CCHP cheat sheet

NCCHC (National Commission on Correctional Health Care) publishes separate standards manuals for jails, prisons, juvenile facilities, and mental health services; each manual uses the same A–E rating structure for essential standards: A = important, B = important but addressable through an action plan, C = desirable, D = conditional (applies only when the service exists), E = not applicable.

Essential standards (A and B ratings) are the compliance floor for accreditation; nonessential standards (C) are reviewed but do not by themselves block accreditation. Compliance is scored as 'met,' 'not met,' or 'not applicable,' and any unmet A or B standard must be addressed in a written corrective plan with a timeline.

The standards are organized into facility-level sections: governance and administration, personnel and training, safety, health services support, inmate/patient care and treatment, health records, and, where applicable, medical-legal issues. Each section contains numbered standards (e.g., P-A-01) whose letter codes indicate the domain and rating.

Accreditation is a voluntary, three-year cycle: a facility submits an application, completes a self-survey against the current manual, receives an on-site survey by NCCHC surveyors, and is then reviewed by the accreditation committee. Reaccreditation requires a new self-survey and survey before the cycle expires.

The health authority (the responsible physician, or a designated clinician with authority over health services) is the single accountable clinical leader for the facility's health program and must be a licensed physician with correctional health experience or documented equivalent training.

A written health services policy and procedure manual must be maintained, reviewed at least annually, dated, and signed by the health authority; it must cover intake screening, sick call, medication administration, emergency response, infection control, and chronic disease management.

Continuity of care is a core standard: the facility must arrange for continuation of prescribed medications and treatment on transfer or release, provide discharge planning for patients with chronic or serious conditions, and document the referral or transfer in the health record.

Confidentiality: health records are kept confidential and separate from custody records; access is limited to clinicians and authorized staff, and disclosures require patient consent or a legally recognized exception (e.g., court order, public health reporting).

Staff training must be documented and role-specific: all staff receive initial and annual training in CPR/first aid, infection control, and emergency response, while clinical staff receive additional training in correctional health topics and licensure verification is maintained on file.

Intake health screening must be completed by a qualified health care professional (or trained staff under clinician oversight) within the first 24 hours of admission and must include medical and mental health history, current medications, communicable disease risk, suicide risk, and dental needs; a positive screen triggers a comprehensive health assessment.

A comprehensive health assessment (history and physical) must be completed by a physician, physician assistant, or nurse practitioner within 7 days of admission for inmates who remain incarcerated, and it must address chronic conditions, medications, and needed referrals.

Sick call and nursing triage: facilities must provide a system for inmates to request care, with triage by a nurse and access to a clinician; requests must be documented, and urgent complaints must be seen the same day rather than queued in routine sick call.

Medication administration must follow written policy: medications are administered by licensed personnel (or trained staff under supervision where permitted), with documented time, dose, and patient response; self-medication (keep-on-person) requires clinician approval and monitoring.

Chronic disease management requires written protocols for conditions such as diabetes, hypertension, asthma, HIV, and seizures, including monitoring parameters, medication refill procedures, and referral criteria to outside specialists.

Suicide prevention is a required program: screening at intake, a documented suicide risk assessment for positive screens, housing and observation levels matched to risk, and staff training in recognition and response; patients on suicide watch require documented monitoring intervals.

Emergency response: each facility must have a written emergency plan, accessible emergency equipment (AED, oxygen, first aid), a defined emergency medical response time, and documented drills; staff must be trained in CPR and first aid.

Health records must be complete, accurate, legible, and contemporaneous, with entries dated and signed by the author; records are retained per state and facility requirements, and the facility must have a process for reviewing records for completeness and quality.

Infection control: a written program must address hand hygiene, sharps handling, communicable disease screening (e.g., TB, HIV, hepatitis), isolation procedures, and reporting of outbreaks to public health authorities; TB screening at intake is a standard expectation.