEO), in collaboration with the Warden, is responsible for the implementation of this policy.

  • Procedure

    • Notification

      • When custody staff initiates CSW, custody staff shall escort the incarcerated person to the Triage and Treatment Area (TTA).

      • In order to ensure continuity of care, TTA staff shall notify the following, as applicable:

        • Primary Care Team

        • Mental Health

        • Dental

        • Medication Nurse

    • Initial Assessment

      • A CDCR 7219, Medical Report of Injury or Unusual Occurrence, shall be completed in the TTA by licensed health care staff and provided to custody staff for placement in the incarcerated person’s C-file.

      • A comprehensive nursing assessment shall be performed by a Registered Nurse (RN) and documented in the health record.

        • Patients with normal vital signs, no complaints, and no physical findings may be released to CSW housing.

        • All other patients shall be referred to a provider for further assessment and orders.

      • The provider shall determine any health care risks or special accommodations, including possible placement in a medical bed, needed for CSW.

      • All patients placed on CSW shall be provided written and verbal information informing them of the risks of ingesting and/or inserting contraband as well as recommendations for elimination of such item(s).

      • A diagnostic study (e.g., x-ray) may be performed when medically necessary only by order of a provider.

        • The presence or absence of a foreign body on an x-ray shall be shared with custody staff.  To the extent that it can be determined, the nature of the foreign body shall be shared with custody staff.

        • When a contraband evaluation is indicated after hours or on a weekend, the on-call provider must evaluate the patient and review the x-ray and document history, indications, examination, and findings.

        • A patient may refuse a medical test (e.g., x-ray for contraband) when ordered or recommended by a provider (in the absence of a court order for the test).  Documentation of the refusal will be obtained and filed in the health record.

        • Upon refusal of the provider ordered/recommended diagnostic study, custody staff may seek a court order to compel the incarcerated person to submit to the diagnostic study.

        • When obtained, a copy of the court order to compel the incarcerated person to comply with the diagnostic study must be provided to medical staff.  A copy of the court order will be placed in the health record.

    • Monitoring

      • During the course of the CSW, if custody staff observes a decline in the incarcerated person’s health, or believes that the incarcerated person’s health is affected by the concealed contraband, medical personnel shall be immediately contacted to reassess the incarcerated person’s condition.

      • A CDCR 7362, Request for Health Care Services, shall be provided upon the incarcerated person’s request as designated by policy.

      • For the duration of the CSW, cell front observation shall be performed on second watch by nursing staff daily.  In CSW housing areas where there is a clinic or exam room (e.g., Receiving and Release, Administrative Segregation), a nursing assessment shall be performed by an RN in the clinic/exam room on second watch every three calendar days subsequent to the initial assessment.

        • In CSW housing areas without a clinic or exam room, vital signs shall be taken in the CSW housing area.  All clinical information shall be documented in the health record. 

        • Patients with physical complaints or abnormal physical findings during the RN assessment shall be referred to a provider for further evaluation and orders.

      • If a provider determines evaluation is required more frequently than once per day, the patient shall be placed in a medical bed.

      • The CEO and Chief Nurse Executive or their respective designee shall be notified by custody when an incarcerated person is retained on CSW for a second three calendar day period.

      • The institutional CEO, or designee, shall initially notify the Deputy Director, Medical Services, or designee, when an incarcerated person is retained on CSW beyond six calendar days and every three calendar days thereafter until the CSW ends.

  • Resources

  • References

    • California Probate Code, Division 4, Part 7, Sections 3200-3212, Capacity Determinations and Health Care Decisions for Adult Without Conservator

    • California Code of Regulations, Title 15, Division 3, Chapter 2, Subchapter 2, Article 2, Section 3999.210, Refusal of Treatment

    • California Code of Regulations, Title 15, Division 3, Chapter 2, Subchapter 2, Article 1, Section 3999.203, Capacity for Informed Consent

    • California Code of Regulations, Title 22, Division 5, Chapter 3, Article 5, Section 72527, Patient’s Rights

    • California Code of Regulations, Title 22, Division 5, Chapter 3, Article 5, Chapter 72528, Informed Consent Requirements

    • California Code of Regulations, Title 22, Division 5, Chapter 12, Article 5, Section 79799, Inmate-Patients’ Rights

    • California Department of Corrections and Rehabilitation, Department Operations Manual, Chapter 5, Article 19, Section 52050.23 Contraband Surveillance Watch

    • California Department of Corrections and Rehabilitation, Mental Health Services Delivery System Program Guide, Chapter 5, Mental Health Crisis Bed, Section H, Clinical Restraint and Seclusion

    • Health Care Department Operations Manual, Chapter 3, Article 1, Section 3.1.5, Scheduling and Access to Care

  • Revision History

    • Effective: 06/2014
      Revised: 03/2015