This report is a required component of the Monthly Health Services Report from all facilities.
MEDICAL/DENTAL
INFIRMARIES NURSING ON-SITE
Infirmary Capacity (= beds, minus off-line) # Intake Screens (Nursing)
# Infirmary Admissions # Nursing Sick Call Visits
# Infirmary Inpatient Days # Nurse Sick Calls not triaged w/in 24 hrs Average Length of Stay (LOS) # Nursing Chronic Care Visits
Average Daily Census # Urgent/Emergent Housing Unit Responses
# Nursing Segregation Visits
DENTAL SERVICES PHYSICIAN SERVICES
# Screenings by Dental Aide # Receiving Intake Physicals
# Dentist Appointments # Physician Visits
# Hygienist Appointments # Annual Physicals
# Emergent/Urgent Dentist Visits # Chronic Care/Physician
# Surfaces filled # Unscheduled Physician Visits
# Extractions # Employees Treated
# Offenders receiving X-ray OFF-SITE SERVICES
# 90 Day dental exams # Emergency Room Visits
# Unscheduled Dental Visits # Ambulance Trips
ANCILLARY SERVICES # Hospital Admissions
# X-ray films taken # In-patient Procedures
# offenders had labs # Out-Patient Surgeries
# lab tests # Hospital days
# Positive PPD reactions # Average Hospital Length of Stay (ALOS) SPECIALTY SERVICES
PHARMACY # AUDIOLOGISTS
# Offenders on Prescription Medication # CARDIOLOGISTS
% Offenders on Prescription Medication # DERMATOLOGIST
# Keep On Person (KOP) # EAR, NOSE & THROAT
# Off-formulary Prescriptions by Physician # GENERAL SURGERY
# Prescriptions ordered by Dentist # GASTROENTEROLY
# Delayed Prescriptions (> 24 hours from order) # HEMATOLOGY
# # of Offenders on Psychotropic Prescriptions # NEUROLOGY
# Off-formulary RX by Psychiatrist # ONCOLOGY
DIALYSIS # OPHTHALMOLOGY
# Dialysis Visits # ORAL SURGERY
# Dialysis Treatments # ORTHOPEDIC
# Peritoneal Visits # PODIATRIST
# Peritoneal Treatments # PHYSICAL THERAPY
MENTAL HEALTH ON-SITE # RADIOLOGY/IMAGING
# MH Therapist Referrals from Intake Screen # UROLOGY
# Psychiatrist Referrals from Intake Screen # INTERNAL MEDICINE
# Psychiatrist Visits # PLASTIC
# Therapists Visits # OTHER
# MH Discharge Referrals to the Community INFECTIOUS DISEASE
DPC # HIV positive Offenders
# Capacity # AIDS offenders
# Admissions # Positive PPD reactions
# Discharges # Confirmed Tb cases
# In-patient days # Hepatitis C offenders
Average Length of Stay (LOS) # Hepatitis C offenders w/ Pharmacotherapy
Average Daily Census # Confirmed MRSA cases
MISCELLANEOUS MEDICAL
# Assaults Treated # Deaths
# Deaths by Suicide # Work Clearance
APPENDIX F
Essential Outcomes Report
The Vendor must be specific on the methodology for collecting and measuring outcomes. Outcome indicators must be based on standards acceptable to the OHS Director. This report is a component of the Monthly Health Services Report for each facility.
Notes:
1. NCCHC = National Commission on Correctional Health Care
2. Annual Reduction in Hospital days (Avoidable Days) = Days of on-site IV therapy (Chemotherapy, Infusion Pump, Antibiotics, other), Holter Monitor, or other procedure days that are saved by providing services on-site.
3. The number of offender medical transports that were saved as a result of #2 above, on-facility suturing, on-site punch biopsies, on-site dialysis, on-site physical therapy.
