BANKS et al v. BOOTH et al, No. 1:2020cv00849 - Document 100 (D.D.C. 2020)
Court Description: MEMORANDUM OPINION. Signed by Judge Colleen Kollar-Kotelly on 6-18-2020. (Attachments: # 1 Exhibit April 19, 2020 Amici Report, # 2 Appendix Appendix to April 19, 2020 Report, # 3 Exhibit Transcript of May 11, 2020 Amici Oral Report, # 4 Exhibit May 22, 2020 Amici Report) (lcckk3)
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BANKS et al v. BOOTH et al Doc. 100 Att. 4 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA ____________________________________ EDWARD BANKS, et al., Plaintiffs, v. No. 1:20-cv-849 (CKK) QUINCY BOOTH, in his official capacity as Director of the District of Columbia Department of Corrections, et al., Defendants. ____________________________________ REPORT SUBMITTED BY AMICUS CURIAE PURSUANT TO APRIL 28, 2020 CONSENT ORDER Pursuant to the April 28, 2020 Consent Order issued in the above-captioned matter, Amici, Grace M. Lopes and Mark Jordan, submit the following report for the Court’s consideration. I. INTRODUCTION On April 9, 2020 amici were appointed to provide specific information to the Court regarding medical services and environmental health and hygiene at two detention facilities operated by the District of Columbia Department of Corrections (“DOC”), the Central Detention Facility (“CDF”) and the Correctional Treatment Facility (“CTF”). Pursuant to that order amici provided information to the Court during an April 15, 2020 teleconference and in a written report on April 18, 2020. On April 19, 2020, the Court issued an order granting plaintiffs’ request for a Temporary Restraining Order (“TRO”) and requiring the defendants to take certain specified actions. Thereafter, on April 28, 2020 amici were appointed to provide information to the Court Dockets.Justia.com regarding certain matters related to the TRO, which concern the COVID-19 pandemic at the CDF and the CTF. Following issuance of the April 28, 2020 order and using the same methodology applied in their earlier review, amici collected and analyzed data obtained from site visits at both facilities; conducted structured interviews with DOC managers, line staff, inmates, and contractors; reviewed electronic health records; and analyzed multiple electronic datasets extracted from information management systems maintained by the DOC or its contract services providers. The April 28, 2020 order required amici to provide information to the Court by answering five questions during an oral report to the Court on May 11, 2020, and four additional questions in a written report required to be submitted by May 20, 2020. Accordingly, during a teleconference with the Court and the parties on May 11, 2020, amici presented their findings concerning the first five questions reflected in the order. This report supplements but does not restate that presentation and summarizes amici’s responses to the remaining four questions reflected in the order. In addition, this report explains the methodology amici relied upon to conduct their assessment, addresses relevant background data regarding the facilities subject to the assessment, and presents updated information concerning the prevalence of COVID-19 cases at both the CDF and CTF. The defendants have continued to cooperate fully with amici’s requests for information. DOC and contract staff at every level, as well as representatives from the Office of the Attorney General, have continued to make themselves available on short notice, on every day of the week, and well after traditional office hours. Data reports and other records have continued to be produced on abbreviated timelines. Amici appreciate the efforts the defendants have continued to make to facilitate their review. 2 II. METHODOLOGY Following the issuance of the April 28, 2020 order, amici conducted unannounced and unescorted site visits on multiple shifts on May 7 and 8, 2020, at both the CDF and CTF, respectively. In addition, amici conducted an unannounced and unescorted site visit at the CDF during the PM shift on May 14, 2020. During the course of these site visits, amici visited general population, maximum and medium security housing units, including housing units on isolation, quarantine and non-quarantine status, special management and mental health units at both facilities, and the CTF infirmary and urgent care clinic. Five housing units at the CDF (N1, NW-1, SW-3, SE-2 and N-2) and six housing units (C3A, C3B, SMUB, D2A, E4B, E4A) in addition to the infirmary at the CTF were visited. The isolation unit at the CDF (N-2) was visited on two separate dates. Observations in housing units included cells, dayrooms, restrooms, supply storage areas, and shower facilities. At both facilities, medical units, administrative offices, and visitor entry areas were visited. Structured in-person and/or telephone interviews were conducted with members of the DOC executive management team, including the DOC Deputy Directors of Administration, Operations, Programs and Case Management, and Professional Development and College and Career Readiness; the DOC Medical Director; the Medical Director, Director of Nursing, and other members of the Correctional Health Program at Unity Health Care, Inc. (“Unity”);1 the CDF and CTF Warden and the Deputy Warden assigned to the CTF; and dozens of correctional officers and supervisory correctional staff assigned to various posts throughout the facilities. Inperson interviews were also conducted, in groups and individually, with over 100 inmates on 1 Unity provides medical services on a contractual basis to inmates at the CDF and CTF. 3 isolation, quarantine and non-quarantine status as well as in restricted housing units and in the general population at both facilities. In addition to the information collected during site visits and from interviews, amici requested and continued to receive access from the DOC to the electronic health records of inmates confined at the CDF and CTF.2 Review and analysis of samples from these records has been conducted and the results were presented during the May 11, 2020 teleconference. The following data for both facilities were also obtained from the DOC and analyzed: Daily census data, including inmate housing assignments, for the period April 1, 2020 to May 14, 2020; Data related to sick call requests for the period April 19, 2020 to April 30, 2020; Data related to urgent care encounters for the period April 19, 2020 to April 30, 2020; Data related to all COVID-19 tests conducted on inmates housed at both facilities through May 14, 2020; and Open work orders for maintenance activities as of May 15, 2020. Data related to DOC correctional staffing levels was also reviewed and is addressed below. III. BACKGROUND As described in amici’s April 18, 2020 report, the CDF is a multi-story, secure detention center. At the time of the May 2020 site visits, population levels hovered at approximately 970, a decrease relative to population levels at the time of the April site visits. The facility has 18 housing units, which are both single and double celled. Analysis of DOC housing data shows that as of May 13, 2020, 59 percent of the inmates housed at the CDF were housed in single cells 2 The team amici assembled for this stage of their work included two additional members. The majority of case record reviews were conducted by Janet Maher, an attorney who has extensive experience in working in institutional and health-care settings. Ms. Maher headed the Office of Corporation Counsel's Mental Health Division from 1992 to 2000, worked as Deputy General Counsel and Chief of Staff for the District's Child and Family Services Agency from 2000 to 2007 and as DOJ Compliance Officer at Saint Elizabeths Hospital from 2007 to 2014. From 2013 to her retirement in 2016, she headed the Hospital's Performance Improvement Department. She also has provided consultative services to the Maryland and Pennsylvania behavioral health systems and to the Special Arbiter appointed by the Superior Court in Jerry M. v. District of Columbia, Superior Court of the District of Columbia, C.A. No. 1519-85. Case records were also reviewed by Brenda Foust, a senior paralegal with substantial experience in similar institutional contexts. 