This section outlines the procedure on how to write sound requests. Giving psychologists the authority to overrule medical doctors’ decisions with respect to potentially medically complicated patients must be one of the most radical policy decisions ever. California legislators, Judge Mueller, and the people of California need to understand the medical dangers California prison inmates are subjected to because of this poor care and corrupt system. Required Services (Refs & Annos) 22 CCR § 72327 § 72327. CDCR recently conducted a study on its classification policies; ... new developments, in June 2012 the CDCR adopted emergency regulations revising its classification rules, which are in Title 15 of the California Code of Regulations. For the status of new regulations or changes to existing regulations proposed by the Department that concern Adult Institutions, Programs and Parole (Title 15, Division 3), Juvenile Justice (Title 15, Division 4), Board of Parole Hearing ((Title 15, Division 2), or California Prison Industry Authority (Title 15, Division 8) please see the following links: We feel certain you’d want the person most highly trained and qualified to treat your loved one: a physician. What’s Going on with Nurse Practitioner Education? Title 15. Without transparency, issues adversely affecting patient care remain hidden and are less likely to be fixed. That patient was reportedly never seen by a psychiatrist who could have appropriately diagnosed and treated her and could very likely have prevented this horrific outcome. State of California California Code of Regulations Title 15. Indeed, a psychologist has been listed as the “physician to call” in at least one CDCR mental health nursing station. Your support ID is: 6601623071967630810. State of California California Code of Regulations Title 15. The scope of practice overreach issue is still to be addressed. How tragic and utterly ridiculous. But those who do are practicing medicine without a license. 22 CCR § 101207 § 101207. 3801.6 Each resident shall have the right to privacy in the provision of personal and medical care. PUBLIC HEALTH AND MEDICINE . It logically follows that the memo is saying that in cases where the psychiatrist and the psychologist disagree (and thus the treatment team can’t reach a decision), the psychologist rather than the psychiatrist makes the decision. There is not a single psychiatry executive in CDCR. The problems have been reported and documented, yet nothing has changed. Title 22 California Code of Regulations Division 5 Page 1 Table of Contents Chapter 1. After all, if all the benchmarks are being met or exceeded, surely there must be overstaffing, right? But that doesn’t mean CDCR is happy about it. The establishment of the CDGC is necessary to ensure CDCR’s compliance with DOM, Chapter 3, Article 22 and SB 1421 and Assembly Bill (AB) 2327 "Peace officers: misconduct: employment" and will greatly reduce CDCR’s liability, costs, and litigation resulting from non-compliance. Unsealed by Judge Kimberley Mueller in October 2018, the Golding Report alleges that data put out by the California Department of Corrections has been inaccurate and misleading, that this has adversely affected patient care, and that CDCR policies facilitate overreach of scope of practice on the part of psychologists, preventing inmates from getting appropriate psychiatric medical care. Later, Golding said, a prison safety committee, whose members had no medical training, found no connection between the patient’s self-mutilation and the lack of medication. But when patients are to be transferred to a licensed psychiatric hospital, there is not even a mandated phone call to a psychiatric physician to make sure that medications are not needed,  nor is a thorough medical evaluation performed to rule out medical causes of psychiatric issues. Title 22 does allow a therapist, physician assistant, or nurse practitioner, acting within the scope of their respective practice, to evaluate each beneficiary for a substance use disorder. Box 942883, Sacramento, CA 94283. CDCR is not mandating that. Restraints are not what most laypeople imagine. Psychologists are excellent therapists but should not be determining psychiatric medical care. Yet, from the Golding Report, we know, for example, that an unlicensed psychology intern overruled an experienced psychiatric physician about the need to discharge a patient from inpatient care, in just one example of inappropriate psychiatric management for these California prisoners. People are often physically injured when struggling against their restraints. Title 22. Crime Prevention and Corrections Division 3 Rules and Regulations of Adult Institutions, Programs, and Parole Department of Corrections and Rehabilitation Updated through January 2013. 