Attachment 23B - Individualized Detention Plan Template.pdf
PDF 196 KB Posted
- Attached to
- Detention Services (Denver AOR) Federal contract opportunity
- Solicitation number
- 70CDCR21R00000002
- Issued by
- Immigration and Customs Enforcement
About this file
This document contains a template for an Individualized Detention Plan for transgender detainees. The template collects personal and medical information through a question guide to inform housing, safety, and care considerations. Sections address TCCC personnel, detainee details, housing assignment and safety accommodations, hygiene and clothing provisions, medical and mental healthcare, and a summary for detainees. Housing preferences, search gender, medical history, and safety needs are addressed. Care includes possible hormone therapy, and medical and mental healthcare. The plan requires TCCC chair approval and updates as needed.
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Text version
Transgender Classification and Care Committee Determination
Question Guide Name:
A#:
Instructions: The Transgender Classification and Care Committee (TCCC)’s designated facility medical representative(s) shall meet with the detainee prior to the TCCC meeting (i.e., no later than 72 hours, excluding weekends, holidays, and emergencies), to gather information necessary to the TCCC’s deliberations.
Administrative Information
Who administered this Question Guide? Click here to enter text.
When was this guide administered? Click here to enter a date.
Personal Information
Do you identify as transgender? Choose an item.
Do you go by or use any other name(s)? Click here to enter text.
What pronoun(s) do you prefer others use to refer to you? Choose an item.
Medical Issues
Prior to coming here, were you taking any hormonal medications? Click here to enter text.
If yes, what were they? Click here to enter text.
If yes, how often were you taking them? Click here to enter text.
If yes, were they prescribed by a doctor? Click here to enter text.
If no, would you like to be assessed for hormone treatment? Click here to enter text.
Hygiene and Grooming
Do you prefer to wear clothing for men or women? Click here to enter text.
Are there any specific clothing items that you need that have not been provided? Click here to enter text.
Are there any specific personal hygiene items that you need that have not been provided? Click here to enter text.
Housing
In general, would you prefer to be housed with females, males, or in the transgender housing unit? Choose an item.
Do you feel you are at risk for your safety based on your gender identity? Choose an item.
Would you feel safer being housed with males or females? Choose an item.
Would you feel safer being housed with people who are transgender? Choose an item.
If so, would you feel safer being housed with transgender men or transgender women? Choose an item.
Would you feel safer being housed in a cell with someone else or by yourself? Choose an item.
Programming
Do you feel comfortable being around male detainees during group activities? Choose an item.
Do you feel comfortable being around female detainees during group activities? Choose an item.
If no to any of the above, would you prefer to be separated from males, females, or both? Choose an item.
Do you feel that complete separation or specific types of safeguards (e.g. staff escort) would address your concerns?
Staff escorts would address my concerns.
If yes, what types of safeguards do you feel you require? Click here to enter text.
Searches
Do you have a preference for whether a male or female staff member searches you? Choose an item.
If yes, what would you prefer? Choose an item.
Other Items
Is there anything else we should know about you related to being transgender? Click here to enter text.
Individualized Detention Plan
Are there any other specific precautions and/or accommodations you think you would like to have to ensure your safety and welfare while at this facility? Click here to enter text.
Instructions: The Transgender Classification and Care Committee (TCCC) facility Chair, or their designee, will fill out all the fields below in accordance with all records and assessments, as appropriate.
The Detention Plan, once completed, shall be kept in the detainee’s file with all other records; a copy shall be provided to the detainee and forwarded to the facility classification supervisor. The Detention
Plan should also be continually revised, as needed, with updates in Section 7 below.
Section 1: TCCC Personnel Information
Facility Name: AOR:
Name of TCCC Chair: Click here to enter text. Title of TCCC Chair: Click here to enter text.
TCCC Chair Phone: Click here to enter text. TCCC Chair Email: Click here to enter text.
Section 2: Detainee Information
Detainee (Legal) Name:
Click here to enter text.