4 and 41 percent were housed in cells with another inmate, which represents an increase in the proportion of inmates housed in single cells compared with the previous month.3 As of May 18, 2020, DOC representatives reported that 41 cells at the CDF could not be occupied because of maintenance issues. All cells at the CDF are “wet” cells, i.e., they have toilets and sinks. Cellblocks are divided into two sides, and for most of the facility’s housing units, each side contains two tiers with 20 cells per tier.4 Each cellblock tier of 20 cells has two showers, which are shared by inmates housed in the unit and located in a common area. The CDF Culinary Unit, which is operated by a contractor and up until April 11, 2020 employed inmate workers, currently supports the food service program for both the CDF and the CTF.5 At the time of the May 2020 site visits, 15 housing units were open and three were closed. In contrast to the April 2020 site visits when there were only two quarantine units and less than a handful of inmates on isolation status, of the 15 open housing units at the CDF, 10 were quarantine units and one was an isolation unit with 26 inmates who had tested positive for COVID-19.6 The CTF had a population of approximately 365 inmates at the time of the May site visits, a decrease relative to the approximately 400 inmates confined there during the April site visits. The facility has 27 housing units. In addition to the 26-room 40-bed infirmary, a limited medical mobility unit can house up to 37 inmates. Eighteen housing units have a capacity of 50 3 Amici previously reported that as of April 13, 2020 43 percent of inmates at the CDF were housed in single cells. See Report Submitted by Amicus Curiae Pursuant to April 9, 2020 Consent Order, filed on April 19, 2020 [hereinafter Amici’s April 2020 Report] at 4. 4 There are two exceptions: N-1 is a restrictive housing unit with 72 cells and NE-3 is a mental health step-down unit with 36 cells. 5 The CTF has a separate Culinary Unit that is responsible for that facility’s food service program. At the time of the April and May site visits, the Culinary Unit at the CTF was closed due to a COVID-19 issue and it remains closed. The closure of the CTF Culinary Unit has continued to place an evident strain on the food service program at the CDF. 6 The number of quarantine and isolation units is, of course, variable, as is the number of inmates assigned to those housing units. 5 beds, four have a capacity of 96 beds, two have a capacity of 23 beds,7 and one has a capacity of 65 beds. According to DOC housing assignment records, as of May 13, 2020, consistent with the levels reported in April, 95 percent of the inmates at the CTF were housed in single cells and five percent were housed with another inmate. As of May 18, 2020, DOC representatives reported that four cells at the CTF could not be occupied because of maintenance issues. With the exception of eight housing units,8 all of the CTF’s housing units have wet cells. At the time of amici’s May site visits, 11 housing units were closed and there was one quarantine unit. There were no open isolation units.9 The four inmates who were confined at the facility on isolation status were housed in the infirmary. The infirmary and all of the quarantine units that were operating had wet cells. In contrast, during amici’s April site visits, the CTF had eight quarantine housing units and three isolation housing units.10 During the May 11, 2020 hearing, amici presented updated data regarding COVID-19 test administration results at the CDF and CTF through May 6, 2020. Subsequent to that hearing, amici obtained and analyzed data regarding COVID-19 testing data at both facilities through May 14, 2020. This analysis indicates that during the two-month period from March 14, 2020 to May 14, 2020, a total of 220 COVID-19 tests were administered to inmates at the CDF and 95 were administered to inmates at the CTF. Medical staff at the CDF ordered three additional tests; however, the inmates refused testing and were assumed to be positive for the virus. At the CDF, as of May 14, 2020, 121 inmates tested positive or were presumed to be COVID-19 positive and at the CTF 64 inmates tested positive.11 The seven-day average peak for positive 7 Each of the two restrictive housing units can house up to 23 inmates. Three of the eight housings units that do not have toilets and sinks were open during the site visits. 9 A closed housing unit was designated for inmates on isolation status, should the need arise. 10 See Amici’s April 2020 Report at 5. 11 See Ex. 1, Chart, COVID-19 Tests Administered at the CTF and CDF, by Date of Administration and Test Result, March 14, 2020 – May 14, 2020. The results of one COVID-19 test was pending as of May 17, 2020. 8 6 COVID-19 test results at the CTF was April 5 and April 6, 2020 (an average of five positive test results per day) whereas the peak for positive COVID-19 test results at the CDF was approximately two weeks later, on April 18, 2020 (an average of 5.86 positive test results).12 At the CTF there have been three positive test results out of 12 administered in the approximately one-month period between April 16, 2020 and May 14, 2020. At the CDF, inmates continued to test positive during the first two weeks of May, albeit in lower numbers than during the mid- to late-April peak. The COVID-19 pandemic has presented formidable challenges for the defendants and has had a significant impact on operations at both the CDF and the CTF. Many of these challenges are the result of decreases in correctional officer and supervisory correctional staffing levels on many shifts at both facilities, which appear in large part to be attributable to decreases in DOC workforce members who are available for duty.13 In order to assess available staffing levels, amici obtained a copy of the official DOC record that reflects every funded correctional officer and supervisory correctional position in the agency. According to this document, which is referred to as the “Schedule A,” as of May 9, 2020, the DOC had a total of 994 correctional staff positions. Of the 994 positions, 844 were correctional officer positions, 93 were lead correctional officer positions, and 57 were supervisory correctional officer positions.14 12 Peaks were measured using seven-day averages of positive COVID-19 test results. See Ex. 2, Table, COVID-19 Test Data, by Facility, by Date, and Seven-Day Average of Positive Test Results, March 14, 2020 – May 14, 2020. 13 Other factors related to the pandemic also have affected staffing levels at both facilities. For example, since approximately mid-March, correctional staff assigned to both facilities have been deployed to external posts in hospitals. This type of assignment is staff intensive, requiring two correctional officers to supervise each hospitalized inmate. At its peak, DOC managers reported that there were as many as 11 inmates in DOC custody at hospitals, which created a need to fill 22 external posts on each shift with correctional officers. This increase in demand for correctional officers placed additional strain on the already diminished workforce. 14 The Schedule A is maintained by the agency’s independent chief financial officer, and reflects every funded position allocated to the agency. 