HomeMy WebLinkAboutHealthcare: Community Reentry Center (CRC) OffendersIdaho
Department of
Correction
Standard
Operating
Procedure
Title:
Health Care: Community Reentry Center (CRC)
Offenders
Page:
1 of 9
Control Number:
401.04.03.004
Version:
4.0
Adopted:
10-29-2002
IDOC Data Sensitivity Classification - L3 Restricted
Pat Donaldson, chief of Management Services, approved this document on
04/13/2015.
Open to the public: Yes
SCOPE
This SOP applies to all Community Reentry Center (CRC) staff, CRC offenders, and
contract medical providers.
Revision Summary
Revision date (04/13/2015) version 4.0:
• Update to section 2.0
Previous Revision date (02/18/2015)
TABLE OF CONTENTS
1. Access to Care: General Guidance .............................................................................. 2
2. Medical Care ................................................................................................................ 4
3. Community Health Care Services ................................................................................ 4
4. Tattoo Removal ........................................................................................................... 5
5. Payment for Health Care Services Received ............................................................... 5
6. Reporting Requirements .............................................................................................. 6
7. Medication Forms ........................................................................................................ 6
8. Training ........................................................................................................................ 8
BOARD OF CORRECTION IDAPA RULE NUMBER 401
Medical Care
POLICY CONTROL NUMBER 401
Clinical Services and Treatment
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
2 of 9
PURPOSE
The purpose of this standard operating procedure (SOP) is to establish procedures to
govern the Health Care of offenders assigned to community reentry centers (CRCs).
RESPONSIBILITY
Health Authority
The health authority is responsible for:
• Monitoring and overseeing all aspects of Health Care services; and
• The implementation and continued practice of the provisions provided in this
SOP.
When Health Care 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 protocols employed by the
contract medical provider to ensure compliance with all Health Care-related
requirements provided in respective contractual agreements and this SOP and in
National Commission on Correctional Health Care (NCCHC) standard P-A-01,
Access to Care.
Contract Medical Provider
When Health Care services are privatized, the contract medical provider is responsible
for:
• Practicing all provisions of this SOP, unless specifically exempted by written
contractual agreements;
• Providing routine, urgent (i.e., same day but not an emergency), and emergency
medical, dental, optical, mental health, and pharmaceutical services to all
offenders housed in CRCs, regardless of an offender’s access to third party
coverage or income; and
• Ensuring all applicable contract medical provider policy, procedure, and forms
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.
GENERAL REQUIREMENTS
1. Access to Care: General Guidance
CRC staff, in partnership with the contract medical provider, shall ensure that procedures
are in place to identify and eliminate unreasonable barriers to all CRC offenders being
provided access to necessary medical, dental, optical, mental health, and pharmaceutical
services.
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
3 of 9
CRC offenders may request Health Care from the contract medical provider via Health Care
services request processes described in IDOC clinical services and treatment guidance
such as, but not limited to the following:
• SOP 401.06.03.001, Access to Care;
• Directive 401.06.03.036, Oral Care;
• Directive 401.06.03.059.01, Eye Examinations; and
• SOP 411.06.03.001, Co-pay for Medical Services
CRC Parent Facilities
Each CRC is assigned a parent facility. The facility health authority at the following parent
facilities will serve as the CRC manager’s (or designee’s) contact for IDOC clinical services and
treatment as described above.
CRC Parent Facility
East Boise South Boise Women’s Correctional Center
Idaho Falls Pocatello Women’s Correctional Center
Nampa Idaho Maximum Security Institution
Treasure Valley South Idaho Correctional Institution
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
4 of 9
Medical Equipment and Supplies
The contract medical provider shall provide all medical equipment and supplies required
to provide Health Care services at the CRC.
Appropriate emergency equipment and supplies shall be provided and maintained by the
contract medical provider.
Note: A list of medical equipment shall be kept in the medical area of each CRC.
2. Medical Care
Routine and Urgent Medical Care
When medical staff are not on site the CRC staff shall contact the on-call contract
medical provider when an offender presents with a non-emergency medical complaint.
The provider will assess the complaint and provide direction to the CRC staff.
