Overview
BCSO should ensure that Inmate Request Slips for sick call requests were triaged on time. During the audit period, there were 7,482 sick call requests submitted by inmates in BCSO’s facility. In our testing, we selected a random, statistical sample of 60 requests and found that 7 (12%) out of 60 sick call requests received were not triaged with a face-to-face meeting with a qualified healthcare professional (QHP) within 24 hours of receipt. For 29 (48%) out 60 sick call requests received, either BCSO did not provide the inmate with a face-to-face meeting at all, or there was no documentation to confirm that BCSO provided the inmate with a face-to-face meeting.
We projected the test results from our sample of 60 sick call requests to the total population of 7,482 sick call requests submitted during the audit period. Based on this calculation, we can project with a 95% confidence level that BCSO did not follow up on at least 363 sick call requests with face-to-face meetings with QHPs within 24 hours of receipt. Additionally, we can project with a 95% confidence level that BCSO did not follow up on at least 2,640 sick call requests with face-to-face meetings with QHPs at all.
If BCSO does not follow up on all sick call requests, then there is a higher-than-acceptable risk that inmates may not have their healthcare issues properly resolved, either within the required 24 hours or at all.
Authoritative Guidance
BCSO’s “BCSO-103R” policy states,
3. A face-to-face encounter is conducted by a qualified health care professional within 24 hours of receipt of a health care request by health staff.
Reasons for Issue
BCSO stated that 3 of the 29 inmates we noted as not having received a face-to-face meeting with a QHP within 24 hours of receipt of a sick call request were seen previously on the day that the Inmate Request Slip was submitted. These inmates were seen previously on the same day for different sick call requests that were not included in our sample or for scheduled medical appointments. While BCSO did provide evidence of these previous sick calls or scheduled medical appointments, BCSO is required to conduct a face-to-face meeting with the inmate for all sick call requests. Additionally, BCSO believes that the remaining 26 submitted slips were for requests that did not require a face-to-face meeting.
Recommendation
BCSO should ensure that its QHPs follow up on all sick call requests, and that they do so within 24 hours of receipt of the request.
Auditee’s Response
BCSO responded to this finding with an edit to policy BCSO-103R. Procedure has been updated to reflect that a face to face encounter is conducted by a qualified health care professional within 24 hours of a health request by health staff if deemed clinically necessary. This response was sent to the audit team on August 26, 2025. The audit report fails to mention the updated policy.
Auditor’s Reply
BCSO did send us its updated policy before the creation of our draft report. This policy was updated after the audit period ended, however, which is why it was necessary to include the finding in this report. We acknowledge that a change has been made to the policy, but we were not able to test the effectiveness of that change because it occurred after the audit period. Based on its response, BCSO is taking measures to address our concerns regarding this matter. As part of our post-audit review process, we will follow up on this matter in approximately six months.
| Date published: | November 25, 2025 |
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