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<regulation prefix="Regulation" num=".02" citation="COMAR 12.14.04.02" title_num="12" subtitle_num="14" chapter_num="04" heading="Standards — Inmate Safety.">
  <paragraph num="A.">
    <text>The managing official shall have a written policy and procedure:</text>
    <paragraph num="(1)">
      <text>Ensuring that the facility meets all fire safety regulations as verified by an annual inspection by authorized representatives of the State Fire Marshal;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Requiring facility personnel with documented training in fire safety practices to perform monthly internal inspections to monitor compliance with fire safety and prevention regulations;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Ensuring that all personnel are informed of the disaster plans in §B of this regulation;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Ensuring 24-hour emergency medical services, including provisions for:</text>
      <paragraph num="(a)">
        <text>Access to health care facilities and qualified health care personnel;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Designation of first-aid kit content and location, approval by qualified health care personnel, and monthly inventories to determine supply; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An individual with current certification in basic first aid and cardiopulmonary resuscitation in inmate living and activity areas during each shift;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Which shall be communicated to personnel having direct contact with inmates, specifying the method for requesting weekly access to sick call and the provisions for prompt staff referral of special medical problems to appropriate health care professionals;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Which states that medical screening of an inmate be conducted by health trained or qualified health care personnel within 24 hours of the inmate's admission to an initial reception facility;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>For the dispensing of prescribed medication, which includes provisions for:</text>
      <paragraph num="(a)">
        <text>Prescription initiation by authorized individuals;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Designation of the method for the filling of prescription orders; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Specification of the system of packaging and labelling of prescription medication;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>For the administration of prescription and over-the-counter medication, which includes provisions for:</text>
      <paragraph num="(a)">
        <text>Standing orders or protocol approved by the physician in charge;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Instruction of nonmedical personnel on the proper method of administration of medication by qualified health care personnel;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A record of the administration and refusal of medications; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Designation of circumstances warranting inmate self-administration;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Governing the availability, control, storage, and management of prescription, stock, and over-the-counter medication, which includes provisions for:</text>
      <paragraph num="(a)">
        <text>Secure storage outside inmate living and activity areas;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Specification of individuals having access and use;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Recorded disposal of unused and expired medications;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A weekly inventory of controlled substances;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Handling of personal medication of a newly admitted inmate; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Handling of personal medication and facility-prescribed medication for an inmate transferred or released;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Governing the availability, control, storage, and use of needles, syringes, and instruments, which includes provisions for:</text>
      <paragraph num="(a)">
        <text>Secure storage outside inmate living and activity areas;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Specification of individuals having access and use;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Quarterly inspection to determine condition;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Weekly inventory to determine accountability;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Disposal of needles and syringes according to established regulations;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Maintenance of a record of the use of needles and syringes; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>A current master listing of medical and dental instruments;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>Ensuring that health care personnel who provide services to inmates have current credentials, certifications, or licenses required by the State;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Providing for the routine health examination of inmates according to established guidelines;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Ensuring that inmate medical records are screened by qualified health care personnel before or within 7 days after release to determine if a medical condition exists which would require referral to community medical resources;</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Ensuring that the facility meets workplace safety and health standards, and ensuring the remediation of deficiencies identified by inspections conducted periodically by the Maryland Occupational Safety and Health Administration;</text>
    </paragraph>
    <paragraph num="(15)">
      <text>Governing the identification, housing, treatment, supervision, and referral of a mentally ill inmate, which includes provisions for:</text>
      <paragraph num="(a)">
        <text>Access to qualified mental health professionals;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Identification of community resources available to assist;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Specification of the process of evaluation and referral;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Designation of the method for referral to community resources according to established guidelines;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Development of comprehensive plans for treatment and care;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Maintenance of supervision records of specified activities and occurrences; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Identification of separate and distinct living quarters; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(16)">
      <text>Governing the notification of next of kin in cases of serious illness, serious injury, or death of an inmate and, in case of the death of an inmate, positive identification is to be made before notification.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The managing official shall have written disaster plans for fires, chemical spills, civil defense, natural disasters, power outages, and other circumstances, which include provisions for:</text>
    <paragraph num="(1)">
      <text>Documented coordination with appropriate responding agencies and organizations;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Specific description of staff duties and responsibilities;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Full, partial, and medical evacuation addressing:</text>
      <paragraph num="(a)">
        <text>The handling of injured individuals;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Security considerations;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Instructions for responding emergency personnel and vehicles; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Movement of affected individuals to safe areas;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>The placement and housing of inmates within the facility and at alternate sites when the facility or portions of it are rendered uninhabitable;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Quarterly fire drills during each shift which include inmates, unless their inclusion compromises security;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>A written evacuation plan that conforms to federal, State, and local fire safety codes; and</text>
    </paragraph>
    <paragraph num="(7)">
      <text>An annual review that includes:</text>
      <paragraph num="(a)">
        <text>Building interior diagram or floor plan;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Marked exits;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Directional symbols; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Locations of posted evacuation diagrams.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The managing official shall have a written policy prohibiting the use of an inmate for medical, pharmaceutical, or cosmetic experiments. This does not preclude the individual treatment of a consenting inmate based on the need for a specified medical procedure which is not generally available.</text>
  </paragraph>
  <paragraph num="D.">
    <text>The managing official shall have a written policy specifying that matters of medical, psychiatric, and dental judgement are the province of qualified health care personnel and are not subject to interference by facility personnel unless necessary to maintain order and security.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The managing official shall provide for a written policy and procedure requiring a physical examination of an inmate by qualified health care personnel within 14 days of admission to the initial reception facility.</text>
  </paragraph>
</regulation>