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Home My WebLink AboutNon-emergency Healthcare Requests and ServicesIdaho Department of Correction Standard Operating Procedure Title: Non-emergency Health Care Requests and Services Page: 1 of 5 Control Number: 401.06.03.037 Version: 5.0 Adopted: 03/11 /1999 IDOC Data Sensitivity Classification - L3 Restricted Pat Donaldson, chief of the division of management services, approved this document on 10/04/2017. Open to the public: Yes SCOPE This standard operating procedure (SOP) applies to all Idaho Department of Correction (IDOC) healthcare services staff, inmates, contract medical providers and subcontractors. Revision Summary Revision date (09/11 /2017) version 4.0: Updated formatting throughout document; revised terms and definitions. Revision date (10/04/2017) version 5.0: Minor changes to add a designee to some areas of responsibility. TABLE OF CONTENTS Board of Correction IDAPA Rule Number 06.01.01.401 ........................................................ 1 Policy Control Number 401................................................................................................... 1 Purpose ................................................................................................................................ 2 Responsibility ....................................................................................................................... 2 Standard Procedures ........................................................................................................... 3 1. Guidelines ...................................................................................................................... 3 2. Compliance .................................................................................................................... 5 Definitions ............................................................................................................................ 5 References ........................................................................................................................... 5 BOARD OF CORRECTION IDAPA RULE NUMBER 06.01.01.401 Medical Care POLICY CONTROL NUMBER 401 Clinical Services and Treatment Control Number: 401.06.03.037 Version: 5.0 Title: Non-emergency Health Care Requests and Services Page Number: 2 of 5 Idaho Department of Correction PURPOSE The purpose of this standard operating procedure (SOP) is to establish a program to ensure that inmates’ routine healthcare needs are met in a timely manner by appropriately qualified health professionals. RESPONSIBILITY Health Services Director The health services director, or designee, is responsible for: • Monitoring and overseeing all aspects of healthcare services. • 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. • 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 healthcare-related requirements provided in this SOP and in National Commission on Correctional Health Care (NCCHC) standard P-E-07, Non-emergency Healthcare Requests and Services (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 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 standard P-E-07, or as indicated in their respective contractual agreement(s). • Ensuring all applicable contract medical provider policy, procedure, and forms are submitted to the health services director, or designee, 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. Health Services Administrator The health services, or designee, administrator will be responsible for: • Ensuring the presence of an adequate number of appropriately trained staff are available to meet the requirements of this SOP. Control Number: 401.06.03.037 Version: 5.0 Title: Non-emergency Health Care Requests and Services Page Number: 3 of 5 Idaho Department of Correction • Establishing and monitoring applicable contract medical provider policy and procedure to ensure that all elements of this SOP and NCCHC standard P-E-07 are accomplished as required. • Evaluating policy, procedure, NCCHC standards, and other information, to include inmate concerns or grievances, workload statistics and continuous quality improvement studies, and adjusting scheduling and staffing accordingly to ensure that the frequency and duration of sick call is sufficient to meet the health needs of the inmate population. In addition, in conjunction with the facility medical director, or designee, the health services administrator, or designee, will be responsible for: • Training staff and establishing applicable contract medical provider policy and procedure and systems of control to ensure that healthcare staff is appropriately trained to perform the duties described in this SOP. Facility Head In conjunction with the health services administrator, or designee, the facility head will be responsible for ensuring that non-healthcare staff does not make determinations regarding whether an inmate shall receive healthcare services. STANDARD PROCEDURES 1. Guidelines Note: The contract medical provider is responsible for supplying and providing any forms indicated in this section. Note: Security Staff must not have access to requests for health assistance. • Inmates must have the ability to request healthcare attention on a daily basis. Requests for health assistance (whether medical, dental, or mental health) must be received, reviewed, documented, and acted upon by qualified healthcare professionals. The inmate’s health complaint must be triaged, treated, and referred based upon the healthcare professional's clinical evaluation. Non-healthcare staff must not determine whether an inmate receives healthcare attention. • All areas of inmate living, segregated and non-segregated, must have access to request healthcare on a daily basis. The process for this will vary from institution to institution and must be delineated in applicable contract medical provider