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Intake Screening Form in TechCareO <br />ct- j <br />Patient: DOE, LANE III: 02510761805067E29d89df Lang: s1d6 (1234) AddlMul lato. f <br />000: 41611996 (Age-26) sex. Female Race: i PICTURE <br />Housing: SM *- MODEW" NOT AVAStAf9tE <br />Status: ACTII Reeking aatW 4/912015 3:56€25 off <br />u aR fat 9sa `�9yss$r6 ia, a�ia sea as . o tazo NA k 5L aY to Lv t4s ° tie M m"3 <br />-- <br />cen WA. Pbad Saotl r1m'gFs beam Yragi's <br />Tfye Una T re �° Prtvwnn Ta�pvxure Ndee Revi4ebin h Fba uo.._., <br />P9am!asv <br />Scrwenere: All quasdona in fire, W. must be addressed. For quecdoaaasith a slisgle checkbox,. <br />by leaving die ehsekbox unadiaeted..gan are docurnundng your Magnate" detail parameters <br />of the quesden are face, ay w a rthq the checabax, you. erg Acknowledging a fradfiv. <br />vespona2 tothe here and Inch., documentation must be Provided in the "cre"rtang <br />goesdons andtaxi boxes.. <br />ARRESTING OFFICER QUESNONS=-Sefoctand document oil that apply . <br />Ic the err dng officer aware of any of the frallowfnp't. <br />Y. <br />U-0'a'Erji6fRCt �4LId�1.§dla) <br />;lkd[r Wkxixxad GUxm.-k¢Mf .' <br />2 n <br />ueR?Mrt3 ?4Gse aZ S4K"6`Y •_.-...._._.__. __ —....��-.._ .... t <br />NWie&i«sRu _T Y a <br />�+aCme+2bt Ma+%cafPaecm±Nh'Yn _ .�.__._.._ <br />Fk4: � <br />e <br />Proactive Health Assessment upon Intake <br />A beneficial feature of NaphCare's Intake Screening process for the SAJ is that we perform the Health <br />Assessment upfront, during intake. By performing this assessment at intake, we can identify urgent <br />medical and mental health issues upon an inmate's arrival. This not only reduces costs for emergency <br />and hospital transportation, but it also reduces the inmate movement required to provide the health <br />assessment at 14 days. We propose to continue this model for the SAJ as we have seen positive results <br />in doing so — Our Proactive Care Model has significantly reduced ER trips by 98% for the SAL <br />Mental Health Screening <br />This screening is NCCHC compliant and was created to be proactive in identifying and prioritizing <br />inmates in need of mental health services. The following is a description of each section of the screening <br />and the information it obtains: <br />Inmate Medical Services RFP No. 17-051 <br />City of Santa Ana 26 <br />