Emergency Medical Care
If an offender presents with an obvious medical emergency the CRC staff shall activate
911 for emergency medical care. Once the offender has been transported to the hospital
the facility health authority must be notified as soon as possible.
The contract medical provider shall be responsible for all medical charges incurred for
routine, urgent or emergency care (unless the charges are covered by Reentryers’
compensation insurance; see section 5).
3. Community Health Care Services
Unless arranged by the contract medical provider, community health care services shall be
limited to the services described in this section. (Cosmetic [elective] procedures shall not be
authorized.) To access community Health Care services, CRC Reentry release offenders
must:
• Meet the Offender Trust Account balance requirements described in section 5;
• Complete appendix 1, Community Health Care Services Appointment Request Form;
and
• Submit the form to the CRC manager (or designee) for verification (e.g., time, date,
and location) and approval.
Note: Before approving the Community Health Care Services Appointment Request Form,
the CRC manager (or designee) shall consider the parameters provided in section 5, and
document the bottom of the form with all required information.
Note: The contract medical provider does not need to be consulted or give approval for a
CRC Reentry release offender to retain community Health Care services.
Medical (Birth Control Only)
120 days prior to release, female offenders may obtain a medical evaluation from a
community medical provider (e.g., a medical doctor [MD], physician’s assistant [PA], or
nurse practitioner [NP]) for the sole purpose of initiating a birth control method. (The birth
control method shall be determined by the community medical provider.)
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
5 of 9
Prescriptions for a birth control method shall be purchased at a community pharmacy,
and the cost shall be the responsibility of the CRC Reentry release female offender.
Dental
CRC Reentry release offenders may choose to seek dental services from a community
dentist.
Prescriptions issued by a community dentist must be purchased at a community
pharmacy, and the cost shall be the responsibility of the CRC Reentry release offender.
Immediately upon returning to the CRC from a dental appointment, the offender must
turn in to CRC staff all medications prescribed by the dentist for documentation in the
offender’s medication record. After recording the offender’s medication in the record,
CRC staff may return to the offender any medications that are appropriate to self-
medicate or ‘keep-on-person’, such as antibiotics or over-the-counter pain relief. All
controlled substances, such as narcotic pain medication, shall be kept secure by CRC
staff and made available to the offender for self-medication purposes as a direct
observation therapy (DOT) per the prescribing dentist’s instructions.
Optical
CRC Reentry release offenders may choose to obtain optical care from a community
optometrist. Optical services will be limited to eye examination, lenses and frames, or
clear (non-tinted or colored) contact lenses. The offender will be responsible for
purchasing the lenses and frames, contact lenses, and all products necessary for the
maintenance and care of the eyewear or contact lenses.
4. Tattoo Removal
CRC offenders may participate in laser (no creams or chemicals) tattoo removal programs
that are offered in the community. Tattoo removal is voluntary and often provided to CRC
offenders as a free or discounted community program in an effort to better their lives and
personal appearance (e.g., ex-gang members or tattoos that are embarrassing). It shall be
the offender’s responsibility to get approval from his employer for any time off needed for
tattoo removal.
Note: The contract medical provider shall not be responsible for any costs associated with
the tattoo removal.
5. Payment for Health Care Services Received
CRC Reentry release offenders are responsible for the payment of medical (birth control
only), dental, optical, and pharmaceutical services. As a result, the CRC manager (or
designee) shall approve or deny the requested services based on the following parameters:
• The cost of the service and the offender’s trust account balance (i.e., is it more than
the offender can afford?);
• The offender’s personal health insurance coverage deductible, if any (i.e., can the
offender afford to pay the deductible and any remaining balance?); and
• The amount of time the offender has remaining at the CRC (i.e., after payment for
services is made in full—to include the insurance deductible, if any— does the
offender have time to rebuild his trust account balance prior to being released?).
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
6 of 9
Note: The contract medical provider shall not be responsible for the payment of any Health
Care services that a CRC Reentry release offender receives from a community medical
(birth control only), dental, or optical provider. CRC Reentry release offenders shall
complete an Inmate Personal Funds Withdrawal Slip so that payment can be made at the
time Health Care services are received (see SOP 114.04.02.001).