Preferred Name (If different): Click here to enter text.
Preferred Pronouns: Choose an item. A#:
Click to enter tex
Housing preference: Choose an item.
Preference for the Gender of the Officer Conducting a Search Choose an item.
Does detainee fear being harmed in detention? Choose an item.
If yes, please explain: Click here to enter text.
Does detainee have a self-reported history of sexual assault? Choose an item.
If yes, please explain: Click here to enter text.
Does detainee have a self-reported history of victimization? Choose an item.
If yes, please explain: Click here to enter text.
Does detainee have a self-reported history of predatory behavior? Choose an item.
If yes, please explain: Click here to enter text.
Does detainee have a documented criminal history? Choose an item.
If yes, please explain: Click here to enter text.
Section 3: Housing Assignment and Safety Needs
Housing assignment selected:
Choose an item.
Reason for assignment:
Will this assignment require safety accommodations?
Choose an item.
If yes, please list safety accommodations:
Section 4: Hygiene and Clothing
Hygiene needs indicated by the detainee:
Hygiene items provided:
Hygiene items available via Commissary:
Accommodations for detainee showering:
Undergarments provided:
Clothing provided consistent with Gender Identity:
Section 5: Medical and Mental Health
Subpart A: Hormone Therapy
Was the detainee receiving hormone therapy prior to entering the facility? Choose an item.
If yes, how long had the detainee been receiving hormone therapy? Click here to enter text.
If yes, how often did the detainee take hormones (i.e. every day)? Click here to enter text.
If yes, was the detainee’s hormone therapy regimen prescribed by a doctor? Choose an item.
If no, has the detainee been assessed for hormone treatment? Choose an item.
If the detainee has been assessed for hormone therapy, what was the result? Choose an item.
Who conducted the assessment? Click here to enter text.
Subpart B: Medical Care
Is other transgender-related medical care required? Choose an item.
If yes, what kind of care is required and how will it be provided? Click here to enter text.
Subpart C: Mental Health Care
Is other transgender-related mental health care required? Choose an item.
If yes, what kind of care is required and how will it be provided? Click here to enter text.
Section 6: Comments and Approval
Subpart A: TCCC Chair or Designee Comments and Approval Required where consensus is reached.
Please include any additional comments, including a justification for housing assignment:
Click here to enter text.
Before signing this document, please verify that the above information is correct.
TCCC Chair or Designee name and title:
Click here to enter text.
Date:
Click here to enter date.
Signature
TCCC Chair or Designee name and title:
Date:
Signature
Subpart B: LGBTI Field Liaison or Designee Comments and Approval (For ICE Use Only)
Required only if consensus is not reached.
Please include any additional comments:
Before signing this document, please verify that the above information is correct.
ERO LGBTI Field Liaison or Designee: ______________________________ ________________________________
Printed name Signature Date: _______________
Section 7: Updates
Updates Date of Update
Detention Plan – Detainee Summary
Per the Transgender Care Memorandum, transgender detainees are entitled to a copy of their Detention
Plan. This summary contains non-sensitive information from the Detention Plan. If you need to access sensitive information such as medical care, mental health care, or hormone therapy, please consult your
Deportation Officer, or call the Detention Reporting and Information Line (DRIL) at 1-888-351-4024.
Language assistance for the DRIL is available as needed.
Section 2: Hygiene and Clothing
Hygiene needs indicated by the detainee:
Hygiene items provided:
Hygiene items available via Commissary:
Accommodations for detainee showering:
Undergarments provided:
Clothing provided consistent with Gender Identity:
Section 3: TCCC Chair or Designee Name, Title, and Date of Plan Approval
TCCC Chair or Designee: Date:
TCCC Chair or Designee: Date:
Section 4: Updates
Updates Date of Update
Section 1: Housing Assignment and Safety Needs
Housing assignment selected:
Reason for assignment:
Will this assignment require safety accommodations?
If yes, please list safety accommodations:
File details come from the government source that posted it. Updated .