SOP 208.01: Management of Inmates Diagnosed Positive for the HIV Antibody

|GEORGIA DEPARTMENT OF CORRECTIONS
Standard Operating Procedures|Col2|Col3|
|---|---|---|
|`Functional Area: `
`FACILITIES OPERATIONS`|`Reference Number: `
`IIA06-0001`|`Revises`
`Previous`
`Effective Date:`
`01/01/05`|
|`Subject:`
`MANAGEMENT OF INMATES`
`DIAGNOSED POSITIVE FOR THE`
`HIV ANTIBODY`|||
|`Authority:`
`Bryson/Jacobs`|`Effective Date:`
`04/22/15`|`Page 1 of`
9 |

I. POLICY:

   The policies of the Georgia Department of Corrections
   regarding the HIV+, ARC, and the AIDS inmate population are as
   follows:

   A. Testing and Assignment: Inmates will be tested for the
      HIV antibody in accordance with OCGA 42-5-52-1. All
      testing will be done in accordance with GDC approved
      Health Services plans.

      1. Inmates who test positive for the HIV antibody as
         normal procedure will be placed in general
         population assuming responsibilities and
         participation in the total operation of the
         facility/center.

      2. If case review indicates that separated housing is
         necessary for the welfare of the inmate or other
         inmates in population, transfer to another
         appropriate facility/center will be initiated.

      3. An inmate diagnosed with HIV infection who while
         living in general population or separate housing is
         sexually active, predatory, or assaultive shall be
         segregated from the general population until
         released through existing administrative segregation
         procedure of the Georgia Department of Corrections.

   B. Criteria for Re-assignment.

      1. Review Procedure. Every 90 days the
         facility's/center's Classification Committee shall
         conduct a review of each inmate in separated
         housing. This review will document the inmate's

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   adjustment and assess his/her participation in high
   risk or assaultive behavior. The results of this
   review will be documented on a standard form (see
   Attachment 1, Re-assignment Review Form) and
   forwarded to the Central Office with a copy given to
   the inmate. The inmate may submit in writing to the
   Warden/Superintendent within 24 hours at the time of
   such review, reasons he/she disagrees with the
   Committee's findings. Every 180 days the Central
   Office shall screen all the facility reviews to make
   recommendations on which inmates may be returned to
   general population.

2. Re-Assignment. When the facility's/center's
   Classification Committee conducts the 90-day review,
   it will recommend whether the inmate should continue
   in "separated housing" or be returned to general
   population. A recommendation for a return to general
   population would be honored if:

   a. There has been no evidence of sexual activity
      or seriously assaultive behavior.

   b. There is no evidence that a return to general
      population would put the individual at risk.

3. Inmate will be returned to general population after
   one review period if so recommended on the
   reassignment review form.

4. Classification Central Office will notify facilities
   of approval/disapproval for general population.

5. Inmates who are placed in separation housing units
   will have access to programs and services.

6. It is the policy of GDC to maintain the
   confidentiality of inmate medical record
   information. Such information will be released to
   parties outside the agency according to established
   medical practices. Information will be released to
   Departmental personnel, as is necessary for them to
   perform their official duties.

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II. APPLICABILITY:

   All state/county facilities and Transitional Centers housing
   GDC inmates.

III. RELATED DIRECTIVES:

   A. OCGA 42-5-52-.1

   B. GDC Rule 125-2-1-.01(e)

   C. GDC SOP IIB09-0001

   D. Clinical Update No. 86.07 (HTVL-III Testing), Clinical
      Update No. 87.04 (Guidelines for HIV Testing), Management
      Protocol for Diagnosis and Treatment of inmates Suspected
      of or Identified with Acquired Immune Deficiency
      Syndrome(August 1, 1985).

IV. DEFINITIONS:

   A. Separate Housing Unit: Living unit or subdivision of a
      living unit housing inmates of the same category such
      that the occupants are not mixed with the general
      population.

   B. HIV Positive (HIV+): For the purpose of this procedure,
      HIV+ will refer to any inmate having tested positive for
      the HIV antibody (includes AIDS, ARC, and HIV+) or those
      diagnosed as having AIDS or ARC by other clinical
      diagnostic procedures.

V. ATTACHMENTS:

   Attachment #1: Re-Assignment Review Form - Separate Housing

VI. PROCEDURE:

   A. Procedures to implement the Departmental procedures are
      grouped under four major categories; education and
      training, testing and infection control, housing and
      program access, and security concerns.

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   Education and Training: All employees and inmates will
   receive appropriate education about the nature of the
   disease and will be trained in methods to prevent the
   spread of infection.