EXPLANATION:
In 1976 that the United States Supreme Court ruled in Estelle v. Gamble affirming that prisoners had the right to be free of
“deliberate indifference to their serious health care needs.” It also affirmed the courts have both the right and the duty to intervene. “Deliberate Indifference” applies “…whether the indifference is manifested by prison doctors in their response to the prisoner’s need or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed. Regardless of how evidenced, deliberate indifference to a prisoner’s serious medical illness or injury states a cause of action.” (Estelle v. Gamble, 1976:104-105) This establishes the mandate for offender health services which is reflected in the ACA, NCCHC, and VADOC Standards cited above, and supported by State and County mental health code.
PROGRAM PARTNERS IN SUPPORT OF OUTCOMES:
DHSS, Vendor, Community Providers, Offenders and Families, Commissioner, DE Department of Correction MAJOR RELATED PLANS AND GUIDELINES:
Strategic Plans and Guidelines. To be provided by the Vendor(s) in their proposal Approved during negotiations by the DDOC.
APPENDIX F
Essential Outcomes Report
DELWARE DEPARTMENT OF CORRECTION
DDOC VISION STATEMENT: To provide essential constitutional health and mental health services to the offender population.
PROGRAM: DDOC Health Services PROGRAM ELEMENT: Mental Health Services
PROGRAM MISSION:Unimpeded access to mental health services which meet the serious mental health needs of offender and prepare them for reentry into the community.
COMMUNITY OUTCOMES SUPPORTED:A safe and secure community, reduced recidivism, efficient use of taxpayer dollars, value in services provided or purchased on behalf of the County and taxpayers.
OUTCOME MEASURES Month 1 Month 2 Month 3 Summary Quarterly
Outcomes/Results:
Rate of referrals for outside mental health specialty services (%) Service Quality:
Compliance with NCCHC, DDOC, and DHSS standards1
Percentage of offenders receiving mental health screening within 2 hours Percentage of offenders taking psychotropic medications
Percentage of offenders on chronic medication with timely renewal
Percentage of Medical referrals to mental health responded to w/in 24 hours Percentage of psychiatric examinations completed within 72 hours
Percentage of referrals to MH that result in referrals to a psychiatrist Number of Suicide Attempts
Number of Suicides Efficiency:
Average cost of mental health services per offender per day ($) Average cost of MH medications per offender per month ($) Percentage of Off-formulary medications prescribed Percentage of laboratory tests clinically justified Workload/Outputs:
Admissions MH screenings Number of Psychiatrist visits Number of Therapists evaluations
Number of Therapist segregation evaluations Number of Suicide Risk Assessments performed Number of Treatment Plans developed
Number of Discharge Plans developed Number of Community Referrals Number of MH Unit Admissions
Mental Health Unit average length of stay (ALOS) Inputs:
Expenditures ($000) Work years
APPENDIX F
Essential Outcomes Report
Notes:
1. NCCHC = National Commission on Correctional Health Care, DDOC Delaware Department of Correction, and DHSS = Delaware Department of Health and Social Services.
EXPLANATION:
In 1976 that the United States Supreme Court ruled in Estelle v. Gamble affirming that prisoners had the right to be free of
“deliberate indifference to their serious health care needs.” It also affirmed the courts have both the right and the duty to intervene. “Deliberate Indifference” applies “…whether the indifference is manifested by prison doctors in their response to the prisoner’s need or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed. Regardless of how evidenced, deliberate indifference to a prisoner’s serious medical illness or injury states a cause of action.” (Estelle v. Gamble, 1976:104-105) This establishes the mandate for offender health services which is reflected in the ACA, NCCHC, and DDOC Standards cited above, and supported by State mental health code.
PROGRAM PARTNERS IN SUPPORT OF OUTCOMES:
Department of Health and Social Services, All health care Vendors, Community Providers, Offenders and Families, Legislators, and all other DDOC Bureaus/Divisions/Offices
MAJOR RELATED PLANS AND GUIDELINES:
Strategic Plans and Guidelines. To be provided by the Vendor(s) in their proposal Approved during negotiations by the DDOC.
APPENDIX G