8 — — 30 to 35. Please take 5 minutes to complete the state’s California COVID-19 vaccine survey. But a whistleblower report tells us that prisoners with severe mental health needs are often not scheduled to see a psychiatric physician for years. (Nevermind that the numbers were apparently inaccurate.) Psychiatrists and psychologists are not interchangeable. California Coronavirus (COVID-19) Response. Many of our prisoners, though, are mentally ill.  And all of them are human and deserve to be treated with compassion and skill. Please enable JavaScript to view the page content. CDCR was about to cut its psychiatry ranks by firing (or otherwise letting go) about 79 psychiatrists. Division 5. It is over 900 pages in length and is also updated periodically through the year. –The Golding Report, Also from the Golding Report: “”[An Official whose name is redacted] signed a memo that gave psychologists the authority to overrule psychiatric physicians’ medical decisions about the medical safety of discharging medically complicated patients from licensed hospitals. California DepartmentofAging Vol. CDCR 22-3100 (2009) 22-3100. Office of Research . Would you let a psychologist in the ER determine medical treatment if your family member was having a heart attack, or if your family member overdosed on an unknown substance or medication? After screaming periodically for four hours, the woman, while lying on the floor, pulled out her left eye, and then, after guards arrived, put her eye in her mouth and swallowed it. California Department ofAging TABLE OF CONTENTS Page Page • Chapter 1. Update: For the latest information regarding CDCR’s preparedness efforts for the novel coronavirus (COVID-19) please visit the CDCR COVID-19 Preparedness page. Then, the psychotic patient pulled out her eye and ate it. Title 22. Once inmates arrive at the prison to which they were assigned at the reception center, they are assigned a custody designation. It’s not like just putting handcuffs and ankle cuffs on someone. TITLE 22. They can aspirate and get pneumonia, or could even die in some cases. The new rules are in Title 15 sections 3480 through 3486. Offender Population Reports. Title 22, the regulatory system for California Prisons, distinct and critical differences between a psychiatrist and a psychologist, Assemblymember.eduardogarcia@assembly.ca.gov, Assemblymember.maienschein@assembly.ca.gov, Assemblymember.petrie-norris@assembly.ca.gov, Assemblymember.robertrivas@assembly.ca.gov, https://www.thedailybeast.com/california-prison-report-alleges-poor-treatment-of-inmates, https://www.ocregister.com/2018/11/08/there-is-nothing-progressive-about-californias-prisons/, https://www.kcra.com/article/horrific-case-of-inmate-who-ate-her-eyeball-included-in-scathing-report-on-prison-psychiatric-care/24560379, https://edca.typepad.com/eastern_district_of_calif/2018/11/edca-court-releases-secret-report-alleging-poor-medical-care-for-california-prison-inmates.html, https://www.kqed.org/news/11702604/california-prisons-chief-psychiatrist-says-hidden-data-exposes-broken-system-of-care, https://www.legalreader.com/california-psychiatrist-corrections-lying-mental-health/, https://www.apnews.com/c29766deb3cc4dfaafeebb9b1b5b2380, https://web.archive.org/web/20190203192902/https://www.sacbee.com/news/state/california/article219790940.html, https://www.apnews.com/9d736f6f3b8d408d897bcb33bc9fd8c7, https://edca.typepad.com/eastern_district_of_calif/2018/10/cal-prison-whistleblowers-testimony-may-be-postponed.html, https://www.apnews.com/592cd04e50e447f89b49b80b661dd1a1, https://www.sacbee.com/news/state/california/article220333785.html, https://californiahealthline.org/morning-breakout/fraud-investigator-to-be-appointed-to-probe-allegations-of-misleading-data-on-prison-psychiatric-care/, https://www.sfgate.com/bayarea/article/Report-rips-California-prison-psychiatric-care-13356438.php, http://www.venturabroadcasting.com/gov-browns-lawyers-move-to-stop-prison-psychiatrist-whistleblower-from-testifying, https://edca.typepad.com/eastern_district_of_calif/2018/10/more-whistleblowers-emerging-over-california-prisons-mental-health-care.html, https://www.correctionsone.com/california/articles/481696187-Calif-prison-psychiatrist-says-whistleblowing-cost-her-job/, https://womensenews.org/2016/08/suicides-put-california-womens-prison-under-mental-health-scrutiny/, No Substitute for Expertise in the Skies and in Healthcare, The Degradation of Medical Specialty Society Fellowship, Critical problem led to deaths of two girls, PRESS RELEASE: PHYSICIANS FOR PATIENT PROTECTION (PPP) STATEMENT ON WGN PATIENT SAFETY REPORT AND RESPONSE TO AANP CRITICISM, PPP Won’t Buckle to Critics on Scope of Practice, A Physician’s Experience with Naturopaths, Watching the Space Shuttle Explode Every Day. While these regulations do govern the facilities licensed by CCLD, they are not hosted on CCLD's website or maintained by the CCLD webmaster. Judge Mueller decided to make the Golding Report public, shining some sunlight on the ugly underbelly of the CDCR. CDCR is not mandating that. Root & Rebound offers this