Chair asks how DOC notifies CHS during lock-ins and prioritizes care

And how does DOC notify CHS when a lock-in begins?

I mean, that's constant conversations, right?

The wardens are very much aware, and you can speak to the abbreviation of the HSA from CHS that are assigned to the jail.

Each facility has an HSA assigned to them.

The warden and their leadership team are having various daily conversations with the HSAs.

I'm not sure if there's additional titles or leadership.

CHS could speak better to that, but these are ongoing conversations that they facilitate these engagement efforts to see what's going on with specific individual custodians, how we can produce people, if there are challenges to produce people.

And so that's ongoing.

It's happening right now.

It happens every day.

And so it's, yes, that's the best way I can, I guess, answer your question.

So for CHS, are you generally notified before the lock-in begins?

Do you know at what part you're notified?

We wouldn't be notified in advance if it were an emergency lock-in.

We, of course, would know if someone wasn't produced to an appointment, at which point we would work to reschedule the individual based on acuity.

And are the lock-ins only when, like, a crisis moment happens, to your point?

Is that the only time the lock-ins are happening?

So if we have credible information that needs to be investigated, that can be a reason, obviously, that we would lock down a unit for investigation into action.

No intelligence or.

And in that moment, are you notifying CHS in advance?

So it's not going to be in advance unless it's something that is pre-scheduled.

Most of those, obviously, events are not pre-scheduled events unless it's a search, which, again, we would notify them as close to the event as possible just to make sure that we are able to conduct a thorough search in a–

Surprise nature.

We have daily huddles with CHS.

We are in constant communication with them.

We have officers that are assigned to the clinic that work in conjunction with CHS.

So the officers in the clinic will be immediately notified, and then our partners would also be notified.

Just because an area is locked down doesn't mean that we cannot produce that person, obviously.

And it's escalated based on the nature of the appointment and the emergent need for that person to be produced.

If an individual is needed, they will be produced.

How does CHS prioritize patients for appointments missed because of a lock-in?

So I'm not even specific to lock-ins, but any time there is a missed appointment, we're looking at clinical acuity need.

I don't know if you want to speak to that.

We look at medication adherence, any incidents documented, what were they looking like in their most recent visit, what has been their level of stability.

Those sorts of factors are taken into account as to...

Prioritization and triaging.

What information does CHS need from the department to safely manage care during a lock-in?

So I think because a lock-in is just this temporary moment in time, I wouldn't necessarily focus non-production to clinic on lock-in.

I think it's broader.

I think the work, as referenced earlier, that our health services administrators are doing with the officers in the clinic and conversations that are happening at the leadership level are really to address the systemic

production challenges.

For our purposes, whether someone missed an appointment because of court or lock-in or barbershop or any number of reasons, it wouldn't change our clinical assessment and need for continued care.

Thank you.