7 Because the Schedule A does not include work availability status nor work assignment location, amici obtained that data from DOC executives. These data were not consistent with the data reflected in the Schedule A.15 For the purposes of analyzing staff availability for duty, amici relied upon the data provided by DOC executives. According to that data, 20 percent of the 925 correctional officers and supervisory correctional officers employed by the agency were unavailable for duty.16 At the CDF, 21 percent (118 of 568 assigned correctional staff) were unavailable, and at the CTF, 19 percent (52 of 279 assigned correctional staff ) were unavailable.17 These calculations do not include budgeted, but unfilled correctional officer and correctional supervisory positions (i.e., vacant positions). According to the Schedule A, as of May 9, 2020, the DOC had 51 funded, vacant correctional positions. When these 51 vacant positions are added to the reported number of correctional staff who are not available for duty, the percentage of positions in the correctional workforce that were either unfilled or filled by staff unavailable for duty is 24 percent. According to CDF and CTF management, numerous correctional staff have returned to work in the past week, which has made staffing shortages less acute. Particularly at the CTF, where the inmate population is low and numerous housing units are closed, it appears staffing shortages are not having as severe an impact as was evident in the recent past. 15 The Schedule A reflects a total of 943 filled correctional officer and supervisory correctional officer positions. Data provided by DOC executive staff reflected a total of 925 filled positions. 16 Reasons staff may be unavailable for duty include the following: workers’ compensation, military leave, family leave, extended sick leave, absent without leave, and quarantine status following close contact with an individual known to have COVID-19. 17 Ex. 3, Table, Correctional Officer and Supervisory Correctional Officer Staff Availability, by Assignment Location, as of May 12, 2020. The Table also reflects that 17 percent of correctional staff assigned to the Central Cell Block and 35 percent of correctional staff assigned to the Transportation Unit were unavailable for duty. 8 IV. FINDINGS This section provides additional information related to two of the five questions in the April 28, 2020 Consent Order that were addressed during the May 11, 2020 teleconference. As contemplated by the order, the narrative provided does not restate amici’s May 11, 2020 presentation to the Court. Amici’s more comprehensive responses to the remaining four questions delineated in the order are also set forth below. A. Supplement to May 11, 2020 Oral Report As noted above, the April 28, 2020 Consent Order required amici to report orally on their answers to five specified questions during the May 11, 2020 teleconference. Supplemental information regarding questions one and three is summarized below. Question One: How are residents on non-quarantine units able to access medical care, including reporting symptoms of COVID-19 to medical staff? During the May 11, 2020 hearing, amici described significant barriers to access to health care that exist for inmates on non-quarantine housing units, including the absence of independent access to sick call request forms (i.e., inmates must request sick call request forms from correctional offices) and current policy that limits out-of-cell time to one hour daily. Amici reported that in practice at the CDF many inmates were not receiving one hour of out-of-cell time daily on a consistent basis and that at times several days elapsed before they were offered any out-of-cell time. Moreover, at the CDF, the combination of staffing limitations, population levels in housing units, and efforts to limit the number of inmates out of their cells at one time have resulted in out-of-cell time being conducted around the clock. This results in some inmates being offered out-of-cell time in the middle of the night. As explained in more detail below, these practices have limited the opportunities for inmates on non-quarantine units to access health care. 9 On May 8, 2020, the defendants provided amici with a document that describes the following six processes through which inmates can access medical care currently at both facilities:18 1) sick call; 2) enhanced access in sick call clinic; 3) urgent care clinic; 4) chronic care clinic; 5) quarantine housing unit monitoring; and 6) medical emergencies. Most inmates on non-quarantine housing units who want to access medical care for non-emergent medical conditions at both the CDF and the CTF rely on the sick call process. As implemented by the DOC, this process requires inmates to request sick call forms19 from correctional officers and to submit those forms to health care staff through designated collection boxes on the housing units.20 As noted above, because inmates do not have independent access to the sick call forms, they must request them from the correctional staff, complete them, and submit them during outof-cell time. During the April and May site visits, amici found that sick call forms were not readily available at both facilities, in all housing units, on a consistent basis. Given the limitations on out-of-cell time, particularly at the CDF, lack of an independent means for requesting sick call, and inconsistencies in the availability of the sick call forms at both facilities, the sick call process does not provide reliable, timely access to health care for inmates on nonquarantine housing units.21 18 See Ex. 4, May 8, 2020 e-mail from Eric Glover, General Counsel, District of Columbia Department of Corrections, to Grace M. Lopes, with attached untitled document describing six methods by which inmates in all housing units can access medical care. 19 See, e.g., Ex. 5, District of Columbia Department of Corrections Central Detention and Central Treatment Facilities, Sick Call Request Form. 20 The collection boxes are locked and a key to the boxes is only issued to health care staff. According to Unity’s health care managers, a nursing assistant or nurse collects the sick call forms from the boxes on a daily basis. The forms are reviewed and triaged for urgency by a nurse. Urgent requests are referred to advanced care providers in the urgent care clinic on an expedited basis and routine requests are expected to be scheduled for sick call on the calendar day following collection of the request form. A nursing sick call triage protocol, which addresses certain COVID-19 symptoms, was issued on May 5, 2020 and is included in the Appendix to this report. See Ex. 6, Unity Health Care, Inc., Sick Call Triage, May 5, 2020. 21 During the May 11, 2020 hearing, amici reported on the timeliness of the sick call process and noted the possibility of including in this report an analysis addressing whether sick call encounters were responsive to the 10 In the defendants’ May 8, 2020 submission, they report that since April 13, 2020, medical staff have been providing enhanced access to sick call, including sick call providers “going out to the [housing unit] tiers and seeing if there are any residents not on the [sick call] schedule who need to be seen that day.”22 This type of process would provide an opportunity for inmates locked in their cells to communicate health problems directly to medical staff on a daily basis, and mitigate the current barriers to accessing medical care for inmates on non-quarantine housing units. During the May 7 and May 8, 2020 site visits, amici could not verify through interviews with inmates and staff that this process is being implemented on non-quarantine housing units. During a May 15, 2020 telephone interview, a DOC manager explained initiatives to bolster the sick call process that the defendants expected to implement on May 18, 2020, including the daily collection and triage of sick call requests forms by 11:00 a.m. and the scheduling of same-day sick call appointments. The manager reported that sick call request forms would be modified to include COVID-19-like symptoms and date stamped prior to distribution by medical staff on a daily basis in an effort to promote more accurate tracking of submission and response timelines.23 While these measures may improve certain aspects of the sick call process for those able to submit request forms, they do not address the barriers accessing sick call that are identified in this report for inmates on non-quarantine units. The other processes outlined in the defendants’ May 8, 2020 submission do not directly address the health care access issues experienced by inmates on non-quarantine units. For issues inmates listed on sick call request forms. In light of time constraints, amici were unable to conduct a comprehensive qualitative analysis of an adequate sample of sick call requests relevant to this issue and thus this matter is not addressed herein. 