5-03/080.00 Handling of Medical Appliances



The term “medical appliance” refers to orthopedic and prosthetic appliances (orthopedic shoes, insoles, prosthetic limbs, or other manufactured body parts), assistive mobility devices (wheelchairs, walkers, crutches, walking canes, etc.), tapping canes, electrolarynx devices, as well as hearing aids, auditory aids, and cochlear implants. For procedures specific to orthopedic and prosthetic appliances, refer to CDM section 5-03/080.10, “Orthopedic or Prosthetic Medical Appliances.” For procedures specific to custom-fitted wheelchairs for paraplegic or quadriplegic inmates, refer to CDM section 5-03/080.15, “Wheelchairs for Paraplegic or Quadriplegic Inmates.”

Absent probable cause that an inmate’s possession of a medical appliance presents an immediate risk to the safety of staff or others, inmates shall not be deprived of the possession or use of any medical appliance, if the medical appliance has been prescribed, recommended, and/or fitted by a physician, and is subsequently approved by a Correctional Health Services (CHS) medical provider, in accordance with this policy.

Probable cause that a medical appliance constitutes an immediate risk of harm to persons, or the security of the facility shall not be solely based on the appliance’s material, if the material is common to the composition of prosthetic appliances (e.g., reinforced plastics, metal alloys, etc.).

INMATE RECEPTION RESPONSIBILITIES

Any medical appliances in the possession of an arrestee shall be transported with the arrestee when he or she is booked at either the Inmate Reception Center (IRC) or the Century Regional Detention Facility (CRDF). The arrestee may use the medical appliance in the reception/intake area, though the medical appliance is subject to search and further evaluation.

Staff shall complete the Arrestee Medical Appliance Clearance Record (SH-R-423) if an arrestee arrives at IRC or CRDF with a medical appliance. Staff shall also initiate this form if “yes” has been checked for question 4 of the “Jailer Observations” section of the Arrestee Medical Screening Form (SH-R-422). The Arrestee Medical Appliance Clearance Record (SH-R-423) form shall be completed within  24 hours after it is initiated.

To ensure accurate tracking, all personnel initiating the Arrestee Medical Appliance Clearance Record (SH-R-423) shall generate a reference number under the incident type “Inmate Medical Appliance.” The facility’s operations personnel shall ensure the completed Arrestee Medical Appliance Clearance Record (SH-R-423) is scanned and appended to the inmate’s booking number in the Custody Automated Reporting and Tracking System (CARTS).

Custody personnel are responsible for inspecting and searching all medical appliances, and may temporarily remove the appliance for inspection, but shall not dismantle or disassemble an appliance beyond what is reasonably necessary for inspection. Custody personnel are also responsible for notifying the facility watch commander if an appliance is withheld. Any decision to withhold a medical appliance shall be documented on the inmate’s Arrestee Medical Appliance Clearance Record (SH-R-423).  

Facility watch commanders shall ensure that within 20 hours of the removal of the medical appliance, an assessment of the inmate and their medical appliance is performed by appropriate CHS personnel, and the watch commander determines whether the inmate’s possession of the appliance is approved or denied.

If the watch commander determines the appliance is to be withheld from the inmate, the watch commander shall ensure a telephonic or emailed notification is made to the Custody Services Division Americans with Disabilities Act (ADA) Compliance Team. The withheld appliance shall be booked in the inmate’s property.

If the watch commander determines the appliance is not a security risk and approves the inmate’s possession of the appliance, the appliance shall be returned to the inmate within 24 hours of the removal.

ASSISTIVE MOBILITY DEVICES

All inmates using a personally-owned assistive mobility device other than orthopedic or prosthetic appliances or custom-fitted wheelchairs for paraplegic or quadriplegic persons (i.e., inmates using standard wheelchairs, walkers, crutches, or walking canes), shall be evaluated by a medical provider during the intake medical screening to determine the necessity of the appliance, and whether an alternative County-issued assistive mobility device will be provided to the inmate.

If the inmate is permitted to retain a personally owned assistive mobility device while in custody, the inmate shall be required to sign the Personal Medical Appliance Waiver, a part of the Arrestee Medical Appliance Clearance Record (SH-R-423).

If a County-issued alternative device is issued to the inmate, staff shall remove and book into the inmate’s property the personally owned assistive mobility device.