policy and procedure. All changes to applicable contract medical provider policy and procedure must be reviewed and approved by the health services director, or designee, prior to implementation. • Requests for ”sick call” can be done by submitting a Health Service Request (HSR). Each HSR will be received daily and triaged within twenty four hours of receipt, seven days a week. If open sick call is used an inmate has the opportunity, daily, to go to medical at an established time, with their completed HSR, to be evaluated by a QHCP. The process for this will vary from institution to institution and must be delineated in applicable contract medical provider policy and procedure. All changes Control Number: 401.06.03.037 Version: 5.0 Title: Non-emergency Health Care Requests and Services Page Number: 4 of 5 Idaho Department of Correction to applicable contract medical provider policy and procedure must be reviewed and approved by the health services director, or designee, prior to implementation. • Mental health requests will be received daily and screened by a qualified health professional. If the request describes the overt intention of self-harm or harm to others, IDOC policy 315, Suicide Risk Management, will be implemented. All other mental health requests will be placed in a box to be picked up by mental health staff for triage. • Not every sick call request requires a sick call appointment; however, when a sick call request describes a clinical symptom, a face-to-face encounter between the inmate and the qualified health professional is required. This requirement applies to mental health and dental symptoms as well. • Following this triage, medical and dental requests that involve a clinical symptom must be seen by a qualified health professional within twenty four hours (seventy two hours on weekends) for evaluation and treatment. • Following triage, mental health requests that involve a clinical symptom must be evaluated by mental health staff within twenty four hours. • Each request for health assistance will be evaluated and must be documented in the inmate healthcare record utilizing the subjective, objective, assessment, plan (SOAP) charting format. Each request that involves a clinical symptom requires the use of a Nursing Assessment Protocol. The inmate must be provided with an explanation of the assessment findings, any further recommended treatment or evaluation, and any patient education relevant to the request for health assistance. All encounters will be dated, timed, signed, and placed in the healthcare record. (Note: In addition to this requirement, a sick call log must be maintained to record, at a minimum, the name of the inmate, the date of the request, the nature of the request, and to who/whom/where the inmate was referred.) • All inmates, regardless of housing assignment, must have access to regularly scheduled sick call. The frequency and duration of sick call must be sufficient to meet the needs of the inmate population and must coincide with other routine inmate activities in the facility (i.e., it cannot take place at an unusually early or late time of day). • Sick call or provider appointments for non-segregated populations are conducted in an area appropriate for the evaluation of the complaint. Inmate healthcare records must be available to the healthcare staff at the time of the sick call contact. Each inmate will be seen on an individual basis in a designated area to ensure privacy and confidentiality. • Inmates who receive a referral to a provider must be seen within fourteen days of the qualified health professional’s assessment at sick call when: ♦ Indicated by protocol. ♦ The patient requires a higher level of evaluation and/or care. ♦ Nursing assessment is deferred. Control Number: 401.06.03.037 Version: 5.0 Title: Non-emergency Health Care Requests and Services Page Number: 5 of 5 Idaho Department of Correction ♦ Two or more recent contacts are made for the same health complaint. 2. Compliance Compliance with this SOP and all related Department-approved protocols will be monitored by the health services director, or designee, by using various sources to include: this SOP, clinical practice guidelines, routine reports, program reviews, and record reviews. The health services director, or designee, must conduct two 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 fifteen individual records. DEFINITIONS Clinical Setting: An environment in which an examination or treatment room is appropriately supplied and equipped to address a patient’s confidential healthcare needs. Contract Medical Provider: A private company under contract with the Department to provide comprehensive medical, dental, and/or mental health services to the incarcerated inmate 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 inmates. Daily: Seven days per week, including holidays. Health Services Administrator: The contract medical provider employee, or designee, who is primarily responsible for overseeing the delivery of medical services in an Idaho Department of Correction (IDOC) facility. Health Services Director: The Department employee, or designee, who has oversight and primary responsibility for auditing and monitoring services provided by the contract medical vendor. Providers’ Clinic: A clinic for sick call, which is held by a qualified health professional. Qualified Health Care Professional: A physician, physician assistant, nurse practitioner, nurse, dentist, mental health professional, or other health professional who — by virtue of his education, training, credentials, and experience — is permitted by law (within the scope of his professional practice) to educate, train, evaluate, provide services, and care for patients. REFERENCES National Commission on Correctional Health Care (NCCHC), Standard P-E-07, Non- Emergency Healthcare Requests and Services – End of Document –