Personal Health Insurance Coverage
For all community appointments described above in this section, the CRC Reentry
release offender may use his personal health insurance coverage if it is available to him,
however, the offender must have sufficient funds available in his account to fully cover
the cost of all services provided by the community provider.
Reentryers’ Compensation
CRC Reentry release offenders who are injured on the job are required to file a claim
through their employer’s Reentryers’ compensation insurance and to receive care, which
includes all community provider-ordered therapy and supplies.
The contract medical provider shall be responsible for:
• Coordinating follow-up care and case management services with the employer’s
Reentryers’ compensation insurer until the offender’s treating physician releases
the offender to return to Reentry or the offender is discharged from the custody
of the IDOC, whichever occurs first; and
• Ensuring that any documentation relating to the Reentryers’ compensation claim
is filed in the offender’s Health Care record.
6. Reporting Requirements
CRC Monthly Medical Report
The purpose of the CRC Monthly Medical Report (appendix 3) is to verify through CRC
staff that the contract medical provider is meeting the terms of the contract. The CRC
Monthly Medical Report shall be completed by the CRC manager (or designee) and
forwarded to the health authority by the 15th day of each month.
7. Medication Forms
For the purpose of providing clarity to this section, in accordance with SOPs 401.06.03.021,
Medication Administration Training, and 401.06.03.090, Pharmaceutical Operations, the
terms distributing and administering shall be defined as follows:
• Distributing – The system of delivering, storing, and accounting for medications
from the source of supply to the nursing station or point where they will be
administered to the patient.
• Administering – The act in which a single dose of an identified drug is given to a
patient.
Note: When distributing medications to the CRC, Health Care services staff shall be
responsible for the labeling of all envelopes and medication cards (or blister packs).
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
7 of 9
Self-medication Administration Record
In accordance with SOP 401.06.03.089, Medication Services, the following guidance
regarding the self-medication program shall be adhered to:
• Each month (normally the 1st day of the month or whenever the CRC offender
needs to begin taking the medication), Health Care services staff shall record on
appendix 4, Self-medication Administration Record, the following information:
♦ The month;
♦ The offender’s name, IDOC#, date of birth (DOB), and allergies; and
♦ The name of the medication, strength, and how often the offender needs to
take it.
• When administering the medication(s) listed on the Self-medication
Administration Record to the CRC offender, the designated CRC staff member
shall document the Self-medication Administration Record as follows:
♦ Officer observed (direct observation therapy) – The staff member shall
place his initials in the appropriate date column and time of day row (e.g.,
M = morning, L = noon, E = evening, or N = night) to indicate when the
medication was administered to the offender.
♦ Entire self-medication card (or blister pack) given to the offender –
The staff member shall place his initials in the appropriate date column and
time of day row, and next to his initials record the number of pills
administered and have the offender sign his name next to that written entry.
For example, if on the 1st day of the month at 8 a.m. the offender is given
the entire blister pack of 31 pills, the staff member will initial the box in the
1st day of the month column and the ‘M’ row, write “issued 31 pills”, and
have the offender sign his name next to that written entry.
♦ Offender will be away from the CRC at the time his next dosage(s) of
medication needs to be taken – The staff member shall (a) place the
required next dosage(s) in an envelope (when feasible) so that the offender
can carry the dosage(s) with him, and (b) place his initials in the appropriate
date column and time of day row(s). For example, if on the 10th day of the
month at 8 a.m. the offender is given his morning and lunch dosages for
that day, the staff member will initial both boxes in the 10th day of the month
column and ‘M’ and ‘L’ rows. The staff member shall only administer the
required dosage(s) needed to get the offender through until he returns to
the CRC and can be administered his medication in accordance with the
standard CRC routine. Upon his return to the CRC, the offender should
return the envelope to the designated CRC staff member for reused on
another date (if necessary).
• After the end of the month, Health Care services staff shall collect and place the
Self-medication Administration Record into the medication administration record
(MAR) section of the CRC offender’s Health Care record.