22 See Ex. 4, supra note 18, Attachment at 1. 23 The manager stated that periodically sick call request forms are found in a collection box for inmate grievance forms. Thus, DOC staff responsible for collecting inmate grievance forms have been asked to identify any sick call request forms that may have been incorrectly submitted and immediately transmit those forms to the medical staff. 11 example, access to the urgent care clinic is dependent upon the intervention of the correctional staff and the availability of escort staff to accompany an inmate to the medical clinic. Furthermore, chronic care clinics are applicable only to those inmates who have been diagnosed with chronic health conditions. These clinics generally occur at one, two, or three-month intervals, and do not lend themselves to reporting health conditions that may arise between scheduled appointments. Question Three: Is the DOC providing consistent and reliable access to legal calls, personal telephone calls, running water, daily showers, and clean clothing and clean linens to all inmates in isolation status? During the May 11, 2020 hearing, in response to questions from the Court and counsel, amici were unable to confirm cleaning practices applicable to the telephones that are made available to inmates on rolling carts in the infirmary and isolation units and to telephones used for inmate legal calls in the offices of case managers. Subsequent review of interview and observation notes as well as a follow-up site visit conducted on May 14, 2020 indicate that the expectation is for the telephone on the rolling cart in the isolation units and infirmary to be cleaned by detail inmates after each inmate uses the telephone, and if detail inmates are not out of their cells, by the correctional staff.24 Amici have not had the opportunity to determine cleaning practices applicable to the telephones inmates use in the offices of case managers. B. Questions Six through Nine Question Six: Have DOC staff received training on properly fitted PPE, disposal of PPE, and operations of non-touch, infrared thermometers? 24 Amici have been informed that the detail inmates who perform cleaning functions in the isolation units are inmates who are housed on that unit who have tested positive for COVID-19. Correctional staff report they select the inmates to be part of the detail cohort in the isolation units after conferring with the medical staff about whether the inmate is medically fit to perform the job. 12 The defendants report that beginning on April 27, 2020 all DOC staff and food service contractors were required to participate in a mandatory training program addressing the proper donning, doffing and disposal of personal protective equipment (“PPE”).25 The training, which was developed by staff in the DOC Center for Professional Development and Learning in consultation with the agency’s infection control specialist, was offered on-line through “Bridge,” the DOC’s online professional development platform,26 as well as through written materials that were distributed to staff at both facilities.27 The defendants report that 91 percent of the DOC workforce available for duty participated in the mandatory training as of May 19, 2020.28 In addition to this training program, relative to the signage amici observed during the April site visits, the defendants have increased the number of informational signs addressing the use of PPE, including donning, doffing and disposal, throughout the CDF and CTF. The defendants also provided online training to correctional staff regarding the use of non-touch infrared thermometers; however, DOC managers have explained that the training was intended merely to familiarize those staff with the operation of the thermometers and there was no expectation that correctional staff would conduct temperature checks on inmates, staff, or visitors. The defendants report that on April 30, 2020 the DOC made an emergency request through a District-wide COVID-related emergency funding process, to fit test 150 DOC employees for N-95 respirators and train an additional 20 DOC employees to serve as fit testers. This funding has not yet been forthcoming. As an adjunct to this initiative, on May 5, 2020, a representative from DC Fire-EMS fit tested an initial cohort of 40 DOC staff for N-95 25 See Ex. 7, Open Letter to All Employees from Director Quincy L. Booth, April 27, 2020, Mandatory Training: IR Thermometer and Personal Protective Equipment. 26 See Ex. 8, “Wearing Personal Protection Equipment,” On-Line Training for DOC Staff. 27 See Ex. 9, Wearing Personal Protective Equipment Training, Handout. 28 This calculation is consistent with amici’s independent review of training data that the defendants have provided. Amici also analyzed specifically the percentage of the correctional staff who completed the training, which was 87 percent. 13 respirators. Staff members with duty assignments that present the greatest risk of exposure were selected for this initial testing. Two of the 40 staff members received training in how to conduct fit testing on DOC staff. The defendants anticipate that the two trained fit testers will work with the 20 additional staff members the DOC hopes to train to fit test the balance of the DOC workforce and thereafter conduct annual fit testing. As of May 18, 2020, the DOC’s emergency funding request remained pending and unresolved. Question Seven: Has the DOC retained a registered sanitarian to oversee the environmental health and safety programs? The defendants report that efforts are underway to hire a full-time sanitarian at the DOC. The position has been established and on May 18, 2020 the agency received authorization to post the position vacancy. Effective May 18, 2020, on an interim basis until a sanitarian can be employed by the agency, the defendants report that the DOC has retained the services of a vendor to perform the following services related to environmental health and safety:29 1) conduct an audit of environmental conditions in the CDF and the CTF, make findings, develop recommendations and formulate a corrective action plan; 2) develop a COVID-19 cleaning protocol for the DOC’s cleaning contractor to implement; and 3) provide oversight for a defined period to the DOC’s on-site cleaning contractor to ensure that the protocol is followed.30 The task order is for an initial period of three months and includes three, one-month option periods. The services of a registered sanitarian to oversee the DOC environmental health and safety program are not required by the task order; however, DOC management reports that 29 Ex. 10, Task Order Agreement No. CW82753, with Attachment A, Statement of Work. The version of the Task Order that defendants submitted to amici on May 19, 2020 is unsigned and undated; however, DOC executives informed amici that work under the contract began on May 18, 2020. 