   1. All facility/center staff will receive an AIDS
      orientation program during their basic training
      period or at their home facility/center. Employees
      working in close contact with the HIV+ inmate
      population will receive special training in
      appropriate methods to prevent exposure to
      infection. Such training will be that appropriate
      for the job responsibilities of the individual
      employee.

   2. All inmates will receive an AIDS orientation program
      during their initial in-processing period and at
      their permanent facility/center.

   3. The content of all instructional programs for staff
      or inmates will be reviewed by appropriate medical
      personnel to insure the accuracy of clinical
      information being presented.

   4. All facilities/centers will be expected to provide
      instruction for staff and inmates that will meet
      that facility's particular needs and circumstances.
      Such instruction will use or be consistent with
      Departmentally approved programs and lesson plans.

   5. All training delivered to staff and inmates will be
      documented in employee training records and inmate
      administrative files.

B. Testing and Infection Control: Each facility/center will
   refer to published medical protocols to insure that
   established testing and infection control guidelines are
   implemented. The following administrative procedures are
   established:

   1. Blood and body fluid precautions will be followed in
      all areas. Common procedures shall be in place at
      each facility/center to guide staff and inmates when
      cleaning up after an accident or injury and for

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cleaning areas potentially contaminated with blood
or other body fluids. Procedures will include:

a. Wear gloves.

b. Cleaning up blood and body fluid spills on
   environmental surfaces soon after the spill
   with a disposable towel and freshly prepared
   household bleach and water solution (one part
   household bleach to nine parts water) or other
   disinfectant.

c. Placing blood or body fluid soaked items that
   are disposable in a sturdy plastic bag (red);
   sealing and marking the bag with "blood and
   body fluid precautions". Persons disposing of
   the plastic bag should wear gloves.

d. Persons cleaning up spills or handling
   contaminated items should wash their hands
   after such activities even if they have been
   wearing gloves.

e. Clothes and linens contaminated with body
   fluids should be placed in a water-soluble bag
   then in a plastic bag and laundered separately.
   Persons handling contaminated clothing should
   wear gloves.

f. Persons whose clothes have been contaminated
   with body fluids from another person should be
   provided with a change of clothes and an
   opportunity to bathe as soon as possible.

g. Any person that has had a significant exposure
   (splashing of a body fluid into the eyes, mouth
   or an open lesion; puncture with an item
   contaminated with the body fluid into the eyes,
   mouth and/or open lesion; puncture with an item
   contaminated with the body fluid; or bite)
   should consult with the health services staff
   concerning the exposure and follow-up
   recommendations.

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   2. Inmates will be tested for the HIV antibody in
      accordance with and O.C.G.A. 42-5-52-.1 in
      accordance with the GDC approved Health Services
      Plan.

   3. Inmates will remain in separated housing until they
      meet criteria for re-assignment to general
      population, are released or until their medical
      condition requires re-assignment to a hospital unit

C. Housing and Program Access for Inmates in Separate
   Housing: It is the goal of GDC that HIV+ inmates have
   access to programs and services.

   1. Counseling: In facilities/centers housing HIV+
      inmates in general population all members of the
      facility's/center's counseling staff will be trained
      to deliver supportive and adjustment counseling to
      HIV+ inmates. They will also insure that the inmates
      understand the nature of their condition and the
      regulations of their housing unit. They will also
      make appropriate referrals to other facility/center
      services as necessary and insure identification of
      HIV+ inmates remains confidential.

   2. Education: HIV+ inmates will have access to current
      educational programs under appropriate supervision.

   3. Recreation: Recreation will be provided to HIV+
      inmates in the same manner provided to general
      population with appropriate supervision.

   4. Chaplaincy: HIV+ inmates will be provided chaplaincy
      services consistent with those provided to general
      population.

   5. Work Assignments: Inmates who are HIV+, but have no
      other medically limiting profile, may be assigned to
      work details where appropriate supervision is
      provided.

   6. Sick Call: All routine sick call procedures will be
      followed for the HIV+ inmates with appropriate
      supervision provided.

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   7. Access to the store will be provided to the HIV+
      inmate population with appropriate supervision being
      provided.

   8. Food Service: HIV+ inmates will eat in the facility
      dining room. No special utensils need be provided
      for this group so long as dishwashing procedures are
      followed and appropriate washing temperatures are
      maintained.

   9. Laundry: Normally soiled laundry will be handled
      according to routine facility procedures. Laundry
      that has been soiled by blood or body fluid will be
      laundered according to instructions provided in
      Attachment 1 of this procedure.