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
8 of 9
Pill Count Sheets and Medication Cards (or Blister Packs)
• Prior to medications being distributed to CRCs, Health Care services staff shall
attach the appropriate pill count sheet (appendix 5 or 6) to the back of the medication
card (or blister pack). (Appendix 5 shall be used for non-controlled medications, and
appendix 6 shall be used for controlled medications such as Ultram, Tylenol 3,
Hydrocodone, Norco, or any other narcotics or dangerous drugs listed per 21 USC
812.)
♦ For controlled medications, Health Care services staff must ensure that the
designated CRC staff member is informed that the medication is controlled so
that the staff member can effectively ensure the medication remains under
control.
Note: Typically, pill count sheets reflect a 30-day supply of medication, which is
reflected from pill # 30 downward so that Health Care services staff can easily
determine how many pills are remaining before issuing a new medication card (or
blister pack).
• The CRC offender shall be responsible for notifying Health Care services staff when
his medication card (or blister pack) reflects that he is down to his last few days of
medication and the medication needs to be refilled.
• Health Care services staff shall be responsible for reviewing weekly, each
medication card (or blister pack) to ensure medication refills will be available to the
CRC offender when needed.
• When administering controlled medications, the designated CRC staff member shall
observe the offender taking and swallowing the medication (direct observation
therapy).
8. Training
The contract medical provider shall provide training for CRC staff for, but not limited to, the
following:
• Automated external defibrillators (AEDs);
• Urgent medical care;
• Emergency medical care; and
• Administering medications (see SOPs 401.06.03.021, Medication Administration
Training, and 401.06.03.090, Pharmaceutical Operations)
DEFINITIONS
Standardized Definitions List
Automated External Defibrillators (AEDs): Electronic devices that interpret cardiac
rhythms and, if appropriate, deliver an electronic shock to the patient.
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
Control Number:
401.04.03.004
Version:
4.0
Title:
Health Care: Community Reentry
Center (CRC) Offenders
Page Number:
9 of 9
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.
Health Authority: The department employee who is primarily responsible for overseeing or
managing the department’s medical services. The health authority is commonly referred to
as the health services director.
Self-medication Program: A program that permits responsible offenders to carry and
administer their own medications. (Also known as Keep-on-Person Program.)
REFERENCES
Appendix 1, Community Health Care Services Appointment Request Form
Appendix 2, CRC Daily Medical Report
Appendix 3, CRC Monthly Medical Report
Appendix 4, Self-medication Administration Record
Appendix 5, Pill Count Sheet
Appendix 6, Controlled Substance Pill Count Sheet
Directive 401.06.03.036, Oral Care
Directive 401.06.03.059.01, Eye Examinations
National Commission on Correctional Health Care (NCCHC), Standard P-A-01, Access to
Care
Standard Operating Procedure 401.06.03.001, Access to Care
Standard Operating Procedure 401.06.03.021, Medication Administration Training
Standard Operating Procedure 401.06.03.088, Health Services Reports
Standard Operating Procedure 401.06.03.089, Medication Services
Standard Operating Procedure 401.06.03.090, Pharmaceutical Operations
United States Code, Title 21, Chapter 13, Subchapter 1, Part B, Section 812, Schedules of
Controlled Substances
– End of Document –
IDAHO DEPARTMENT OF CORRECTION
Community Healthcare Services Appointment Request Form
Appendix 1
401.04.03.004
(Appendix last updated 11/8/10)
IDOC Data Sensitivity Classification - L3 Restricted
Name: Date: _______________ Last, First M/DD/YY
IDOC# Date of Birth: _______________
M/DD/YY
Name of Medical Provider:
(For birth control only)
Name of Dental Provider:
Name of Optical Provider:
Address:
Phone Number:
What are you requesting to be seen for? (Be Specific):
Type of Appointment: First Time Visit for this Problem Follow-up
Date of Appointment: _______________ Time: __________ AM PM M/DD/YY
Estimated Amount of Time for the Visit: (Ask the provider when making appointment)
Is this a Reentryers’ Compensation claim? Yes No
Is this covered by personal health insurance? Yes No
Offender’s Signature: Date:
M/DD/YY
FOR CRC STAFF USE ONLY
Note: If this request is related to a Reentryers’ Compensation claim, the offender is responsible for filing
the claim through his employer.
