SOP_NUMBER: 208.01 TITLE: Management of Inmates Diagnosed Positive for the HIV Antibody REFERENCE_CODE: IIA06-0001 DIVISION: Facilities TOPIC_AREA: 208 Policy-Facilities Care/Medical Management EFFECTIVE_DATE: 2015-04-22 WORD_COUNT: 2417 POWERDMS_URL: https://public.powerdms.com/GADOC/documents/105687 URL: https://gps.press/sop-data/208.01/ SUMMARY: This policy establishes procedures for managing inmates with HIV, AIDS, or ARC diagnoses in Georgia Department of Corrections facilities. HIV-positive inmates are generally placed in general population, but may be assigned to separate housing if necessary for their welfare or the safety of others. The policy requires 90-day reassessment reviews for inmates in separated housing and mandates education and training for all staff and inmates on HIV prevention and infection control procedures. KEY_TOPICS: HIV management, AIDS, ARC, inmate housing, separate housing, segregation, HIV testing, infection control, blood and body fluid precautions, classification review, medical confidentiality, inmate population, sexually active inmates, assaultive behavior, general population placement ATTACHMENTS: 1. Re-Assignment Review Form - Separate Housing re HIV Antibody URL: https://gps.press/sop-data/208.01-att-1/ ======================================================================== FULL TEXT: ======================================================================== |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 ``` |Functional Area:
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`(208.01)`| ``` 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. ``` |Functional Area:
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`(208.01)`| ``` 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. ``` |Functional Area:
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`(208.01)`| ``` 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 ``` |Functional Area:
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`(208.01)`| ``` 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. ``` |Functional Area:
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`(208.01)`| ``` 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. ``` |Functional Area:
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`(208.01)`| ``` 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 ``` |Functional Area:
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`(208.01)`| ``` 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. ``` |Functional Area:
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`(208.01)`| ``` 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. ``` |Functional Area:
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`(208.01)`| ``` 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. ```