site "as-is" and makes no representations or warranties of any kind concerning content, express, implied, statutory, or otherwise, including without limitation, warranties of accuracy, completeness, title, marketability, merchantability, fitness for a particular purpose, noninfringement, or the presence or absence of errors, whether or not discoverable. California law and precedent mandates that a psychiatric physician be intimately involved in the care of prisoners housed by the California Department of Corrections and Rehabilitation (CDCR). The Voice of Young Physicians Regarding Scope of Practice. Page 3 CDCR 22-3801 3801.5 Each MHCRF shall provide each resident at the time of admission with a copy of any grievance or complaint procedures. Title: Health Care Definitions (NCHCR 20-03) Section(s): 3341.3, 3341.5, 3377.1, 3999.98, 3999.99, 3999.364, 3999.365, and 3999.367 Notification Date: October 02, 2020 Public Hearing Date: N/A Permanent Adoption Date: TBD. For Narcotic Treatment Programs, Title 22 … Is there discrimination against California prisoners who need mental health treatment? The neutral expert will be reporting his findings to the Judge by April 22, and Judge Mueller is expected to respond within the next few weeks. Social Security, California Code of Regulations California Code of Regulations (Last Updated: August 6, 2014) Title 22. The CDCR may believe so, as they apparently report those encounters as full psychiatric evaluations, despite the lack of privacy and lack of depth of discussion. § … Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies, Title 22. Psychologists in CDCR very often override psychiatrists’ judgement and/or medical orders, and the CDCR system effectively supports them in doing that rather than discouraging it. 4 — ... CDCR Classifies Inmates Into Six Custody Designations. We then examined this DOM section to understand the reporting process for employee discipline (see Appendix A). The CDCR is supposed to provide each person in prison with a copy of the CDCR regulations within 14 days after arrival in the prison system.17 The book of regulations is commonly referred to as “Title 15” or the “CDCR Rulebook.” The CDCR regulations are also on the CDCR … goal of the California Department of Corrections and Rehabilitation (CDCR) is to perform each patient transfer in a manner that ensures thecontinuity of high quality, safe care for each patient within CDCR. For the latest information regarding CDCR’s preparedness efforts for the novel coronavirus (COVID-19) visit the CDCR COVID-19 Preparedness page. Title 15 is in a continual state of development because the CDCR is not a static entity. CDCR Scenarios** Test^^ Post-Test Written and Skills 30 4.66 Supplemental Student Information – A Title 22 Requirement The information provided below must be discussed, demonstrated and/or practiced as indicated. Psychologists wear name badges saying “Dr.” and not specifying that their doctorate is in psychology rather than a medical doctor. A joke of a “psychiatric evaluation” and padded documentation. Title 22 Social Security Title 22 Social Security California Code of Regulations provides information about nurse-to-patient ratios, licensing and certification of health facilities, home health agencies, clinics, and referral agencies. Rehabilitation (CDCR or Department), proposes to amend Sections 3075.2, 3545, and 3754 of Title 15, Division 3, Chapter 1, regarding forms used in the parole process. CHAPTER 31. The bad news for the prisoners is that these unlicensed non-physician practitioners don’t know what they don’t know, yet they and CDCR don’t seem to care. Title 22, the regulatory system for California Prisons, clearly states that physician approval is needed for restraints to be applied in licensed hospitals. * 7100. Nursing Service -Director of Nursing Service. What needs to happen now and how you can help: California Prison System Skirting the Law? A neutral expert investigator was appointed by Judge Kimberley Mueller to look into the data-related allegations in the Golding Report. The psychiatrist and the psychologist are both members of the treatment team. Title 22 Regulations apply to all community care facilities regulated by the Community Care Licensing Division, except where specifically exempted, and are available at the California Department of Social Services website at the above link. Written comments can be sent to CDCR, Regulation and Policy Management Branch, P.O. Patients with psychiatric disorders need proper medical care too. Logging this “telepsychiatry” visit as an actual medical evaluation makes CDCR appear to meet required benchmarks. These trainees or unlicensed Psychologists and Social Workers are being trained in a system that allows them to overrule a physician’s medical decision. Psychologists overruling medical doctors even in emergency situations and about discharging medically complex patients from hospitals has had a steep cost in terms of bad outcomes.”