VISUAL AIDS

Corrective Lenses

Staff are not required to complete the Arrestee Medical Appliance Clearance Record (SH-R-423) for inmates who have corrective lenses (prescription glasses, spectacles, or contact lenses). Inmates possessing corrective lenses shall be handled in accordance with CDM section 5-03/105.00, “Acceptance of Prescription/Corrective Eyeglasses.”

Tapping Canes

Absent probable cause that an inmate’s possession of a medical appliance presents an immediate risk to the safety of staff or other inmates, staff shall not deprive a blind or visually impaired inmate of the possession or use of his or her personally-owned tapping cane. As with all other medical appliances, the Arrestee Medical Appliance Clearance Record (SH-R-423) shall be completed whenever a tapping cane is brought into a custody facility.

Should there be a reason to believe an inmate’s personally-owned tapping cane presents an immediate risk to the safety of staff or other inmates, staff shall confiscate the tapping cane and immediately notify the watch commander. Should the watch commander determine the tapping cane will be withheld, staff shall escort the inmate for examination by a CHS medical provider as soon as possible, but no later than 10 hours after the confiscation of the tapping cane.

The watch commander shall document the removal of the tapping cane and the reason for removal in the Watch Commander’s Log, and make an electronic notification to the “ADA Compliance-Custody” e-mail group within 12 hours of the removal. Staff shall book the tapping cane into the inmate’s property.

During the evaluation period, staff shall place the inmate in an area where custody personnel are able to maintain unobstructed visual observation. Alternatively, the inmate may be placed in a holding cell and staff shall conduct a safety check every thirty (30) minutes. Staff shall not intermix the blind or visually impaired inmate in a cell or pod with general population inmates, and the blind or visually impaired inmate must be escorted at all times by custody personnel when leaving their assigned location.

Additionally, custody personnel shall routinely inquire whether the blind inmate requires assistance. If yes, custody personnel shall provide assistance or supervise inmate workers in assisting the blind inmate with obtaining food/water or in reaching a restroom area.

INMATES WITH MEDICAL APPLIANCES IN THEIR HOUSING LOCATIONS

Inmates arriving at housing locations with medical appliances shall be allowed to retain their appliances or will be given a County-issued replacement, if the above requirements are met, unless there is probable cause that an inmate’s possession of a medical appliance presents an immediate risk to the safety of staff or other inmates. Housing facility concerns pertaining to an inmate’s medical appliance shall be directed to the facility watch commander and the facility’s Americans with Disabilities Act (ADA) coordinator.

The housing facility’s watch commander is responsible for determining if the removal of the medical appliance is appropriate, taking into consideration the decision of the IRC or CRDF watch commander and any changes in circumstances.

If the watch commander believes the inmate’s possession of the medical appliance constitutes an immediate safety or security risk to the facility, the watch commander may direct custody personnel to take possession of the medical appliance, provide the inmate with a property receipt, and place the item in the inmate’s property. The watch commander shall make a notification to the “ADA Compliance-Custody” email group, complete an Arrestee Medical Appliance Clearance Record (SH-R-423), and note any changes and/or safety concerns regarding the medical appliance.

Any medical appliance that has been altered from its original form or purpose shall be removed and handled as contraband, as outlined in CDM section 5-07/010.00, “Contraband Defined.”

Any medical appliance that has been weaponized, or is being used as a weapon, shall be immediately confiscated from the inmate. An immediate notification to the watch commander shall also be made.

REQUESTS FOR WITHHELD MEDICAL APPLIANCES

Any inmate who was not booked with their personally-owned medical appliance, or had the appliance withheld at some point during their arrest or incarceration, and is desirous of obtaining their appliance or requesting a suitable county-issued replacement, shall be directed to submit an Inmate Request Form (SH-J-437) or Inmate Grievance Form (SH-J-420). The request for the items shall be handled in accordance with CDM section, 8-03/030.00 “ADA-Related Requests and Grievances.” Retrieval of the items shall be handled as outlined in Access to Care Bureau (ACB) unit orders relating to the retrieval of medical appliances.

ADA COMPLIANCE TEAM

The ADA Compliance Team shall track and ensure the timely handling of ADA-related inmate requests and grievances, and review all Arrestee Medical Appliance Clearance Record forms (SH-R-423) to ensure the appropriateness of the withholding of any medical appliance.

The ADA Compliance Team may be contacted at (213) 893-5500, RightFax [REDACTED TEXT], or e-mail to the “ADA Compliance-Custody” email group.