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UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE (When Completed) <br />lf 'No', when were results provided? <br />months days <br />Do all prisoners undergo mental health screening during the initial intake process? <br />CYes CNo <br />lf '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 />CYes CNo <br />lf 'No', how long after intake does the dental health screening occur? <br />months days <br />Are all medicalscreening results reviewed by a physician? <br />CYes CNo <br />How long after intake does this occur? <br />months days <br />Are medical screening records maintained for every prisoner? <br />CYes CNo <br />Medical, Dental, and Mental Health <br />Does the facility have a medical unit staffed 2417? <br />CYes CNo <br />Does the facility employ an on-site mental health professional? <br />CYes CNo <br />Are prisoners with mental health issues identified as part of the vulnerable population? <br />CYes CNo <br />Are prisoners with mental health issues referred to qualified mental health professionals? <br />CYes CNo <br />Routine, Chronic, and Emergency Health Services <br />Are all prisoners made aware of the process for requesting health care services? <br />CYes CNo <br />Does the facility have a policy or procedures for identifying medical emergencies? <br />CYes CNo <br />Does lhe facility provide access to prescription medication? <br />CYes CNo <br />NoTlcE: This document is intended FOR oFFlclAL USE oNLY and may contain LAW ENFoRCEMENT SENslTlvE oR CoNFIDENT|AL information <br />which is tor the $ole use of the intended recipient(s). Any unauthorized review, use, disclosure, or distribution is prohibited. lf you are not the intended <br />recipient, please contact lhe sender and destroy all copies of this document. Any Protected Heallh lnformation contained in this document is to be used <br />only to aid in providing heallhcare 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 />UNCLASSIFIEDILAW ENFORCEMENT SENSITIVE (When Completed) <br />Page I of 22 <br />Form USM-218 <br />Rev.07121