Offender’s Trust Account Balance:
Appointment Verified By:
Printed Name Employee #
I approve deny the offender’s request for community Health Care services. I denied the request for
the following reason(s):
CRC Manager’s (or designee’s) Printed Name Employee #
CRC Manager’s (or designee) Signature Date
IDAHO DEPARTMENT OF CORRECTION
CRC Monthly Medical Report
Appendix 3
401.04.03.004
(Appendix last updated 11/8/10)
IDOC Data Sensitivity Classification - L3 Restricted
Month/Year
For CRC:
1. Were contract medical provider Health Care services (for offender facility
Reentryers) or community Health Care services (by a licensed provider for Reentry
release offenders) delivered to the offenders at regularly scheduled intervals?
Yes No
Comments:
2. Were contract medical provider Health Care services (for offender facility
Reentryers) or community Health Care services (by a licensed provider for Reentry
release offenders) offered at times that were convenient for the offenders?
Yes No
Comments:
3. How many hours per month did the following spend in CRC clinics?
Physician # hours:
Physician’s Assistant or
Nurse Practitioner
# hours:
Nurse # hours:
Dentist # hours:
Other # hours:
4. Are ordered (procured) medications delivered to the offenders within 24 hours? Yes No
Comments:
5. Is the contract medical provider (for offender facility Reentryers) or licensed
community providers (for Reentry release offenders) seeing offenders immediately
for injuries or acute illnesses?
Yes No
Comments:
6. Are offender health encounters (either at the contract medical provider’s facility or
licensed community provider’s office) conducted in relative privacy?
Yes No
Comments:
7. Has there been an increase in medical complaints since the previous monthly report
was submitted?
Yes No
If so, does there appear to be a prevailing subject in the complaints? Yes No
Comments:
8. Are medical concerns and grievances being addressing by the contract medical
provider in a timely and appropriate manner?
Yes No
Comments:
9. Our addition comments or concerns are:
CRC Manager’s Name (Print) Signature Date
IDAHO DEPARTMENT OF CORRECTION
Self-medication Administration Record
Appendix 4
401.04.03.004
(Appendix last updated 11/8/10)
IDOC Data Sensitivity Classification - L3 Restricted
Offender Name: IDOC #: Date of Birth:
Allergies:
Medication 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
M
L
E
N
Medication 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
M
L
E
N
Medication 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
M
L
E
N
Medication 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
M
L
E
N
Officer Observed
(direct observation therapy)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
M
L
E
N
Legend Key: M = morning, L = noon, E = evening, and N = night.
IDAHO DEPARTMENT OF CORRECTION
Pill Count Sheet
Appendix 5
401.04.03.004
(Appendix last updated 11/8/10)
IDOC Data Sensitivity Classification - L3 Restricted
Medication Name: Medication Name:
Milligrams: Milligrams:
Number Received: Date:
Pill Count Sheet Pill Count Sheet
No. Offender’s Signature Staff
Initials
Date Time No. Offender’s Signature Staff
Initials
Date Time
30 30
29 29
28 28
27 27
26 26
25 25
24 24
23 23
22 22
21 21
20 20
19 19
18 18
17 17
16 16
15 15
14 14
13 13
12 12
11 11
10 10
9 9
8 8
7 7
6 6
5 5
4 4
3 3
2 2
1 1
IDAHO DEPARTMENT OF CORRECTION
Controlled Substance Pill Count Sheet
Appendix 6
401.04.03.004
(Appendix last updated 11/8/10)
IDOC Data Sensitivity Classification - L3 Restricted
Medication Name: Medication Name:
Milligrams: Milligrams:
Number Received: Date: Number Received: Date:
Controlled Substance Pill Count Sheet Controlled Substance Pill Count Sheet
No. Offender’s Signature Staff
Initials
Date Time No. Offender’s Signature Staff
Initials
Date Time
30 30
29 29
28 28
27 27
26 26
25 25
24 24
23 23
22 22
21 21
20 20
19 19
18 18
17 17
16 16
15 15
14 14
13 13
12 12
11 11
10 10
9 9
8 8
7 7
6 6
5 5
4 4
3 3
2 2
1 1
IDOC Data Sensitivity Classification - L3 Restricted