30 The task order specifies that following implementation of the cleaning protocol, the vendor will have no fewer than two personnel on site at the CDF and CTF to “shadow the onsite cleaning contractor” for not more than ten eight-hour days. See Ex. 10, Attachment A at 2, supra note 29. The task order also provides for two “follow up monthly COVID-2 inspections” and requires the vendor to submit additional recommendations “to ensure the recommended protocols are sustainable beyond the contract term.” Id. 14 the vendor will provide a team of two sanitarians to perform on-site oversight and inspections related to the COVID-19 cleaning protocol during the period of the service agreement. Question Eight: Has the DOC contracted for professional cleaning services on the secure side of the facility? On May 12, 2020 the District finalized a 90-day emergency contract with Rock Solid District Group, LLC, for comprehensive hazardous materials environmental cleaning services related to the SARS-CoV-2 (COVID-19) pandemic at the CDF.31 The contract provides for environmental HAZMAT-level cleaning services on the secure and non-secure sides of the facility, including the common areas of all housing units.32 The defendants report that a virtually identical emergency contract was finalized this week with a different contractor for services at the CTF. Amici has requested but not obtained a contract reflecting service delivery at the CTF.33 Question Nine: Has the DOC consulted with public health professional[s] regarding strategies to strengthen the COVID-19-related education program for both staff and inmates; if so, has the DOC implemented those education program strategies? According to DOC management, the agency developed certain educational materials related to COVID-19, which they transmitted for review and comment to staff in the District of Columbia Department of Health’s epidemiology division on May 9, 2020. These materials include frequently asked questions, and information regarding personal protective equipment. Some of the materials are intended to be distributed to staff only and others are intended for both inmates and staff. As of May 15, 2020, the DOC had received some substantive feedback from the epidemiology staff at DOH and anticipated receiving additional feedback in the near term. 31 See Ex. 11, Contract No. DCAM-20-NC-EM-0079A, effective May 12, 2020. See Ex. 12, Areas of Responsibility for Cleaning Crew [Central Detention Facility]. 33 The defendants provided amici with a copy of a contract reported to cover the CTF; however, while it appears this was a drafting error, the document that was submitted addresses HAZMAT-level cleaning services at the CDF and not the CTF. 32 15 The DOC plans to revise the educational materials they have developed based on the feedback that is received from DOH epidemiologists and thereafter distribute these materials, as applicable, to staff and inmates. DOC representatives report that they have an inventory of 350 computer tablets, onto which they load educational and other materials for inmates who participate in specialized programs. These tablets now include health information related to COVID-19. The agency recently received approval to procure 1000 additional tablets on an expedited timetable. It is anticipated that these tablets will be distributed to inmates at both the CDF and CTF. The defendants contemplate including the educational materials that are the subject of ongoing review by DOH on the tablets. Observations and discussions with inmates and DOC staff during the May site visits underscore the critical need for intensified educational efforts related to COVID-19, including the importance of consistently and properly wearing personal protective equipment and when testing for the virus is indicated. V. CONCLUSION Since amici’s April 19, 2020 report, the impact of COVID-19 at the CDF and CTF has changed significantly. While the COVID-19 outbreak began at the CTF in late-March 2020 and spread rapidly among the population housed there, beginning in mid-April 2020 the number of new cases at the CTF declined to very low levels. In contrast, the CDF was impacted by COVID-19 for the first time during the second week of April 2020, when the novel coronavirus began its spread during the subsequent five-week period to over 120 inmates and an indeterminate number of staff. At both facilities, by mid-May 2020, the rate of new COVID-19 cases had dropped significantly from peak levels. 16 DOC management and its contracted health care agency have begun the process of implementing improvements to the medical and environmental health programs to contain and mitigate the effects of the COVID-19 outbreak at the two facilities. Medical staff routinely monitor and assess inmates housed on quarantine and isolation housing units; however, access to medical care for inmates on non-quarantine housing units has been limited due, in large part, to lack of independent access to health care providers coupled with inmates confined to their cells for extended time periods. DOC representatives report that an enhanced sick call process has been implemented involving sick call providers walking housing unit tiers to ask inmates directly if they have health issues they would like medical staff to address. However, during the May 2020 site visits, neither inmates nor housing unit staff could verify that this process has been implemented. Such a process, if consistently implemented, would provide inmates who are confined on nonquarantine housing units much greater access to health care than they currently have. DOC representatives have indicated that they are making additional changes to the sick call system to address the timeliness of responses to sick call requests. While these changes may result in improvements, it does not appear that these changes will address the barriers that amici have identified. Since amici’s April 2020 site visits, personal protective equipment has been made much more widely available to inmates and staff at the CDF and CTF and most staff have been trained on proper donning, doffing and disposal procedures. As addressed in this report, there is a need for continued emphasis on the importance of consistently and properly wearing personal protective equipment for inmates and staff alike. Fit testing of N-95 respirators has begun for 17 DOC staff with the greatest exposure risk and there are short and long-term plans to fit test the remainder of the DOC correctional workforce. The DOC has received authorization to hire a sanitarian to oversee the environmental health and safety program at both facilities. Until that individual is employed, the agency has retained a professional environmental consulting firm to provide specified services related to environmental health, including the development of a COVID-19 cleaning protocol. Furthermore, the DOC has contracted for professional and specialized cleaning services on the secure and non-secure sides of both facilities. The efforts described above have the potential to reduce the spread and impact of COVID-19 at the CDF and CTF. During this period that the DOC is responding to the COVID19 outbreak, inmates and staff alike are feeling the consequences acutely. For inmates, social distancing, quarantine, and medical isolation practices have resulted in prolonged periods of severely restrictive confinement, isolation, and idleness. Inmates express anger and frustration at being required to spend extended periods in their cells and fear at the prospect of contracting COVID-19. There is a need to provide ongoing support and opportunities for inmates to engage in constructive activities as well as to provide inmates with continuing education about COVID19 and how to prevent its spread. The effectiveness of the DOC’s response continues to depend on the efforts of staff working in the facilities each day. The correctional workforce is currently diminished due to large numbers of staff being unavailable for duty and many housing units operate short staffed. Members of the correctional staff have consistently told amici that they are exhausted from working long hours under very stressful working conditions, which may include exposure to the novel coronavirus and in some instances the need to wear