Provider Oversight | Access to Care and Availability Standards
Provider Type
- Physicians
- Hospitals
- Ancillary
Availability of Providers
Provider Delays
On the day of a scheduled appointment, if there is a delay that prevents services from being delivered, providers or their staff must immediately notify:
- The chief medical executive (CME), or their designee, at the California Department of Corrections and Rehabilitation (CDCR) facility and the facility chief medical officer (FCMO) by phone, if the patient or Department of Juvenile Justice (DJJ)* youth is still at the facility.
- The custody officers, and provide an estimate of the delay, if the patient or DJJ* youth is already at the provider's office.
If providers are unable to render scheduled services for reasons other than illness of their staff members, providers must notify California Correctional Health Care Services (CCHCS) at least 24 hours in advance or immediately provide alternative medical service arrangements to avoid disruption of service.
CCHCS may cancel, modify or change a request for services by phone without incurring any liability, up to 24 hours before services are provided. If CCHCS cancels, modifies or changes a request for any reason, including emergency security situations, such as a lockdown, less than 24 hours before a scheduled service CCHCS makes every effort to notify the provider immediately.
*As of June 30, 2023, all Divisions of Juvenile Justice (DJJ) are closed. Juvenile offenders are no longer committed to the DJJ as of this date. Effective July 1, 2023, claims for health care services rendered to the DJJ youth should be directed to the county where the patient is located. Claims for services rendered on or prior to June 30, 2023, will continue to be the responsibility of California Department of Corrections and Rehabilitation (CDCR).
Appointment Access Standards for CDCR Patient and Division of Juvenile Justice (DJJ) Youth
The time a patient or DJJ* youth waits for a scheduled office visit must not exceed 30 minutes past scheduled appointment time.
Routine appointments for specialist services must not exceed a 90 calendar day period upon request for an appointment from California Correctional Health Care Services (CCHCS). Outpatient specialty care must also be scheduled within 90 calendar days of receiving the request from CCHCS or DJJ* for elective services.
Appointments for medium priority specialty care must not exceed a 45 calendar day period from the CCHCS appointment request.
Appointments for urgent care must not exceed 14 calendar days following CCHCS or DJJ* appointment request.
There must be access to a restroom and water fountain in waiting areas for block-scheduled appointments.
*As of June 30, 2023, all Divisions of Juvenile Justice (DJJ) are closed. Juvenile offenders are no longer committed to the DJJ as of this date. Effective July 1, 2023, claims for health care services rendered to the DJJ youth should be directed to the county where the patient is located. Claims for services rendered on or prior to June 30, 2023, will continue to be the responsibility of California Department of Corrections and Rehabilitation (CDCR).
Providers must make every effort to offer scheduling blocks to treat multiple patients consecutively to minimize travel and custody costs.
Block-scheduled appointments for multiple California Department of Corrections (CDCR) patients or Department of Juvenile Justice (DJJ)* youths during the same day must start and finish with no more than a 10-minute wait time between each appointment.
There must be access to a restroom and water fountain in waiting areas for block-scheduled appointments.
*As of June 30, 2023, all Divisions of Juvenile Justice (DJJ) are closed. Juvenile offenders are no longer committed to the DJJ as of this date. Effective July 1, 2023, claims for health care services rendered to the DJJ youth should be directed to the county where the patient is located. Claims for services rendered on or prior to June 30, 2023, will continue to be the responsibility of California Department of Corrections and Rehabilitation (CDCR).
Participating providers must immediately notify the institution chief executive officer/chief medical executive/chief medical officer (CEO/CME/CMO) or designee in the event of a CDCR patient, parole agent or UM team for a medical parolee, or facility chief medical officer (FCMO) of a DJJ* youth death while under their care or in the hospital. The attending provider(s) will discuss with the Institution CEO/CME/CMO or designee and/or the DJJ* FCMO, or their designee the appropriateness and need for a post-mortem. Both parties must mutually agree upon the decision for an autopsy, prior to or in conjunction with the coroner’s office. The coroner’s office has the final decision on whether an autopsy is necessary.