. The final rules could be the same as or different than the emergency rules. GENERAL PROVISIONS . Psychiatrists need to be directing psychiatric patient care, not psychologists, particularly in the complex prison population. To make these changes permanent, CDCR must go through formal rule-making proceedings, including receiving public comments. Regardless of platitudes about the importance of including psychiatric physicians in decision making, CDCR’s actions are not consistent with such platitudes. We will update … When a psychiatric patient is treated under a different standard of care than other patients, that is discrimination. Resources. Patient harm has been documented, yet that hasn’t been enough to change the system. Article 3. CDCR has one of the highest suicide rates in the country for a prison system. How many patients should suffer needlessly before something is changed?? For the latest information regarding CDCR’s preparedness efforts for the novel coronavirus (COVID-19) visit the CDCR COVID-19 Preparedness page. Not all CDCR psychologists do this. In one disturbing example, a woman removed, then ate, her own eye four hours after an evaluation by a psychologist and being placed on suicide watch. Bob Egelko wrote for the San Francisco Chronicle: [The] woman who had been refusing to take medications was diagnosed as gravely disabled by a staff psychologist and placed in a prison hospital on suicide watch, attended by a nurse, the report said. But CDCR’s policy is to have psychologists, rather than psychiatrists, direct psychiatric patient care, even in licensed inpatient and crisis psychiatric hospitals. Because the psychiatric physician did not have to be contacted by mandate to evaluate a a patient in an emergency when the patient was to be admitted to the crisis hospital – the non-medical psychologist’s evaluations was deemed sufficient —  a psychotic patient screamed for hours and received no calming psychiatric medications. That includes proper evaluation and care by medical doctors specializing in psychiatry. If you were in prison, and someone standing outside your cell held up a laptop so you could talk to a psychiatrist on the computer screen through the narrowest window-slit in the cell door  (telepsychiatry) for a few minutes—all with your fellow prisoners nearby–should that count as a psychiatric evaluation?? Chapter 3. Juvenile Research. CDCR must abandon its policy of having a psychiatric system led and run by psychologists. Chapter 2. Both Title 15 and the DOM should be available in every prison law library, as should other CDCR policy memos, remedial plans, and documents affecting people’s rights. The memo said that the decision to discharge is made by “the primary clinician or treatment team”. Title 1. CDCR perversely deems the non-medically trained psychologist, rather than the psychiatrist (i.e., the medical doctor) to be the “primary clinician”. Title: 20-002 Implementation of the Peace Officer Selection and Employee Development revision of DOM Sections 31060.10, 32020.6, 32020.6.1, 32020.7, 32020.7.2, 32020.8 and 32020.10.3 at CDCR Subject: Addendum regarding Implementation of the Peace Officer Selection and Employee Development revision of Department Operations Manual \(DOM\) Sections 31060.10, 32020.6, … Official California Code of Regulations (CCR), Title 22, Division 4.5 The list below of the Chapters of CCR, Title 22, Division 4.5 are links to the OFFICIAL version of CCR, Title 22, Division 4.5, that is maintained by Thomson Reuters under contract with the California Office of Administrative Law. So does using the prisoner transfer system to change due dates for psychiatric visits. But none of this is based in reality, it seems. Skilled Nursing Facilities. Recidivism Reports. They may not be seen for years. Having no medical training, psychologists have no ability to evaluate medical issues such as whether a patient’s diabetes or high blood pressure is stable, or whether there is toxicity from a psychiatric medication, or indeed whether psychiatric medications are increasing or decreasing suicidal risk. Social Security. Psychiatrists should be the treatment team leaders. Exclusions. Dr. Michael Golding is the brave psychiatrist who is behind the Golding Report that set off a whole chain of events within and outside of CDCR. You can email them by cutting and pasting these email addresses:  Assemblymember.gonzalez@assembly.ca.gov,  Assemblymember.bigelow@assembly.ca.gov,  Assemblymember.bloom@assembly.ca.gov,  Assemblymember.bonta@assembly.ca.gov,  Assemblymember.brough@assembly.ca.gov,  Assemblymember.calderon@assembly.ca.gov,  Assemblymember.chau@assembly.ca.gov,  Assemblymember.carrillo@assembly.ca.gov,  Assemblymember.diep@assembly.ca.gov,  Assemblymember.eggman@assembly.ca.gov,  Assemblymember.fong@assembly.ca.gov,  Assemblymember.gabriel@assembly.ca.gov,  Assemblymember.eduardogarcia@assembly.ca.gov,  