full PPE for extended time periods. It 18 is important to continue to reinforce for staff the essential role that they play in controlling the spread of the virus and the methods they should employ to minimize the risk of contracting or spreading COVID-19. The significant contribution of DOC staff members during this public health emergency should be recognized and they should be provided with the necessary supports to perform their duties. Amici are available to answer any questions the Court or the parties have about the matters addressed in this summary report. Respectfully submitted, /s/_Grace M. Lopes_______ Amicus Curiae Grace M. Lopes Bar No. 358650 Executive Director Rising for Justice 901 4th Street, N.W., Suite 6000 Washington, D.C. 20001 202-607-2224 gmlopes@risingforjustice.org Mark Jordan mark@markjordan.consulting 1220 19th Street, N.W. Suite 500 Washington, D.C. 20036 202-525-6732 May 20, 2020 Washington, D.C. 19 INDEX TO EXHIBITS Exhibit 1 Chart, COVID-19 Tests Administered at the CTF and CDF, by Date of Administration and Test Result, March 14, 2020 – May 14, 2020 Exhibit 2 Table, COVID-19 Test Data, by Facility, by Date, and Seven-Day Average of Positive Test Results, March 14, 2020 – May 14, 2020 Exhibit 3 Table, Correctional Officer and Supervisory Correctional Officer Staff Availability, by Assignment Location, As of May 12, 2020 Exhibit 4 May 8, 2020 e-mail from Eric Glover, General Counsel, District of Columbia Department of Corrections, to Grace M. Lopes, with attached untitled document describing six methods by which inmates in all housing units can access medical care Exhibit 5 District of Columbia Department of Corrections Central Detention and Central Treatment Facilities, Sick Call Request Form Exhibit 6 Unity Health Care, Inc., Sick Call Triage, May 5, 2020 Exhibit 7 Open Letter to All Employees from Director Quincy L. Booth, April 27, 2020, Mandatory Training: IR Thermometer and Personal Protective Equipment Exhibit 8 “Wearing Personal Protective Equipment ,”On-line Training for DOC Staff Exhibit 9 Wearing Personal Protective Equipment Training, Handout for DOC Staff Exhibit 10 Task Order Agreement No. CW82753, with Attached A, Statement of Work Exhibit 11 Contract No. DCAM-20-NC-EM-0079A, effective May 12, 2020 Exhibit 12 Areas of Responsibility for Cleaning Crew [Central Detention facility]. EXHIBIT 1 25 Refused 3/15/2020 3/17/2020 3/19/2020 3/21/2020 3/23/2020 3/25/2020 3/27/2020 3/29/2020 3/31/2020 4/2/2020 4/4/2020 4/6/2020 4/8/2020 4/10/2020 4/12/2020 4/14/2020 4/16/2020 4/18/2020 4/20/2020 4/22/2020 4/24/2020 4/26/2020 4/28/2020 4/30/2020 5/2/2020 5/4/2020 5/6/2020 5/8/2020 5/10/2020 5/12/2020 5/14/2020 3/14/2020 3/16/2020 3/18/2020 3/20/2020 3/22/2020 3/24/2020 3/26/2020 3/28/2020 3/30/2020 4/1/2020 4/3/2020 4/5/2020 4/7/2020 4/9/2020 4/11/2020 4/13/2020 4/15/2020 4/17/2020 4/19/2020 4/21/2020 4/23/2020 4/25/2020 4/27/2020 4/29/2020 5/1/2020 5/3/2020 5/5/2020 5/7/2020 5/9/2020 5/11/2020 5/13/2020 COVID-19 Tests Administered at the CTF and CDF, by Date of Administration and Test Result March 14, 2020 - May 14, 2020 Total Tests During Period Administered at CTF = 95 Positive Tests = 64 Negative Tests = 31 Positive Tests Presumed Positive Tests Total Tests During Period Administered at CDF = 223 Positive Tests = 118 Presumed Positive = 3 (Inmates Refused Test) Negative Tests = 101 Pending Results = 1 20 15 10 5 0 CTF CDF Negative Tests Pending Results EXHIBIT 2 COVID-19 Test Data, by Facility, by Date, and Seven Day Average of Positive Test Results March 14, 2020 - May 14, 2020 Positive Tests Row Labels CTF Refused 3/14/2020 3/15/2020 3/16/2020 3/17/2020 3/18/2020 3/19/2020 3/20/2020 3/21/2020 3/22/2020 3/23/2020 3/24/2020 3/25/2020 3/26/2020 3/27/2020 3/28/2020 3/29/2020 3/30/2020 3/31/2020 4/1/2020 4/2/2020 4/3/2020 4/4/2020 4/5/2020 4/6/2020 4/7/2020 4/8/2020 4/9/2020 4/10/2020 4/11/2020 4/12/2020 4/13/2020 4/14/2020 4/15/2020 4/16/2020 4/17/2020 4/18/2020 4/19/2020 4/20/2020 4/21/2020 4/22/2020 4/23/2020 4/24/2020 4/25/2020 4/26/2020 4/27/2020 4/28/2020 4/29/2020 4/30/2020 5/1/2020 5/2/2020 5/3/2020 5/4/2020 5/5/2020 5/6/2020 5/7/2020 5/8/2020 5/9/2020 5/10/2020 5/11/2020 5/12/2020 5/13/2020 5/14/2020 64 Presumed Positive Tests Negative Pending Grand Tests Results Total 31 95 1 1 1 1 1 3 1 3 2 1 2 3 2 1 2 4 2 4 10 9 7 3 2 3 3 1 2 1 2 1 1 1 2 3 1 3 5 2 10 11 7 3 8 4 1 5 1 2 1 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 6 1 1 2 1 1 1 1 1 Seven Day Average of Positive Test Results 0.00 0.00 0.00 0.00 0.00 0.14 0.57 0.57 0.86 1.00 1.29 1.71 1.57 1.43 2.00 1.71 3.00 4.00 4.57 5.00 5.00 4.86 4.86 3.86 2.71 2.00 1.71 1.71 1.29 1.29 0.86 0.71 0.43 0.29 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.14 0.14 0.14 0.14 0.14 0.14 0.14 0.00 0.00 0.00 0.00 0.14 0.29 0.29 COVID-19 Test Data, by Facility, by Date, and Seven Day Average of Positive Test Results March 14, 2020 - May 14, 2020 CDF Refused 3/14/2020 3/15/2020 3/16/2020 3/17/2020 3/18/2020 3/19/2020 3/20/2020 3/21/2020 3/22/2020 3/23/2020 3/24/2020 3/25/2020 3/26/2020 3/27/2020 3/28/2020 3/29/2020 3/30/2020 3/31/2020 4/1/2020 4/2/2020 4/3/2020 4/4/2020 4/5/2020 4/6/2020 4/7/2020 4/8/2020 4/9/2020 4/10/2020 4/11/2020 4/12/2020 4/13/2020 4/14/2020 4/15/2020 4/16/2020 4/17/2020 4/18/2020 4/19/2020 4/20/2020 4/21/2020 4/22/2020 4/23/2020 4/24/2020 4/25/2020 4/26/2020 4/27/2020 4/28/2020 4/29/2020 4/30/2020 5/1/2020 5/2/2020 5/3/2020 5/4/2020 5/5/2020 5/6/2020 5/7/2020 5/8/2020 5/9/2020 5/10/2020 5/11/2020 5/12/2020 5/13/2020 5/14/2020 Grand Total 118 3 3 1 1 1 1 1 1 1 2 2 2 2 2 1 1 2 2 2 2 2 1 2 9 2 2 21 3 7 13 1 5 9 10 12 5 7 4 4 7 8 3 9 7 9 2 4 1 2 6 3 1 3 1 3 2 2 6 4 3 2 2 5 8 1 5 2 3 3 2 3 1 3 3 3 2 1 3 223 3 1 1 2 2 1 9 2 2 12 3 5 9 1 4 7 4 9 4 4 3 4 4 6 1 3 3 182 101 132 1 1 8 4 5 8 10 4 1 5 4 3 1 318 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.14 0.29 0.43 0.57 0.57 0.86 1.14 2.71 3.00 3.57 4.71 4.86 5.14 5.86 4.71 5.57 5.43 4.71 5.00 5.00 4.57 4.86 3.71 3.57 3.43 3.00 2.86 2.57 2.00 2.57 3.29 3.00 3.00 2.86 2.71 2.43 1.71 EXHIBIT 3 Correctional Officer and Supervisory Correctional Officer Staff Availability, by Assignment Location As of May 12, 2020 Location CDF CTF CCB Transportation Grand Total Work Status Available for Duty Unavailable for Duty Number Percentage Number Percentage 450 227 39 20 736 79.23% 81.36% 82.98% 64.52% 79.57% 118 52 8 11 189 20.77% 18.64% 17.02% 35.48% 20.43% TOTAL PERCENTAGE 568 279 47 31 925 100.00% 100.00% 100.00% 100.00% 100.00% EXHIBIT 4 From: Glover, Eric (DOC) <eric.glover@dc.gov> Sent: Friday, May 8, 2020 9:06 AM To: Grace Lopes <gmlopes@risingforjustice.org> Cc: Saindon, Andy (OAG) <andy.saindon@dc.gov>; Mark Jordan <mjordan@sparb.org> Subject: RE: Time-Sensitive Data Requests -- Banks v. Booth Grace, Attached is a worksheet describing the six paths to medical treatment for residents at DOC. Thank you and have a good weekend. Regards, Eric S. Glover General Counsel District of Columbia Department of Corrections 2000 14th Street, 7th Floor Washington, D.C. 20009 Phone: (202) 671-0088 Office Cell: (202) 286-8736 Fax: (202) 671-2514 Confidentiality Notice: This message is being sent by or on behalf of a lawyer. It is intended exclusively for the individual or entity to which it is addressed. This communication may contain information that is proprietary, privileged or confidential, or otherwise legally exempt from disclosure. If you are not the named addressee, you are not authorized to read, print, retain, copy, or disseminate this message or any part of it. If you have received this message in error, please notify the sender immediately by email and delete all copies of the message. Metadata: This email transmission and any accompanying material may contain embedded metadata. Any included metadata is confidential or privileged information and is not intended to be viewed by a non-client recipient. Residents in all housing units are able to access medical care on all housing units via six processes outlined as follows: 1. Sick Call- Sick call requests are collected daily by nursing staff, where they are date stamped, then triaged according to Unity’s “Sick Call Triage” policy. The slips are then given to the unit clerk/medical assistant who schedules the resident’s appointment. This scheduling process is trackable in the Electronic Medical Record (EMR). If the nature of the sick call request is not urgent or symptom-based, the resident might be assessed after 48 hours depending on the nature of the concerns. After the unit clerk/medical assistant schedules the appointment, the sick call slip is scanned into the EMR within 24 hours (and the hard copy is shredded for HIPAA compliance). Occasionally residents place their sick call slips in the resident grievance box or in the mail, which can cause the slip to be delayed in arriving to the nursing triage areas. Date-stamping the sick call slip, scheduling the appointment in the EMR, and viewing the clinical note in the EMR are all easy to track and essentially serve as an electronic log for this process. 