Each facility shall have and implement a written plan, approved by the Commission, for inmate medical, mental, and dental services. The plan shall:
  (1) provide procedures for regularly scheduled sick calls;
  (2) provide procedures for referral for medical, mental, and dental services;
  (3) provide procedures for efficient and prompt care for acute and emergency situations;
  (4) provide procedures for long-term, convalescent, and care necessary for disabled inmates;
  (5) provide procedures for medical, to include obstetrical and gynecological care, mental, nutritional requirements, special housing and appropriate work assignments and the documented use of restraints during labor, delivery and recovery for known pregnant inmates. A sheriff/operator shall notify the commission of any changes in policies and procedures in the provision of health care to pregnant prisoners. A sheriff/operator shall notify the commission of any changes in policies and procedures in the placement of a pregnant prisoner in administrative separation. As soon as practicable after receiving a report of a miscarriage or physical or sexual assault of a pregnant inmate while in the custody of a county jail, the sheriff shall ensure that an obstetrician or gynecologist and a mental health professional promptly:
    (A) review the health care services provided to the prisoner; and
    (B) order additional health care services, including obstetrical and gynecological services and mental health services, as appropriate.
  (6) provide procedures for the control, distribution, secured storage, inventory, and disposal of prescriptions, syringes, needles, and hazardous waste containers;
  (7) provide procedures for the distribution of prescriptions in accordance with written instructions from a physician by an appropriate person designated by the sheriff/operator;
  (8) provide procedures for the control, distribution, and secured storage of over-the-counter medications;
  (9) provide procedures for the rights of inmates to refuse health care in accordance with informed consent standards for certain treatments and procedures (in the case of minors, the informed consent of a parent, guardian, or legal custodian, when required, shall be sufficient);
  (10) provide procedures for all examinations, treatments, and other procedures to be performed in a reasonable and dignified manner and place;
  (11) provide that adequate first aid equipment and patient evacuation equipment be on hand at all times;
  (12) provide procedures that shall require that a qualified medical professional shall review as soon as possible any prescription medication an inmate is taking when the inmate is taken into custody. These procedures shall include providing each prescription medication that a qualified medical professional or mental health professional determines is necessary for the care, treatment, or stabilization of an inmate with mental illness;
  (13) provide procedures that shall give inmates the ability to access a mental health professional at the jail or through a telemental health service 24 hours a day and approved by the Commission by August 31, 2020. If a mental health professional is not present at the county jail at the time or available by telemental health services, then require the jail to provide the inmate access to, at a minimum, a qualified mental health professional (as defined by 25 TAC §412.303(48)) within a reasonable time;
  (14) provide procedures that shall give prisoners the ability to access a health professional at the jail or through a telehealth service 24 hours a day or, if a health professional is unavailable at the jail or through a telehealth service, provide for a prisoner to be transported to access a health professional and approved by the Commission by August 31, 2020; and
  (15) provide procedures to train staff to identify when a pregnant inmate is in labor and provide access to appropriate care. Inmates shall be promptly transported to a local hospital when they state that they are in labor or are determined by a person at the level of emergency medical technician or above to be in labor.

Source Note: The provisions of this §273.2 adopted to be effective December 20, 1994, 19 TexReg 9650; amended to be effective December 30, 2009, 34 TexReg 9482; amended to be effective September 12, 2012, 37 TexReg 7196; amended to be effective December 22, 2015, 40 TexReg 9305; amended to be effective January 1, 2018, 42 TexReg 6631; amended to be effective August 26, 2018, 43 TexReg 5541; amended to be effective November 28, 2019, 44 TexReg 7409; amended to be effective March 29, 2022, 47 TexReg 1625; amended to be effective March 1, 2023, 48 TexReg 1153