Care for the Terminally Ill

Idaho
Department
of Correction Standard
Operating
Procedure
Title:
Care for the Terminally Ill

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401.053
Version:
3
Adopted:
09/26/2008

Kim Brown, Chief of the Division of Management Services, approved this
document and it was published on 08/20/2026.
Open to the public: Yes No
SCOPE
This standard operating procedure (SOP) applies to all Idaho Department of
Correction (IDOC) employees and contract medical provider staff that oversee the
health and security of IDOC residents with terminal illnesses.
Version Summary
Version 3: This SOP replaces and renumbers previous SOP 401.06.03.053 v2.0.
This version updates terminology; revises compliance and audit requirements;
shortens hospice eligibility from one year to six months; and clarifies
responsibilities, care plan requirements, and reporting procedures for end-of-life
care.
TABLE OF CONTENTS
Scope ....................................................................................................... 1
Table of Contents ........................................................................................ 1
A. Statutory Authority ................................................................................. 1
B. Board of Correction IDAPA Rule ................................................................. 2
C. Governing Policy Statement ...................................................................... 2
D. Purpose ................................................................................................ 2
E. Responsibility ......................................................................................... 2
F. Definitions .............................................................................................. 2
G. Standard Procedures ............................................................................... 3
1. Guidelines ......................................................................................... 3
2. Compliance........................................................................................ 5
H. References ............................................................................................ 5