2. Enhanced Access in Sick Call clinic- Each day in DOC’s housing units, residents are seen by a nurse practitioner, physician’s assistant, or physician on their unit’s Sick Call clinic. Residents are placed on the sick call schedule in a variety of ways. One way, referenced above, is through the sick call request process. Patients may also be scheduled by the urgent care provider (for example, a blood pressure check after a patient is seen in urgent care for a high blood pressure reading). Chronic care providers can also place patients on the sick call schedule for similar, simple follow up needs. The sick call providers also receive all abnormal intake lab results and see patients to discuss and treat a positive result, such as for chlamydia or a syphilis infection. Lastly, sick call providers are also going out onto the tiers and seeing if there are residents not on the schedule who need to be seen that day. This enhancement enables those who may not have filled out a sick call slip, or those who may not want to discuss their COVID-19 status or other concerns in a public setting, to be seen by a provider in the sick call clinic that day. On any given day, more patients may be seen in the Sick Call clinic than were on the original roster. The sick call process can be tracked in the EMR. This enhancement commenced on 04/13/2020. 3. Urgent Care Clinic - Residents are instructed in the Inmate Reception Center, the Intake Housing Unit and on all housing units that they can bring more urgent health concerns (including a wide range of symptoms that could be consistent with COVID) to a DOC officer’s attention and be seen in at the DOC’s Urgent Care Clinic, the same day of their complaint. Once alerted of a resident’s complaint, DOC’s correctional officers call medical staff who instruct the officers to bring the resident directly to the Urgent Care Clinic to be seen. Resident visits to the Urgent Care Clinic are documented in their EMR notes. 4. Chronic Care Clinic- Residents receive a comprehensive medical assessment during their initial intake screening. Those who present with a chronic medical condition are assessed, treated then scheduled for a follow-up appointment in the Chronic Care Clinic. The follow up appointments are usually scheduled 30 days out, but can be scheduled sooner, if necessary. Based on the stability of their condition, resident will have follow-up care appointments at either 30, 60 or 90 day intervals (or sooner as needed). These appointments are tracked in the EMR. If a patient presenting for a Chronic Care Clinic appointment exhibits COVID-19 related symptoms (e.g, as detected by vital signs), they will be placed under investigation for COVID – 19. 5. Quarantine Housing Unit monitoring: Residents on the quarantine unit are seen twice daily by Unity’s nursing staff. On their rounds on the quarantines housing units, nurses assess residents’ vital signs and ask the residents if they have any COVID-19 symptoms or other concerns. These visits are noted in the EMR. As an enhancement designed to help pick up COVID-19 positive patients quickly, when nurses note any abnormal vital signs or have a resident complain of symptoms, the nurses immediately call a provider (NP, PA or MD) and the resident is seen (and generally swabbed) within two hours. Regular Sick Call clinic also occurs on all housing units under quarantine. Patients seen in sick call clinic that day may exceed the initial roster of patients scheduled if nurses note abnormalities in vital signs or want residents to be quickly seen given their complaints. This enhancement to care commenced 03/26/2020 with the first quarantine unit. 6. Medical Emergencies- When a resident has an acute medical emergency, DOC’s correctional officers call Unity’s Urgent Care Provider and a code is called to that Unit. The Medical Emergency Response Team promptly response to the call to assess the resident. If the resident requires treatment beyond what can be provided at DOC, 911 is called and DC Fire and Emergency Medical Services arrive to assess the need for the resident to be transferred to a higher level of care. Medical emergencies can be tracked through a resident’s EMR. EXHIBIT 5 EXHIBIT 6 DEPARTMENT: CENTRAL DETENTION FACILITY AND CORRECTIONAL TREATMENT FACILITIES HEALTH SERVICES DIVISION REVIEWED BY: UNITY HEALTH CARE, INC. TITLE: Nrsng Protocol: Triage Sick Call Triage PAGE: 1 of 1 EFFECTIVE DATE: DATE REVISED: May 05,2020 APPROVED BY MEDICAL DIRECTOR: PURPOSE: To establish and maintain a guidance for triage of sick call slips as part of the Sick Call process at the DC Department of Corrections. DEFINITION: The process of determining the priority of patients' treatments based on the severity of their condition or likelihood of recovery with and without treatment. PROCEDURE: Upon review of th£?sick'call slips, using clinical judgement, determine the triage level 1. .Level 1- Emergency/Urgent Care Chest pain Withdrawal Symptoms Respiratory Symptoms (shortness of breath, hyperventilation, respiratory depression) Syncope (passed out, confusion, "blackout," Seizure activity Positive TSTITB Exposure Severe injury Severe abdominal pain Severe dehydration COVID symptoms (headache, GI symptoms, SOB, cough, fever) Suicidal Ideation/Gestures/Attempt 2. Level 2 - Sick Call (schedule appointment) Mild cold symptoms Minor injuries Rx refill requests Mild-Moderate Pain (1-6/10 pain scale) Well ness Checks Dietary Requests STD Testing Blood Pressure Check Specialty requests (Ophthalmology, podiatry, dermatology) Nursing Sick Call Triage Protocol . 1 EXHIBIT 7 D.C. Department of Corrections Office of the Director Open Letter to All Employees From Director Quincy L. Booth DOC-OL20-09: April 27, 2020 (Mandatory Training: IR Thermometer and Personal Protective Equipment) In these unprecedented times, DOC appreciates your ongoing dedication, professionalism and support of the agency’s critical mission. The safety and security of staff, residents and contractors is our top priority. As we work together to respond to the COVID-19 public health emergency, we need to constantly emphasize the importance of personal protective equipment (PPE). That is why we are providing masks and gloves to everyone entering our facilities and requiring they be worn at all times. Staff assigned to transportation and the quarantine and isolation units will be provided specific PPE for use in those areas. It is imperative that all staff understand how to properly use, don, doff, and dispose of their PPE. I want to thank the Center for Professional Development and Learning team for creating the required training module, “Wearing Personal Protective Equipment,” through the Bridge Learning Management System. This training is mandatory for all DOC staff. Please take the necessary time to complete the training. If you are completing the training