Access to Care

Idaho
Departm ent of
Correction
Standard
O perating
Proce dure
Title:
Acce ss to Care
Page:
1 of 6
Control Num ber:
401.06.03.001
Vers ion:
5.0
Adopted:
11/08/1998

Pat Donaldson, chief of the div ision of manage me nt se rv ice s, approved this docume nt on 01/11 /2018.
Open to the public : Yes
SCO PE
This SOP applies to all Idaho Departm ent of Correc tion (IDO C) em ployees , inm ates,
contrac t m edical providers and s ubc ontrac tors .

Revision Summary

Revision date (01/11/2018) vers ion 5.0: Added c larific ation regarding inm ate acces s to healthc are.
Revision date (10/04/2017) vers ion 4.0: Added a des ignee to s ome areas of res pons ibility.
Revision date (09/15/2017) version 3.0: Reformatted entire doc ument; updated term s and definitions.

TABLE O F CO NT ENT S
Board of Correc tion ID APA Rule Num ber 06.01.01.4 01 .......................................................... 1
Policy Control Num ber 401 ....................................................................................................... 1
Purpos e ..................................................................................................................................... 2
Responsibility ............................................................................................................................ 2
Standard Proc edures ................................................................................................................ 3
1. Intro duction ......................................................................................................................... 3
2. Eliminating Barriers to Healthc are Services ....................................................................... 4
3. Providing Heal thc are Servic es ........................................................................................... 4
4. Inm ate Conc erns................................................................................................................. 5
5. Com plianc e ......................................................................................................................... 5
Definitions ................................................................................................................................. 5
Referenc es................................................................................................................................ 6

BOARD OF CORRECT ION IDAPA RULE NUMBER 06.01.01.401
Medical Care
POLICY CONT ROL NUMBER 401
Clinic al Services and Treatm ent
Idaho Departm ent of Correction
Control Number:
401.06.03.001
Ve rsion:
5.0
T itle :
Access to Care
Page Numbe r:
2 of 6

PURPO SE
The purpos e of this s tandard operating proc edure (SO P) is to establish a program to ens ure
that inm ates have unim peded access to healthc are s ervic es to meet their s erious m edic al,
dental and m ental health needs.
RESPONSIBILIT Y
Health Services Director
The health services director, or designee, is res ponsible for:
• Monitoring and overs eeing all as pects of healthc are servic es .
• The im plem entation and continued prac tic e of the provis ions provided in this
SOP.
W hen healthcare s ervices are privatized, the health servic es direc tor, or des ignee, will
als o be responsible for:
• Reviewing and approving (prior to implementation) all applic able c ontract m edic al
provider polic y, proc edure, and form s .
• Monitoring the c ontract m edic al provider ’s perform anc e, to include but not lim ited
to reviewing proc esses , procedures, form s, and protoc ols em ployed by the
c ontract m edic al provider to ensure c ompliance with all healthc are-related
requirements provided in respective c ontractual agreements , this SOP, and in
National Commission on Correctional Health Care (NCCHC) standard P-A-01,
Access to Care. (See sec tion 5 of this SO P.)

Contract Medical Provider
W hen healthcare s ervices are privatized, the c ontrac t medic al provider is res pons ible
for:
• Im plem enting and practic ing all provis ions of this SOP, unless s pec ific ally
exempted by written contractual agreem ents .
• Ensuring that all as pects of this SO P and NCCHC s tandard P-A-01 are
addressed by applic able contrac t m edical provider polic y and proc edure.
• Ensuring fac ility health authorities utilize all applic able c ontract m edical provider
policy, proc edure, form s, and educational information to fulfill all healthc are-
related requirements provided in this SOP, NCCHC s tandard P-A-01, or as
indicated in their respective contractual agreem ent(s ).
• Ensuring all applic able c ontract m edic al provider polic y, procedure, and forms are
submitted to the health services director, or des ignee, for review and approval
prior to im plem entation.

Note: Nothing in this SOP shall be construed to relieve the contract m edical provider(s) of
any obligation and/or respons ibility s tipulated in respec tive contractual agreem ents.
Idaho Departm ent of Correction
Control Number:
401.06.03.001
Ve rsion:
5.0
T itle :
Access to Care
Page Numbe r:
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Health Services Adm inistrator
The health s ervices adm inistrator, or des ignee, will be res pons ible for:
• Ens uring the presenc e of an adequate num ber of appropriately trained staff and
m aterials are available to m eet the requirem ents of this SOP.
• Es tablishing and m onitoring applic able c ontract medic al provider polic y and
proc edure to ens ure that all elements of this SOP and NCCHC standard P-A-01 are
accom plis hed as required.
• Es tablishing form al relations hips with community hos pitals , s pecialists, and others as
needed to m eet the requirem ents of this SOP and NCCHC s tandard P-A-01.
• Es tablishing and m onitoring proc edures to ens ure inm ates rec eive care that is
ordered by qualified health professionals .
• Es tablishing and m onitoring proc edures to ens ure the m edical c o-pay program is
adm inis tered pursuant to policy 411, Medic al Co-pay.

