All inmates being processed for housing in the Los Angeles County Jail system shall be screened for tuberculosis by Correctional Health Services (CHS) personnel prior to being assigned to a housing area. The preferred screening method is the chest x-ray; however, a Purified Protein Derivative (PPD) skin test or blood test may also be used, as necessary.
If an inmate refuses a chest x-ray for tuberculosis screening, they shall be given the opportunity to take either a PPD skin test or blood test as an alternative. Inmates who are awaiting the results of alternative testing methods shall be medically segregated as directed by CHS personnel.
If the inmate refuses the chest x-ray and all screening alternatives, the Inmate Reception Center (IRC) Watch Commander shall be notified. The IRC Watch Commander, or their designee (of the rank of Sergeant or above), shall contact the inmate to determine the reason for the refusal.
If it appears the inmate is refusing due to a cultural issue such as a language barrier or religious belief, every reasonable effort shall be made to provide a translator and/or explain the necessity of the screening to the inmate. If the inmate continues to refuse screening, they shall be medically segregated as directed by CHS personnel.
If it appears the inmate is refusing due to a mental illness or developmental disability, the IRC Watch Commander, or their designee, should confer with Department of Mental Health (DMH) personnel to determine if the inmate can be persuaded to submit to tuberculosis screening. If the inmate continues to refuse the screening, they shall be medically segregated as directed by CHS personnel.
If it is determined that the inmate is refusing in an effort to delay an appearance in court or to otherwise disrupt the intake process, the inmate shall be subject to disciplinary procedures per CDM section 5-09/030.00, "Disciplinary Guidelines." Additionally, the inmate shall be medically segregated as directed by CHS personnel.
If an inmate continues to refuse all tuberculosis screening methods, regardless of reason, the IRC Watch Commander shall make an entry detailing the refusal and all attempts by sworn personnel to convince the inmate to submit to tuberculosis screening in the Watch Commander Incident Notifications for Custody Facilities log (commonly referred to as the "Watch Commander's Log").
Subsequent to CHS personnel designating the appropriate housing location, the IRC Watch Commander shall notify the Watch Commander of the Custody Services Division facility designated to house the inmate of the pending transfer and the need to medically segregate the inmate due to tuberculosis screening refusal.
Twenty four (24) hours after the inmate's initial refusal to submit to the tuberculosis screening, the Watch Commander (or their designee) of the facility where the inmate is housed shall conduct a follow-up and offer the inmate another opportunity to submit to a tuberculosis screening. In the event the inmate agrees to submit to the tuberculosis screening, CHS personnel shall be notified and the screening shall be facilitated. Details regarding the follow-up shall be entered in the facility's Watch Commander's Log. Any subsequent or prior attempts by sworn personnel to convince the inmate to submit to tuberculosis screening and the inmate's refusal of and/or submission to tuberculosis screening shall also be entered in the Watch Commander's Log.
At the beginning of each shift, Watch Commanders shall review the Watch Commander's Log to monitor the status of inmates who have been medically segregated due to tuberculosis screening refusal and to ensure the above procedures are adhered to.