A. STATUTORY AUTHORITY
1. Idaho Code § 20-217A, Appointment of Director – Salary – Powers and Duties
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2. Idaho Code § 20-244, Government and Discipline of the Correctional Facility –
Rules and Regulations
3. Idaho Code § 20-1006, Medical Parole – Required Report
B. BOARD OF CORRECTION IDAPA RULE
06.01.01.401, Medical Care
C. GOVERNING POLICY STATEMENT
1. It is the policy of IDOC and its contractors to provide proper medical, dental,
psychiatric, and psychological services and treatment to residents incarcerated
under its jurisdiction. All health care must be provided in accordance with the
National Commission on Correctional Health Care (NCCHC) Standards for Health
Services in Prisons.
2. Nothing in this SOP overrides or relieves contract medical providers of any
obligation or responsibility stipulated in their respective contractual
agreements.
D. PURPOSE
To establish procedures to address the needs of terminally ill residents, including
pain management and protecting their rights regarding end-of-life decisions.
E. RESPONSIBILITY
1. Health Services Director
a. Review and approve (prior to implementation) all applicable contract medical
provider policies, procedures, and forms.
b. Monitor the contract medical provider’s performance to ensure compliance
with all healthcare-related requirements provided in respective contractual
agreements, this SOP, and in NCCHC standard P-F-07, Care for the
Terminally Ill.
2. Contract Medical Provider
a. Implement all provisions of this SOP, unless specifically exempted by written
contractual agreements.
b. Ensure that all aspects of this SOP and NCCHC standard P-F-07 are
addressed by applicable contract medical provider policy and procedure.
c. Submit all applicable contract medical provider policy, procedure, and forms
to the health services director for review and approval prior to
implementation.
F. DEFINITIONS
1. Contract Medical Provider: A private company or other entity that is under
contract with the IDOC to provide comprehensive medical, dental, and/or
mental health services to the IDOC’s incarcerated resident population.
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2. Correctional Management System (CMS): A digital platform used by
correctional agencies to store, manage, and analyze comprehensive data
about individuals throughout their entire criminal justice process, including
intake, sentencing, incarceration, parole, and probation, allowing for
informed decision-making regarding their supervision and rehabilitation. This
includes systems such as Reflections, CIS, and Atlas.
3. Early Release: The release of a resident from IDOC custody before the
expiration of their sentence due to the resident being diagnosed as terminally ill
or permanently incapacitated.
4. Facility Health Services Administrator: The contract medical provider
employee who is primarily responsible for overseeing the delivery of
contracted medical and behavioral health services in an IDOC correctional
facility.
5. Health Services Director: The IDOC employee primarily responsible for
oversight of auditing and monitoring services provided by the contract
medical vendor.
6. Hospice Care: A set of specialized healthcare services that (a) provide support
to terminally ill residents and their families, and (b) focus on symptom control
and quality-of-life issues (e.g., providing comfort) rather than attempting to
cure conditions.
7. Hospice Care Worker: A qualified IDOC resident who has received specific
IDOC-delivered training to provide bedside vigil to residents who are currently
receiving hospice care at an IDOC facility. The qualified IDOC resident must not
deliver healthcare services such as attending to activities of daily living or
nursing tasks.
8. Resident: A person who has been convicted of a crime against the laws of
the state and ordered into the care and custody of the Board of Correction.
Resident includes any use in Idaho law, Board of Correction rule, or IDOC
policy or procedure of the terms “offender(s),” “prisoner(s)”, “inmate(s)”,
“incarcerated person(s)”, or any other term referring to a person residing in
a correctional facility in the care and custody of the Board of Correction.
9. Site Medical Director: The highest-ranking contract physician in an IDOC
facility.
10. Terminally Ill: To have an illness or disease that is in an advanced stage, has
an unfavorable prognosis, no known cure, and expected to result in death.
G. STANDARD PROCEDURES
1. Guidelines
a. Hospice care will be provided for residents who are in the last stages of a
diagnosed terminal illness.
i. Residents become eligible for hospice care when they are diagnosed with a
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terminal disease and have a prognosis of six months or less to live.
ii. The site medical director must inform the resident of the prognosis and
treatment options, to include hospice care.
iii. Hospice care includes providing a safe, pain-controlled, and comfortable
environment and an opportunity to receive assistance in navigating their
terminal illness as it relates to their physical, mental, spiritual, and
emotional capacity.
b. Residents diagnosed with a terminal illness must have a care plan.
i. The care plan is developed by the healthcare provider treating the
resident.
ii. Minimally, the care plan must include, weekly face-to-face provider visits
that address treatment, pain control, and resuscitation status for each
resident diagnosed with a terminal illness.
iii. The care plan must be reviewed by the hospice Interdisciplinary Care
Team comprised of direct care healthcare services staff, religious
activities staff, mental health staff, IDOC health services staff, and off-
site consulting practitioners.
iv. The care plan includes directions to healthcare and other personnel
regarding their roles in the care and supervision of the resident.
v. The care plan must reference the resident’s most up-to-date advanced
care plan which should include physician orders for scope of treatment.
vi. Residents in hospice care who require skilled nursing intervention must
be admitted to the acute care infirmary, which must be reflected in the
care plan.
c. The facility health services administrator and the site medical director (or
designee) are jointly responsible for assigning and monitoring hospice
admissions to the infirmary for clinical appropriateness, quality of
compassionate care, and pain management. This must include:
i. Facilitating the early and timely release of the resident in accordance with
SOP 324.02.01.002, Parole of Offenders with a Terminal Disease or
Permanent Incapacitation.
ii. Scheduling weekly hospice Interdisciplinary Care Team meetings.
iii. Coordinating with security staff to facilitate special visits for residents
receiving hospice care and their families (when appropriate).
iv. Coordinating with IDOC to ensure hospice care worker availability as
appropriate.
v. Ensuring all residents on hospice have an updated end-of-life care plan.
d. Requests for early release (i.e., medical parole) for those residents diagnosed
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with a terminal illness must be processed pursuant to SOP 324.02.01.002,
Parole of Offenders with a Terminal Disease or Permanent Incapacitation.
e. Procedures following the death of a resident with a terminal illness:
i. The facility health services administrator must notify the facility head and
the health services director in writing within six hours of a resident’s
death.
ii. After the resident’s death, the facility health services administrator will
arrange access to critical incident stress management, counseling, and
other bereavement services as needed for healthcare services staff
involved in the deceased resident’s care.
2. Compliance
a. Compliance with this SOP and all related protocols will be monitored by the
health services director (or designee).
b. The health services director (or designee) must conduct two audits per year.
Audits consist of monitoring applicable policies and procedures of IDOC and
the contract medical provider owned and IDOC-identified patient health
outcomes.
H. REFERENCES
1. Cited Documents
a. National Commission on Correctional Health Care (NCCHC), Standards for
Health Services in Prisons, Standard P-G-11, Care for the Terminally Ill
b. SOP 324.02.01.002, Parole of Offenders with a Terminal Disease or
Permanent Incapacitation
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