Hospital and Specialty Care

Idaho
Department of
Correction

Standard
Operating
Procedure

Division of
Education
and
Treatment

Operational
Services
Control Number:
401.06.03.030
Version:
2.0
Page Number:
1 of 6
Adopted:
11-16-1998
Reviewed:
12-28-2008

Title:
Hospital and Specialty Care

This document was approved by Dr. Mary Perrien, c hief of the Division of
Education and Treatment, on 12/28/08 (signature on file).
BOARD OF CORRECTION IDAPA RULE NUMBER 401
Medical Care
POLICY STATEMENT NUMBER 401
Hospitalization, Institutional Clinical Services, and Treatment
POLICY DOCUMENT NUMBER 401
Hospitalization, Institutional Clinical Services, and Treatment
DEFINITIONS
Standardized Definitions List
Contract Medical Provider: A private company under contract with the Department to
provide comprehensive medical, dental, and/or mental health services to the incarcerated
offender population. A contract medical provider may include private prison companies and
other entities under contract with the Department to operate the Idaho Correctional Center
(ICC) and other out-of-state facilities housing Department offenders.
Facility Health Authority: The contract medical provider employee who is primarily
responsible for overseeing the delivery of medical services in an Idaho Department of
Correction (IDOC) facility.
Facility Medical Director: The highest ranking physician in an Idaho Department of
Correction (IDOC) facility.
Health Authority: The Department employee who is primarily responsible for overseeing or
managing the Department’s medical and mental health services. The health authority is
commonly referred to as the health services director.
Specialty Care: Specialist-provided healthcare such as nephrology, surgery, dermatology,
orthopedics, etc.
Written Medical Agreement: A contract, letter of agreement, or memorandum of
understanding between an Idaho Department of Correction (IDOC) facility and a hospital,
clinic, or specialist for the care and treatment of offenders .
Control Number:
401.06.03.030
Version:
2.0
Title:
Hospital and Specialty Care
Page Number:
2 of 6

