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<chapter num="09" heading="Medical Services" title_num="12" subtitle_num="02">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Abortion” means spontaneous or induced termination of pregnancy.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Commissioner” means Commissioner of the Division of Correction or designee.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Director” means Director, Health and Mental Health Services of the Division.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Division” means Division of Correction.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Involuntary admission” means admission of an inmate to a psychiatric hospital other than voluntarily.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Medical parole” means a parole granted to an inmate because of a diagnosed serious medical condition.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Parole” means a conditional early release of an inmate from the Division of Correction.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Postnatal care” means the necessary intervention affording health care and support to the infant.</text>
      </paragraph>
      <paragraph num="(9)">
        <text>“Postpartum care” means the necessary intervention affording health care and support to a recently delivered mother.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>“Pregnancy” means the gestational process of growth and development within a woman of a new individual from conception through the embryonic and fetal periods to birth.</text>
      </paragraph>
      <paragraph num="(11)">
        <text>“Prenatal care” means the necessary intervention affording health care both to the woman and to the fetus during pregnancy and before birth.</text>
      </paragraph>
      <paragraph num="(12)">
        <text>“Terminal” means ending in death.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Inmate Pregnancy.">
    <paragraph num="A.">
      <text>Assessment and Treatment.</text>
      <paragraph num="(1)">
        <text>The health services provider shall provide a complete history, physical examination, and definitive laboratory test to determine pregnancy when requested by:</text>
        <paragraph num="(a)">
          <text>The inmate;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Medical staff; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The warden.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Prenatal and postpartum care shall be provided in accordance with acceptable health services standards to include:</text>
        <paragraph num="(a)">
          <text>Regular appointments with an accredited obstetrical clinic;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Medications as necessary; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Patient education.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The Commissioner shall ensure that standards are developed to address:</text>
      <paragraph num="(1)">
        <text>Prenatal care;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Postnatal care;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Postpartum care;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Abortion;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Hospital admission;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Disposition of the child in accordance with Correctional Services Article, §9-601, Annotated Code of Maryland; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Executive clemency.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Involuntary Admission of an Inmate to a Psychiatric Hospital.">
    <paragraph num="A.">
      <text>The warden shall:</text>
      <paragraph num="(1)">
        <text>Ensure that an admission to a mental hospital is limited to a Maryland Department of Health psychiatric hospital; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Comply with the requirements for an involuntary admission under Health-General Article, §§10-613—10-617, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A Division institution transferring an inmate shall provide the Maryland Department of Health psychiatric hospital with the following information:</text>
      <paragraph num="(1)">
        <text>Current condition of inmate;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The inmate's medical and psychiatric history;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Circumstances threatening the life or safety of the inmate or others; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Current medication and other treatment being provided to the inmate.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A Division institution that transfers an inmate to a Maryland Department of Health psychiatric hospital shall pick up and return the inmate to the Division institution following notification by the Maryland Department of Health psychiatric hospital that the inmate is ready to be discharged from the hospital.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Commissioner shall develop directives to standardize operations of a Division mental health unit.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Medical Parole.">
    <text>Criteria for medical parole consideration include all of the following:</text>
    <paragraph num="A.">
      <text>The inmate is imminently terminal or has a condition which would indicate that continued imprisonment would serve no useful purpose. An example of the latter would be an irreversible coma.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The inmate's release would not unduly jeopardize public safety.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Contents of Medical Parole Request.">
    <paragraph num="A.">
      <text>A warden shall ensure that all documents forming the basis for a medical parole request are submitted to the Parole Commission through the Division Director and the Commissioner. Upon approval, the Commissioner shall forward a recommendation for medical parole to the Parole Commissioner for consideration.</text>
    </paragraph>
    <paragraph num="B.">
      <text>To initiate consideration for a medical parole, a warden shall send a summary of an inmate's incarceration record since admission or last parole consideration to the Division Director. The summary shall include the following:</text>
      <paragraph num="(1)">
        <text>History of program participation;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Special housing requirements;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Statement by the attending physician which includes:</text>
        <paragraph num="(a)">
          <text>Diagnosis,</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Prognosis,</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Inpatient or outpatient status, and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Criteria justification; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>Statement by the warden which includes:</text>
        <paragraph num="(a)">
          <text>A recommendation to either approve or disapprove the medical parole request,</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The reasons for the recommendation, in §B(4)(a), and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>An aftercare treatment plan for the inmate.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The Commissioner may reject a recommendation for medical parole which has been submitted by the Director. The Commissioner's decision to deny a medical parole is final.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Medical Treatment of Inmates While on Work Release, Leave, or Escape.">
    <paragraph num="A.">
      <text>The Division is financially responsible for treatment of injury or illness sustained by an inmate while on unescorted family leave, work release, unescorted special leave, or in an escape status.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Emergency medical treatment shall be provided to Division inmates by a community hospital.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Invoices for services provided shall be submitted to the Division health services contractor.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Nonemergency treatment shall be rendered by the Division health services provider.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Correctional Services Article, §2-109(c), Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: May 27, 1991 (18:10 Md. R. 1117)</annotation>
  </annotations>
</chapter>