Advance Directive for Health Care: A written instrument which allows the patient to do either or both of the following: 1) state instructions for future health care decisions; and/or 2) appoint an agent with Power of Attorney for Health Care.

Bundling: When a patient has multiple pending appointments, setting appointments sequentially on the same day so that a patient need only be seen in one encounter for multiple purposes. Bundling helps increase clinic efficiency, meet mandated timeframes, and limit the need for custody escorts, lessening redundant work for custody and health care staff as well as making appointments more convenient for the patient.

California Department of Corrections and Rehabilitation Heart Healthy Diet: A meal plan restricted in sodium and fat while supplying adequate calories, fiber and all essential nutrients, provided by California Department of Corrections and Rehabilitation and approved by a Registered Dietitian,

California Department of Corrections and Rehabilitation Standardized Master Menu: A four week menu cycle based on the California Department of Corrections and Rehabilitation (CDCR) Heart Healthy Diet that is planned by the CDCR Department Food Administrator and approved by a Registered Dietitian.

Care Guide: A care guide supports the application of proven prevention, diagnosis, and treatment strategies, and the overall practice of evidence-based medicine improving patient care and outcomes by supporting the application of evidence-based medicine; developing recommendations conforming to current evidence in clinical science in the form of treatment guidelines; and providing assistance in clinical decision-making for California Correctional Health Care Services health care staff. A collection of CCHCS care guides can be found on our Clinical Resources Page.

Chronic Care: The ongoing care for a current health problem that impacts or has the potential to impact a patient’s functioning and long-term prognosis and has lasted, or is expected to last, for more than six months.

Correctional Clinic: A primary care clinic, pursuant to California Health and Safety Code Division 2, Chapter 1, Article 1 Section 1206(b), conducted, maintained, or operated by the State to provide health care to eligible patients of California Department of Corrections and Rehabilitation.

Correctional Treatment Center: A health facility operated by California Department of Corrections and Rehabilitation that provides inpatient health care services to patients who do not require a general acute care level of essential services and are in need of professionally supervised health care that cannot be provided on an outpatient basis.

Death Review: A type of review conducted by Nurse Consultant Program Review staff which assesses the quality and appropriateness of nursing care, nursing practice issues, best practices, and factors that may have significantly impacted the quality of patient care, thereby contributing to the death of a patient. The most recent annual death review can be found on our reports page.

Designated Reception Center Institution: An institution that receives persons newly committed to California Department of Corrections and Rehabilitation custody. CDCR Reception Centers include CCWF, NKSP, and WSP.

Do Not Resuscitate: A written order which directs that resuscitation efforts (i.e., intubation and assisted mechanical ventilation, cardiac compression, defibrillation, and administration of cardiotonic drugs) are not to be initiated in the event of cardiac and/or respiratory arrest.

Durable Medical Equipment: Equipment prescribed by a licensed provider to meet medical equipment needs of the patient that can withstand repeated use; is used to serve a medical purpose; is not normally useful to an individual in the absence of an illness, injury, functional impairment, or congenital anomaly; and is appropriate for use in or out of the institutional housing.

Gender Dysphoria: A Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which refers to discomfort or distress caused by a discrepancy between a person’s gender identity and that person’s assigned sex at birth.

Hospice: Services that are designed to provide palliative services to patients needing end-of-life care. Services are designed to alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease and to provide supportive care to the primary caregiver and the family. A skilled or unskilled person may provide care under a plan of care developed by a physician or interdisciplinary team under medical direction. Hospice services may be provided in all levels/areas of a specialized health care housing unit.

Latent Tuberculosis Infection: A tuberculosis (TB) infection that has not developed into disease. Persons with latent TB infection are at risk of developing TB disease throughout their lifetime, with immunocompromised patients at even higher risk.

Outpatient Housing Unit: A designated housing area within institutions designed to provide supportive services, including low-intensity nursing care, for patients who may require limited assistance with activities of daily living or short-term observations.

Palliative Care: Services that support a patient in managing his or her health care needs associated with a serious illness. Services are designed to provide comfort, relief from pain, support the patient, and to maintain or improve functioning and quality of life. Palliative care services can be provided at any stage of illness and at all levels of care within California Department of Corrections and Rehabilitation.

Peer Mentor Program: Inmate Peer Mentors provide structured peer preventions and evidence-based strategies to deliver patient education, support patient well-being, and modify patient behaviors within California Department of Corrections and Rehabilitation and following release.

Primary Care Provider: A physician, nurse practitioner, or physician assistant designated to have primary responsibility for the patient’s health care or, in the absence of a designation or if the designated physician is not reasonably available or declines to act as primary physician, a physician who undertakes the responsibility.

Primary Care Team: An interdisciplinary team that organizes and coordinates services, resources, and programs to ensure consistent delivery of appropriate, timely, and patient-centered, evidence-based care to a designated patient panel.

Quality Management: A planned, strategic, system-wide approach to defining, evaluating, and improving organizational performance, thereby continually enhancing the quality and value of patient care and services provided and the likelihood of desired outcomes.

Six Sigma: A measurement-based, data-driven, systematic approach to process improvement and problem solving through the application of tools and techniques with the purpose of minimizing unnecessary variation in processes and eliminating defects.

Skilled Nursing Facility: A health facility or a distinct part of a hospital which provides continuous skilled nursing care and supportive care to patients whose primary need is for skilled nursing care on an extended basis. It provides 24-hour inpatient care and at a minimum includes physician, skilled nursing, dietary, and pharmaceutical services as well as an activity program.

Specialized Health Care Housing: A distinct housing unit located within a facility or institution operated by California Department of Corrections and Rehabilitation that provides health care services 24 hours a day to patients who are in need of professionally supervised health care. Specialized Health Care Housing units may, or may not be licensed and/or accredited. Specialized Health Care Housing units include the following levels of care: Outpatient Housing Unit, Correctional Treatment Center, Mental Health Crisis Bed, Psychiatric Inpatient Program, Skilled Nursing Facility, Hospice, Acute Care Facility (Mental Health), and Intermediate Care Facility (Mental Health).

Specialized Medical Bed: An institutional Correctional Treatment Center, Outpatient Housing Unit, Skilled Nursing Facility, or Specialized Outpatient bed.

Specialized Outpatient: A high medical risk outpatient who has long-term care needs with the potential for clinical deterioration, decompensation, morbidity, or mortality.

Telemedicine Services: Through the Telemedicine Program, California Correctional Health Care Services coordinates with private health care entities to provide specialty care services using audio-visual technologies to California patients in California Department of Corrections and Rehabilitation institutions. The Telemedicine Program links health care providers and patients with high-definition cameras, electronic medical instruments, and voice to enhance physicians’ abilities to diagnose and connect with patients remotely.

Transgender: Describing or relating to a person whose gender identity is different from the person’s sex assigned at birth.

Tuberculin Skin Test: The Mantoux Tuberculin Skin Test is a method of determining whether a person is infected with Mycobacterium tuberculosis.

Tuberculosis Disease: A disease caused by Mycobacterium tuberculosis or other bacteria in the Mycobacterium tuberculosis complex. Tuberculosis (TB) is a treatable infectious disease that usually affects the lungs and airway but may also affect other parts of the body. People with TB disease of the lungs or airway may be infectious to others until they have received their initial phase of treatment with TB medications. People with TB disease in other parts of the body but not in the lungs are not infectious to others.

Whole Person Care: A model or approach which recognizes the best way to improve health outcomes is to coordinate the full spectrum of patient needs – including medical, behavioral, socioeconomic, and beyond.