PURPOSE
The purpose of this standard operating procedure (SOP) is to establish procedures for
ensuring systems are in place to provide hospitalization and specialty care to offenders as
needed.
SCOPE
This SOP applies to all Idaho Department of Correction (IDOC) healthcare services staff,
offenders, contract medical providers and subcontractors .
RESPONSIBILITY
Health Authority
The health authority is responsible for:
• Monitoring and overseeing all aspects of healthcare services , and
• The implementation and continued practice of the provisions provided in this
SOP.
When healthcare services are privatized, he will also be responsible for :
• Reviewing and approving (prior to implementation) all applicable contract medical
provider policy, procedure, and forms ; and
• Monitoring the contract medical provider’s performance, to include but not limited
to reviewing processes, procedures, forms, and pr otocols employed by the
contract medical provider to ensure compliance with all healthcare-related
requirements provided in respective contractual agreements, this SOP, and in
National Commission on Correctional Health Care (NCCHC) standard P -D-05,
Hospital and Specialty Care. (See section 2 of this SOP.)
Contract Medical Provider
When healthcare services are privatized, the contract medical provider is responsible
for:
• Implementing and practicing all provisions of this SOP, unless specifically
exempted by written contractual agreements ;
• Ensuring that all aspects of this SOP and NCCHS standard P -D-05 are
addressed by applicable contract medical provider policy and procedure;
• Ensuring facility health authorities utilize all applicable contract medical provider
policy, procedure, forms, and educational information to fulfill all healthcare-
related requirements provided in this SOP, NCCHC s tandard P-D-05, or as
indicated in their respective contractual agreement(s); and
• Ensuring all applicable contract medical provider policy, procedure, and forms (to
include the emergency equipment/medications list) are submitted to the health
authority for review and approval prior to implementation.
Note: Nothing in this SOP shall be construed to relieve the contract medical provider(s)
of any obligation and/or responsibility stipulated in respective contractual agreements.
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401.06.03.030
Version:
2.0
Title:
Hospital and Specialty Care
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Facility Medical Director
The facility medical director will be responsible for:
• Conferring with the hospital’s treating practitioner in order to m aintain continuity
of the offender’s care and treatment, and
• Assisting, as requested or as needed, the hospital’s treating practitioner in
considering the provisions for the offender’s discharge and the capacity of care
the offender will need upon discharge and return to the facility.
Facility Health Authority
The facility health authority will be responsible for:
• Ensuring the presence of an adequate number of appropriately trained staff and
materials are available to meet the requirements of this SOP ;
• Establishing and monitoring applicable contract medical provider policy and
procedure to ensure that all elements of this SOP and NCCHC standard P-D-05
are accomplished as required;
• Providing a daily written report to the health authority for all admissions and
discharges to and from community hospitals that occurred the previous business
day;
• Ensuring the accuracy of all information provided to the health authority and that
the health authority is given the most up-to-date information when reported; and
• Assisting, as requested or as needed, the hospital’s treating practitioner in
considering the provisions for the offender’s discharge and the capacity of care
the offender will need upon discharge and return to the facility.
Table of Contents
General Requirements .............................................................................................................. 3
1. Guidelines ........................................................................................................................... 3
Formal Written Medical Agreements ............................................................................ 4
Facility Specific Procedures.......................................................................................... 4
Discharges .................................................................................................................... 5
Receiving the Offender at the IDOC Facility ................................................................ 5
Written Status Reports.................................................................................................. 6
2. Compliance ......................................................................................................................... 6
References ................................................................................................................................ 6
GENERAL REQUIREMENTS
1. Guidelines
Note: When referenced in the subsections below, it shall be noted that at community work
centers (CWCs) the facility medical director is not always on-site. As a result, unless facility-
specific guidance adequately provides the instruction to comply with this section, the
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following CWCs should coordinate with the facility indicated : Nampa CWC – coordinate with
Idaho Maximum Security Institution (IMSI), South Idaho Correctional Institution (SICI)
CWC – coordinate with SICI, Twin Falls CWC – coordinate with SICI, East Boise CWC –
coordinate with South Boise Women’s Correctional Center (SBWCC), and Idaho Falls CWC
– coordinate with Pocatello Women’s Correctional Center (PWCC).
Established Arrangements
• Each facility shall have established arrangements with hospitals and specialized
ambulatory care facilities for the care of offenders requiring their services.
• The contract medical provider’s healthcare services administrator (or designee) will
meet with administrative personnel of the hospital(s) and/or specialized ambulatory
care facility—in the community where the IDOC facility is located—to develop an
arrangement for hospital services.
Note: Arrangements for hospitalization and/or specialized ambulatory care services
shall be made only with licensed hospitals and specialized ambulatory care facilities.
• Arrangements for hospitalization and specialized ambulatory care will specify the
range of services to be provided, the expectations of the facility referring the
offender, expectations for transfer of medical information and the method of
payment.
Formal Written Medical Agreements
• When healthcare services are privatized, it is understood that formal written medical
agreements will be developed at the corporate level; however, these formal written
medical agreements are incumbent upon the facility health authority meeting with
key personnel at the referral facility on an ongoing basis to enhance efforts to ensure
that the facility understands all special considerations in providing hospital and
specialty care services to offenders.
• Formal written medical agreements shall include provisions for the hospital nursing
staff to contact the facility health authority (or designee) when the offender is to be
discharged so that information about discharge orders, discharge instructions, and
follow-up appointments that need to be scheduled is shared. (Also see the note box
in the subsection titled Discharges .)
• Out of security concerns, formal written medical agreements (and other
communications) should emphasize that hospital staff are not to provide the offender
information regarding follow-up appoints . (Also see the subsection titled Receiving
the Offender at the IDOC Facility.)
• Formal written medical agreements shall include provisions for hospital nursing staff
(or designees) to copy pertinent portions of the offender's hospital medical reco rd
and provide them to the transporting officer in a sealed envelope. (Also see the
subsection titled Receiving the Offender at the IDOC Facility.)
Facility Specific Procedures
Each facility shall develop specific procedures for referral for hospital care. The
procedures must specify, at a minimum:
• Who has the authority to make decisions to have an offender transported to the
hospital’s emergency room;
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• The procedure for contacting the hospital by telephone or fax to arrange the
admission or to notify the emergency room of an impending admission;
• The staff member(s) responsible for copying or otherwise providing pertinent
portions of the offender's healthcare record;
• Specific material from the offender’s healthcare record to be copied and provided
to the hospital;
• Specific forms containing pertinent current information, including the reason for
referral;
• The staff member(s) responsible for determining the appropriate method for
transporting the offender to the hospital, which shall be based upon the
offender's condition; and
• Procedures for arranging the specific mode of transportation.
Procedures shall also include provisions for documenting hospital referrals in the
offender's healthcare record and designate which staff will be responsible for
documenting the referrals.
Discharges
The decision to discharge an offender from hospitalization will be made by the hospital’s
treating practitioner.
Note: The facility medical director or facility health authority can assist the hospital’s
treating practitioner in considering the provisions for the offender’s discharge and the
capacity of care the offender will need upon discharge and return to the facility.
Note: Facilities should make sure that the hospital provides, in advance, information
about the discharge orders, discharge instructions, and follow -up appointments that
need to be scheduled s o that the facility’s healthcare providers have enough time to
make arrangements for any medications, equipment, supplies not usually stocked, and
other special accommodations required by the hospital’s treating practitioner.
Receiving the Offender at the IDOC Facility
• When the offender is discharged from the hospital, the hospital’s nursing staff (or
designees) will give the transporting officer a sealed envelope containing copies of
the offender’s hospital medical record to include, at a minimum: discharge orders,
admission dictation, discharge instructions, and the consultation sheet sent by the
referring facility.
• The transportation officer shall deliver the sealed envelope to the facility health
authority (or designee) at the time the offender is received at the IDOC facility.
• The facility health authority (or designee) shall immediately open the sealed
envelope received from the transporting officer for follow -up with the facility’s treating
practitioner. The facility health authority (or designee) shall also provide a copy of the
hospital discharge summary to the facility medical director when it becomes
available.
• The facility's treating practitioner may request additional information from the
hospital if the information is pertinent to the offender's ongoing care and treatment.
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Version:
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Page Number:
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• Facility healthcare services staff shall be responsible for scheduling the offender’s
follow-up appointments.
Written Status Reports
The facility health authority shall provide a daily written status report to the health
authority for all offender admissions and discharges to and from community hospitals
that occurred the previous business day (Monday thru Friday).
The written status report shall include, at a minimum the:
• Offender’s identifying information;
• Admitting diagnosis;
• Current status;
• Anticipated date and time of discharge, if known; and
• Special considerations, if any.
2. Compliance
Compliance with this SOP and all related Department -approved protocols will be monitored
by the health authority (or designee) by using various sources to include: this SOP, clinical
practice guidelines, routine reports, program reviews, and record reviews.
The health authority (or designee) must conduct two (2) audits a year (or more frequently as
desired based on prior audit results). The audits must consist of monitoring applicable
contract medical provider and IDOC policy and procedures, applicable NCCHC standards,
and the review of a minimum of 15 individual records.
REFERENCES
National Comm ission on Correctional Health Care (NCCHC), Standard P -D-05, Hospital and
Specialty Care
– End of Document –