Policy Text
Copyright Lexipol, LLC 2025/06/ 27, All Rights Reserved.
Published with permission by Santa Clara County Office of the
Sheriff Non-Emergency Health Care - 1 Santa Clara County Office of the Sheriff
Custody Manual
Non-Emergency Health Care
702.1 PURPOSE AND SCOPE
The purpose of this policy is to support Adult Custody Health Services (ACHS) in delivering non-
emergency health care, including facilitation of Medical, Dental, and Mental Health services.
702.2 POLICY
It is the policy of the Santa Clara County Office of the Sheriff to support ACHS in delivering health
care services to all incarcerated persons (15 CCR 1200).
The Executive Medical Director, in coordination with the Assistant Sheriff of Custody Operations
or the authorized designee, is responsible for developing a process that includes:
(a) A process for incarcerated persons to request health care services on a daily basis.
(b) A priority system for health care services to acquire and address requests for routine
health care, and for urgent or emergent injuries, illnesses, and conditions.
(c) Making sick call forms available in each housing unit for all incarcerated persons (15
CCR 1211).
(d) A system in which sick call requests are documented, triaged, and referred
appropriately.
(e) Restrictions that prohibit non -health services personnel from diagnosing or treating
an illness.
702.3 HEALTH SERVICE REQUESTS
Health service request forms are used to request health services such as medical, mental health
or dental. Health service request forms shall be made readily available in all housing units for all
incarcerated persons at all times.
Incarcerated persons may submit a health care request form to a locked mailbox that may be
accessed only by ACHS staff. Incarcerated persons who are not able to submit a written health
service request form for security or behavioral reasons, shall be permitted to submit a request for
health care services during sick call.
Incarcerated persons who are unable to submit a written health service request form, may verbally
report a healthcare need to any Custody Bureau staff and/or ACHS staff. In the event an
incarcerated person submits a health service request to Custody Bureau staff, the staff member
shall forward all requests to ACHS. Collection and triaging of health service request forms are the
responsibility of ACHS.
702.4 INCARCERATED PERSON PERSONAL DOCTOR AND/OR DENTIST
(a) Incarcerated persons who wish to see their own personal doctor or dentist must obtain
a court order. The court order must state the name and address of the doctor/dentist
and the date and time of the appointment.Policy
702
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Copyright Lexipol, LLC 2025/06/ 27, All Rights Reserved.
Published with permission by Santa Clara County Office of the
Sheriff Non-Emergency Health Care - 2 Santa Clara County Office of the Sheriff
Custody Manual
Non-Emergency Health Care
(b) All expenses of a private doctor or dentist are incurred by the incarcerated person to
include transportation and supervision costs of the Sheriff's Office Custody Bureau
escort.
702.5 POLICY REVIEW
This policy shall be reviewed at least once every two years.
702.6 POLICY TRACKING
Date of Origin 09/06/2023
Review Date 06/27/2027
Revision Date
Date Approved 06/27/2025
Effective Date 06/27/2025
Supersedes New Policy
References DOC Policy Manual 12.01 Rev. 12/20/2023, DOC
Policy Manual 12.31 Rev. 11/04/2008, 15 CCR
1200, 15 CCR 1211
Regulatory Authority 15 CCR 1206
Signature of Issuing Authority
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