   10. Visiting: HIV+ inmates will be allowed normal
      visiting privileges. Their visits will be
      supervised.

   11. Library: HIV+ inmates will have access to library
      services consistent with that provided to general
      population with appropriate supervision provided.

   12. Volunteers: If volunteers are used in close contact
      with the HIV+ population, they will receive the
      basic AIDS orientation training provided to GDC
      employees. Delivery of that training will be
      documented.

D. Security Procedures: Management of HIV+ inmates will
   require only limited additional security precautions.

   1. When inmates leave the separated unit for group or
      individual activities, appropriate supervision will
      be provided.

   2. Each facility/center will be issued an allocation of
      special protective equipment and supplies. At a
      minimum, each facility having a segregation unit
      will be issued three (3) sets of equipment.
      Additional sets may be authorized by specific
      approval of the Division Director, Facilities
      Operations. Such equipment will be used with the

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HIV+ population only when there is a known or
expected threat of violence from a specific inmate.
The authorized list of equipment and supplies is as
follows:

a. Security Equipment and Supplies.

   1) Nitrile Coated Glove and Safety Arm Guard:
      For use of force situations. Both items
      have stainless steel cores. The glove has
      a slip-resistant surface

   2) Maxfit Eye Protectors: Worn for use of
      force situations and when working in the
      vicinity of inmates known to throw body
      fluids.

   3) Riot Shields: To control inmates in a
      confrontation situation.

b. Special Supplies.

   1) CPR Microshield: For mouth to mouth
      resuscitation. The item is used once and
      discarded. It contains a one-way valve to
      prevent the passage of body fluids.

   2) Grease Resistant Gloves: Heavy gauge
      gloves used by maintenance personnel
      working around sewerage disposal lines.

   3) Coverall, Poly-Tyvek: Disposable, non      absorbent coverall used when cleaning
      blood or body fluid spills. Also used when
      there is blood or body fluid on an inmate
      that must be handled or when handling an
      inmate known to throw body fluids.

   4) Gloves, vinyl: This is a dishwashing glove
      available through normal retail outlets
      used by officers for cell and body
      searches.

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      5) Sanitizing Mixture: A mixture of 9 parts
         water and l part bleach, used as a
         disinfectant fluid. To be placed in spray
         bottles in the housing unit and search
         areas to disinfect gloves, equipment, and
         working surfaces. Must be mixed daily to
         be effective.

      6) Hibiclens, Antiseptic: Used for
         handwashing and placed in control
         stations.

      7) Vinyl Shoe Protectors: To be worn with
         disposable coveralls.

      8) Trash Can Liners (Red): For any
         contaminated clothing or linen items that
         are to be burned.

      9) Pocket Mirrors: For use in cell searches.

3. Disciplinary Procedures: All routine disciplinary
   procedures will be followed. In addition, aggressive
   measures will be taken to suppress sexual activity,
   predatory behavior, I.V. Drug use, tattooing, and
   other high-risk behavior through use of GDC
   disciplinary sanctions and/ or prosecution in local
   courts where appropriate. The facility/center
   classification committee will review each HIV+
   inmate and determine through Central Office
   Classification whether the inmate is sexually
   active, whether he is reasonably believed to be a
   predator, or has prior incarceration for sexually
   predatory acts, or if any other conditions or
   circumstances exist where separation would be in the
   best interest of GDC and the inmate population.

4. Transfers: When transporting HIV+ inmate’s
   appropriate precautions shall be taken. Any
   receiving officer or facility/center shall be
   notified of any special precautions.

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      5. Crime Scenes: Crime scenes involving blood or body
         fluids must be preserved. The area of the spill will
         be sealed and protected until clearance is given to
         clean it. When the facility/center reports such an
         incident, it will be specifically noted that a crime
         scene involving blood or body fluids is being
         preserved to insure a priority response from
         Internal Affairs and other Central Office Units

      6. Exposure Incidents: Should a staff member or inmate
         be involved in an incident where exposure to HIV+
         virus is suspected, appropriate first aid will be
         administered; preferably by medical personnel. The
         individual will then receive appropriate follow-up
         consultation by facility/center medical staff. The
         HIV antibody test will be offered to the Staff
         member or inmate upon his/her request. Staff members
         will be referred to the nearest Critical Incident
         Debriefing Team for consultation and support. A
         complete incident report will be forwarded through
         established channels.

      7. Development of local procedures. Each facility may
         develop local procedures as necessary to implement
         each component of this GDC-SOP.

VII. RETENTION SCHEDULE:

      ATTACHMENT 1 - Once completed, the attachment to this SOP
      becomes part of the Inmate Case History File and is
      governed by the official records retention schedule of
      that file.