SOP_NUMBER: 220.09-att-1 TITLE: Statewide Classification Committee (SCC) Referral Form DIVISION: Facilities TOPIC_AREA: 220 Policy-Facilities Diagnostics/Classification EFFECTIVE_DATE: 2019-07-26 WORD_COUNT: 555 POWERDMS_URL: https://public.powerdms.com/GADOC/documents/461176 URL: https://gps.press/sop-data/220.09-att-1/ SUMMARY: This form is used by the Georgia Department of Corrections to collect and document information about offenders being reviewed by the Statewide Classification Committee, with particular focus on gender identity, transgender status, intersex conditions, and housing preferences. The form captures information from facility classification committees, includes a structured interview with the offender, and provides sections for recommendations from PREA coordinators, medical directors, mental health directors, and facilities leadership regarding appropriate facility placement. All completed forms become permanent parts of the offender's institutional file. KEY_TOPICS: Statewide Classification Committee, SCC referral, gender identity, transgender offenders, intersex status, facility housing placement, PREA risk screening, offender classification, gender-affirmed housing, safety assessment, disciplinary history, pronoun preference, sexual orientation, facility type preference ATTACHMENTS: 1. Statewide Classification Committee (SCC) Referral Form URL: https://gps.press/sop-data/220.09-att-1/ 2. PREA Standards and Information Related to Transgender/Intersex Offenders URL: https://gps.press/sop-data/220.09-att-2/ ======================================================================== FULL TEXT: ======================================================================== SOP 220.09 Attachment 1 7/26/19 Page 1 of 3 **Statewide Classification Committee (SCC) Referral Form** **FACILITY CLASSIFICATION COMMITTEE:** **Offender Name:** **GDC#** **Date of Birth:** **Height** **Weight:** **Intersex :** `☐` **Yes** `☐` **No** **If, yes what gender does the offender identify as?** `☐` **Male** `☐` **Female** **Gender:** `☐` **Transgender Female:** Biologically male; identifies as female `☐` **Transgender Male:** Biologically female; identifies as male **What pronoun does the offender prefer to be called?** `☐` **Female Pronouns** `☐` **Male Pronouns** **What facility-type does the offender prefer? (Explain)** `☐` **Female Facility** `☐` **Male Facility** **Medical Profiles:** **Does the offender receive hormone treatments?** `☐` **Yes** `☐` **No** **PREA Risk Screening Result:** `☐` **Victim** `☐` **Aggressor** `☐` **BOTH, Victim AND Aggressor** **Has the offender ever been convicted of a sex offense?** `☐` **Yes (explain)** `☐` **No** **Does the offender have a disciplinary history of a sexual nature?** `☐` **Yes (explain)** `☐` **No** **Has the offender ever been convicted of a violent offense?** `☐` **YES (explain)** `☐` **No** **Does the offender have a disciplinary history of assaultive behavior?** `☐` **Yes (explain)** `☐` **No** **Would you recommend this offender to be placed/remain in the offender’s preferred facility type? (Explain)** `☐` **Yes** `☐` **No** **Classification Chairperson (Print Name)** **Chairperson’s Signature** **Date** **Warden’s Recommendation/Comments:** **Warden’s Signature** **Date** Retention Schedule: Upon completion, this form shall become a permanent part of the offender’s institutional file. SOP 220.09 Attachment 1 7/26/19 Page 2 of 3 **SCC INTERVIEW WITH OFFENDER:** a. _Are you transgender (is your gender identity, how you feel inside, different from your assigned sex at birth)?_ - Yes - No - Declined to answer b. _Are you intersex? (have you been told by a doctor that you have an intersex medical condition?)_ - Yes - No - Declined to answer [NOTE: **If the inmate in custody answers “YES” to Question a. or b** ., ask the following:] _1._ _What is your gender pronoun?_ - He/him/his - She/her/hers _2._ _What is your sexual orientation (Who are you sexually attracted to)?_ - Males - Females - Both - Declined to answer _3._ _Would you feel safer being housed in a male or female facility? (Say: we cannot guarantee your choice will be available to_ _you, but we use your choice as a factor in determining where you will be housed.)_ - Male facility □ Female facility - No preference 4. _Do you prefer underwear and hygiene products for women or men? Do you need a bra?_ - Male underwear/hygiene items □ Female underwear/hygiene items - Needs bra 5. _Do you have any concerns for your safety we should know before we decide where to house you?_ - Yes: (explain) ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ - No **Interviewer’s Comments:** ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ _______________________________________ ________________________ Staff Signature Date _______________________________________ _________________________ Inmate Signature Date Retention Schedule: Upon completion, this form shall become a permanent part of the offender’s institutional file. SOP 220.09 Attachment 1 7/26/19 Page 3 of 3 **SCC HOUSING RECOMMENDATIONS:** **PREA Coordinator:** `☐` **Remain in Current Facility Type** `☐` **Transfer to facility based on gender identity** **Justification:** **PREA Designee Signature** **Date** **Medical Director:** `☐` **Remain in Current Facility Type** `☐` **Transfer to facility based on gender identity** **Justification:** **Medical Designee Signature** **Date** **Mental Health Director:** `☐` **Remain in Current Facility Type** `☐` **Transfer to facility based on gender identity** **Justification:** **Mental Health Designee Signature** **Date** **Facilities Director:** `☐` **Remain in Current Facility Type** `☐` **Transfer to facility based on gender identity** **Justification:** **Facilities Designee Signature** **Date** **Assistant Commissioner:** `☐` **Remain in Current Facility Type** `☐` **Transfer to facility based on gender identity** **Justification:** **Assistant Commissioner, Facilities Signature** **Date** Retention Schedule: Upon completion, this form shall become a permanent part of the offender’s institutional file.