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UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed) <br />If 'No', when were results provided? <br />months days <br />Do all prisoners undergo mental health screening during the initial intake process? <br />(, Yes C No <br />If 'No', how long after intake does the mental health screening occur? <br />[� months days <br />Do all prisoners undergo dental health screening during the initial intake process? <br />C Yes C No <br />If'No', how long after intake does the dental health screening occur? <br />months days <br />Are all medical screening results reviewed by a physician? <br />C~ Yes (' No <br />How long after intake does this occur? <br />months clays <br />Are medical screening records maintained for every prisoner? <br />C` Yes (- No <br />Medical, Dental, and Mental Health <br />Does the facility have a medical unit staffed 2417? <br />(- Yes (' No <br />Does the facility employ an on-site mental health professional? <br />C Yes (' No <br />Are prisoners with mental health issues identified as part of the vulnerable population? <br />C Yes C No <br />Are prisoners with mental health issues referred to qualified mental health professionals? <br />(, Yes (- No <br />Routine, Chronic, and Emergency Health Services <br />Are all prisoners made aware of the process for requesting health care services? <br />C Yes r No <br />Does the facility have a policy or procedures for identifying medical emergencies? <br />(' Yes (1 No <br />Does the facility provide access to prescription medication? <br />C Yes (` No <br />NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information <br />which is for the sole use of the intended recipients) Any unauthorized review, use, disclosure, or distribution is prohibited If you are not the intended <br />recipient. please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used <br />only to aid In providing healthcare services to federal prisoners Any other use is a violation of Federal HIPAA Law and/or the Privacy Act and will be <br />reported as such. <br />UNCLASSIFIEDIILAW ENFORCEMENT SENSITIVE (When Completed) <br />Page 9 of 22 <br />Form USM -218 <br />Rev 07121 <br />