during your shift, you must get your supervisor’s approval prior to completing the course during your shift. Please see the attached instructions on how to navigate the system. It is critical that everyone take this course and I ask for your cooperation. If you have any questions or concerns, please contact Dr. Lynnita Thomas at Lynnita.thomas@dc.gov. All DOC staff must complete the training by Monday, May 4, 2020. If you do not attend, your supervisor and division Deputy Director will be notified by the online system. The D.C. Department of Corrections’ vision is to be a benchmark correction agency. To become benchmark agency, we will serve with pride, passion and professionalism in caring for human lives. Please continue to practice health and safety precautions that will help us keep our DOC facilities, staff, and residents safe and healthy. Follow the guidance below on how to reduce your risk of infection and slow its spread. • • • • • • • Practice social distancing by staying at least six feet away from other people. Thoroughly wash your hands for at least 20 seconds multiple times a day. Avoid close contact with people who are sick. Avoid touching your eyes, nose, and mouth. Sanitize your equipment. Follow the safety protocols in place at each of the DOC facilities. If you are sick, contact your healthcare provider and request sick leave through your supervisor. Thank you for your continued commitment to serving our city and our neighbors. For more information about COVID-19, visit: https://coronavirus.dc.gov/ https://dchealth.dc.gov/coronavirus https://cdc.gov/coronavirus/2019- ncov/index.html https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/ PLEASE READ AT ALL ROLL CALLS FOR SEVEN (7) CONSECUTIVE DAYS AND POST ON ALL APPROPRIATE BULLETIN BOARDS The D.C. Department of Corrections’ vision is to be a benchmark correction agency. To become benchmark agency, we will serve with pride, passion and professionalism in caring for human lives. EXHIBIT 8 “Wearing Personal Protection Equipment” On-Line Training for DOC Staff Video links Infrared Thermometer https://youtu.be/UrMoK9CD4f0 Face Mask Use https://youtu.be/JwPWdkbyizw Donning and Doffing PPE https://youtu.be/quwzg7Vixsw EXHIBIT 9 Wearing Personal Protective Equipment Training The DC Department of Corrections takes the safety and well-being of staff, residents, visitors, volunteers and contractors extremely serious. This presentation offers information about our efforts to maintain safety! Objectives This presentation will provide: Staff training on the use of infrared thermometers & responding to inaccurate readings. Basic Personal Protective Equipment (PPE) training for staff who will train other staff and staff who will wear PPE. A review of the proper way to don, doff and discard PPE. Information on the importance of social distancing in the DOC. COVID-19 What we know about COVID-19: Coronavirus (COVID-19) is an illness caused by a virus that can spread from person to person via respiratory droplets among close contacts. The virus that causes COVID-19 is a new coronavirus that has spread throughout the world. COVID-19 symptoms can range from mild (or no symptoms) to severe illness. Preliminary Screening Any person entering the Central Detention Facility (CDF) and/or the Correctional Treatment Facility (CTF) will be required to: Allow medical staff to conduct a body temperature screening. Using Enhanced Body Temperature screening equipment (infrared technology) to measure temperature at a distance using a forward looking infrared camera. After an individual enters the building, they may be asked to pause for a few seconds for a screening. Each individual will be required to take off hats, face coverings and/or glasses. If an individual has an elevated temperature reading of 100.4°F (38°C) or higher, they will be asked to step aside for a secondary temperature screening. If the secondary screening confirms an elevated temperature, the individual will be referred to their primary health care provider and asked to leave the CDF and/or CTF. In the next slide, we will provide you with an overview of the type of Infrared No Touch Thermometer medical staff will be using. Infrared Thermometer Use In this video, an overview is provided describing the type of Infrared No Touch Thermometer medical staff will be using to conduct preliminary screenings at the CDF/CTF: Remove the protective cap from the thermometer. Press the power button to turn it on. Hold the thermometer steady for accurate reading. Make sure any hair, dirt, or sweat is clean and clear from the forehead. Position the thermometer between the eyebrows (up to 2 inches from forehead) Press the temperature button to begin. Once taken, the reading will show a green, yellow, or red light. The thermometer will beep 10 times when the temperature is 99.4 degrees or above. When you are done using the thermometer, press the power button to turn it off. (It will automatically power down after 60 seconds without use). What type of PPE will be issued? Upon entry into the CDF/CTF, individuals will be provided with Personal Protective Equipment (PPE). When is PPE Necessary? DOC staff and resident are required to wear a mask and gloves at all times to help stop the spread of the COVID-19. Staff assigned to work in isolation units shall wear PPE for the duration of being physically present in the identified isolation housing units. PPE should be worn by individuals transporting residents who are under investigation for (suspected or possible exposure) or confirmed with COVID19 within a facility. Wash Your Hands? First things first, all staff and residents are required to follow the Center for Disease Control's guidelines: • Clean and disinfect frequently touched surfaces. • Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol. Face Mask Use All DOC staff and residents are required to wear a face mask while inside any DOC facility. The use of face masks is crucial for medical staff and other people who are taking care of someone infected with COVID-19 in close settings. Wearing Gloves and Gowns Gloves should be worn when in direct contact of patients who are under investigation for (suspected or possible exposure) or confirmed with COVID-19 within our facility. Gloves should be changed between patients and hand hygiene performed before and after use. See instructions below: Proper Way to Don and Doff PPE Take a moment and review the steps showing you the proper way to Don (put on) and Doff (take off) PPE... Disposal of used PPE Once you have properly doffed your PPE, proper disposal of all used PPE is very important. At identified locations within the CDF and CTF, waste cans will be placed to receive used PPE items. Locations will be identified with clear signs stating: "For PPE Here Inside Place usage only". Importance of Social Distancing at DOC Social distancing at DOC: Social distancing, also called “physical distancing,” means keeping space between yourself and others while inside the CDF and CTF. Importance of Social Distancing at DOC To practice social or physical distancing in the DOC, we have implemented the below: ODRs: the ODR floor where a table is placed will be marked with an X to indicate the inability to use. Tables will be spread apart with one chair at each. Pool room: signage will be posted stating "no more than 2 persons with a reminder to maintain 6ft distance from each other". Staff Entrances signage will be posted encouraging social distance. Housing Units- an X will be marked on the telephone and seated area to indicate the inability to use. IRC- the seating area will be marked with an X to indicate the inability to use. Signage will be posted "please practice social distancing...” Roll Call- an X will be placed on the CTF gym floor and CDF outdoor recreation yard to encourage social distancing. Stay Safe! Quincy L. Booth Director EXHIBIT 10 EXHIBIT 12
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