Assemblymember.maienschein@assembly.ca.gov,  Assemblymember.obernolte@assembly.ca.gov, Assemblymember.petrie-norris@assembly.ca.gov,  Assemblymember.quirk@assembly.ca.gov,  Assemblymember.robertrivas@assembly.ca.gov, Sacramento Bee  LA Times Medical Board of California, https://www.thedailybeast.com/california-prison-report-alleges-poor-treatment-of-inmates https://www.ocregister.com/2018/11/08/there-is-nothing-progressive-about-californias-prisons/ https://www.kcra.com/article/horrific-case-of-inmate-who-ate-her-eyeball-included-in-scathing-report-on-prison-psychiatric-care/24560379 https://edca.typepad.com/eastern_district_of_calif/2018/11/edca-court-releases-secret-report-alleging-poor-medical-care-for-california-prison-inmates.html https://www.kqed.org/news/11702604/california-prisons-chief-psychiatrist-says-hidden-data-exposes-broken-system-of-care, CDCR Witnesses Misleading Judge https://www.legalreader.com/california-psychiatrist-corrections-lying-mental-health/ https://www.apnews.com/c29766deb3cc4dfaafeebb9b1b5b2380 https://web.archive.org/web/20190203192902/https://www.sacbee.com/news/state/california/article219790940.html, CDCR Probe https://www.apnews.com/9d736f6f3b8d408d897bcb33bc9fd8c7, CDCR Whistleblower Case History https://edca.typepad.com/eastern_district_of_calif/2018/10/cal-prison-whistleblowers-testimony-may-be-postponed.html https://www.apnews.com/592cd04e50e447f89b49b80b661dd1a1 https://www.sacbee.com/news/state/california/article220333785.html https://californiahealthline.org/morning-breakout/fraud-investigator-to-be-appointed-to-probe-allegations-of-misleading-data-on-prison-psychiatric-care/ https://www.sfgate.com/bayarea/article/Report-rips-California-prison-psychiatric-care-13356438.php http://www.venturabroadcasting.com/gov-browns-lawyers-move-to-stop-prison-psychiatrist-whistleblower-from-testifying, More CDCR Whistleblowers Come Forward https://edca.typepad.com/eastern_district_of_calif/2018/10/more-whistleblowers-emerging-over-california-prisons-mental-health-care.html, CDCR Retaliation Against Psychiatrist https://www.correctionsone.com/california/articles/481696187-Calif-prison-psychiatrist-says-whistleblowing-cost-her-job/. California Code of Regulations, Title 15, Division 3, Chapter 1; Pending Changes to Department Regulations; Recently Adopted Department Regulations; Appendices; Authorized Pilot Programs ; Department Operations Manual (DOM) Department Operations Manual (DOM) The 2020 DOM incorporates 11 Notices of Change to DOM (NCDOMs) issued from January 1 through December 31, 2019. Social Security Division 1.8. The attorneys are representing CDCR prisoners in lawsuits claiming psychiatric mistreatment. 22 to 29. Form 22 is governed by Title 15, section 3086. CDCR must obey the law (CA Title 22), and stop enabling non-medical providers to practice medicine without a license. LICENSING OF HEALTH CARE AND COMMUNITY RESI-DENCE FACILITIES . After the Golding Report came out, the staffing changes were abandoned. General Provisions Crime Prevention and Corrections Division 3 Rules and Regulations of Adult Institutions, Programs and Parole Department of Corrections and Rehabilitation Updated through October 15, 2009. 22 CCR § 101208 § 101208. These are the same people who may be caring for your family members once they (IF they) become licensed. It’s not like just putting handcuffs and ankle cuffs on someone. CDCR needs transparency, including making data available to the psychiatric leadership to guide care throughout the California System. Does anyone care about our prisoners? The DOM is the Department Operating Manual and is also available on the CDCR web site. For example, patients with a severe brain disorder called schizophrenia may refuse medications, after which they need to be monitored and persuaded to take the medicines they need to tame their disease. PUBLIC COMMENT PERIOD The public comment period begins January 22, 2021 and closes on March 12, 2021. Well, that’s not entirely true–some things have changed. Are there psychiatrists to take care of California’s prisoners, as required by law? 28 THOMSON \NEST* BARCLAYS OFFICIAL CALIFORNIA CODE OF REGULATIONS 425 Market Street.Fourth Floor.San Francisco, CA 94105 800-888-3600 • Title 22 California Department ofAging Table ofContents Division 1.8. If you click on links within the blog post, you'll find the…, Patients deserve truth and transparency regarding their healthcare and those providing their…, Please explain how this harms patients., Please provide evidence. Please take 5 minutes to complete the state’s California COVID-19 vaccine survey. The Golding Report was submitted by attorneys to a judge, The Honorable Kimberley Mueller. And we wonder how that event might be related to the resignation of the Chief Psychiatristof the California Institute for Women, who was given no power to change the culture and policies of the CDCR to improve patient care. 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