Qualified Health Professional
The qualified health professional will be responsible for:
• Providing inform ation to inm ates, delineating how spec ific healthcare s ervic es
are obtained.
• Perform ing a prelim inary health screening, appropriate to the gender of the
inm ate, for all new inm ates at the Receiving and Diagnos tic Unit (RDU), including
transferees from county jails , privately m anaged correctional facilities , and out-of-
s tate c orrectional facilities .
• Sc heduling tim ely appointm ents with the appropriate practitioner when a m edic al
or m ental health need requiring evaluation and/or intervention by a lic ens ed
m edical, m ental health, or allied healthcare provider (including spec ialis ts and
sub-specialists) is identified.
• Providing tim ely and adequate healthc are services per referral from qualified
health professionals .
• Docum enting all c linic al c ontacts in the inm ate’s healthcare rec ord.
GENERAL REQ UIREM ENT S
1. Intr oduction
In a tim ely m anner, an inm ate c an be seen by a clinic ian, be given a professional c linic al
judgm ent, and rec eive care that is ordered. Healthc are provided to inmates during
inc arceration foc uses on prevention and m aintenance of the inm ate’s health status. Acces s
to healthcare servic e is the foundation upon which all routine and em ergent healthc are
s ervices are dependent.
Idaho Departm ent of Correction
Control Number:
401.06.03.001
Ve rsion:
5.0
T itle :
Access to Care
Page Numbe r:
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2. Eliminating Barrie rs to He althcare Se rv ice s
Each health services adm inistrator, or des ignee, will ens ure that proc edures are in plac e to
identify and eliminate unreas onable barriers to inmates’ access to healthcare servic es.
Exam ples of unreas onable barriers inc lude, but are not lim ited to, the following:
• Punis hing inm ates for s eeking c are for their s erious health needs
• As sessing exc essive c o-paym ents that prevent or deter inm ates from s eeking care
for their serious health needs
• Deterring inm ates from seeking c are for their serious health needs, such as holding
sic k c all at 2:00 a.m., when this prac tic e is not reasonably related to the needs of the
fac ility
• Healthcare serv ice s will not be de nie d or de laye d base d on an inmate ’s
inability to pay.
3. Prov iding He althcare Se r v ices
Note : The contract m edical provider is res ponsible for s upplying and providing any form s
indicated in this sec tion.
• W ithin 24 hours of an inm ate’s arrival to the IDOC, the inm ate m ust receive written
and verbal instructions regarding access to healthcare services. W ritten inform ation
m us t be m ade available in both English and Spanis h (if an inm ate does not speak
English, a written interpretation or telephone interpretation servic e must be provided
in the language s poken.) In addition, the contrac t m edical provider shall c om plete a
Prison Medic al His tory and Screening form for each inm ate upon arrival into the
correctional setting.
• Inform ation about how specific healthc are services are obtained by an inm ate during
inc arceration must be reviewed with the inmate (a) at the time of the m edical his tory
and screening, (b) any tim e an inm ate rec eives a particular servic e for the first tim e,
and (c ) on any other occas ion when an inm ate displays a lac k of unders tanding
about how healthc are servic es are obtained. In addition, the contract m edic al
provider shall com plete a Phys ical Assessm ent form for eac h inm ate and repeat the
assessment as referred by a qualified health professional in c onsideration of the
individual inmate’s age, gender, and health needs.
• Each health servic es adm inistrator, or des ignee, m us t establish and monitor
proc edures to ens ure inmates have acces s to qualified health professionals and that
procedures inc lude, but not be limited to, c linic al aspec ts, monitoring
appropriateness, timeliness and respons iveness of care and treatm ent, and review of
recommendations for treatm ent of inm ates m ade by healthcare providers.
• Inm ate requests for healthcare servic es m ust be reviewed daily and the appropriate
dis position m ade and noted in the healthcare rec ord.
• Changes in the procedures for obtaining healthc are servic es m ust be posted in eac h
hous ing unit no fewer than s even calendar days prior to implementation of the
c hange.
Idaho Departm ent of Correction
Control Number:
401.06.03.001
Ve rsion:
5.0
T itle :
Access to Care
Page Numbe r:
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• Non-healthc are servic es staff (i.e., security staff) must not be allowed to approve or
deny requests for healthcare m ade by an inmate. (Non-healthc are s ervices s taff
m ust forward reques ts for healthc are to healthc are servic es s taff at the facility for
review and ac tion if nec essary.)
• Upon identific ation of any m edic al or m ental health need requiring evaluation and/or
intervention by a phys ician, m id-level provider, dentis t, or mental health professional,
arrangem ents must be made to provide timely exam ination, assessm ent, and/or
treatm ent by scheduling an appointm ent with the appropriate prac titioner.
4. Inmate Concerns
Inm ates who feel they have not been provided acces s to care s hall have the right to file a
conc ern, whic h m ust be done by completing an IDOC Inmate Conc ern Form and s ubm itting
it to the proper authority for res olution. (See SOP 316.02.01.001, Griev ance and Inform al
Res olution Procedure for Inm ates, for procedures and the c onc ern form .)
5. Compliance
Com plianc e with this SOP and all related IDO C-approved protoc ols will be m onitored by the
health servic es direc tor, or des ignee, by us ing various s ources to inc lude: this SOP, c linic al
prac tic e guidelines, routine reports, program reviews , and rec ord reviews.
The health servic es director, or designee, m ust c onduc t two audits per year, per fac ility (or
m ore frequently as des ired bas ed on prior audit results ). The audits m ust cons ist of
m onitoring applicable c ontract m edic al provider, IDOC policy and procedures , applic able
NCCHC standards , and the review of a minim um of fifteen individual records.
DEFINIT IONS
Clinical Practice Guideline: A system atic ally developed, science-based guideline
(presented by a national professional organization and accepted by experts in their
respective medic al field) designed to assist the prac titioner and patient with dec isions about
appropriate healthc are for s pecific clinical c irc um s tanc es.

Contract Medical Provider: A private com pany or other entity that is under contract with
the Idaho Department of Correction (IDOC) to provide c om prehens ive m edical, dental,
and/or m ental health s ervices to the IDO C’s incarc erated inm ate population.

Health Services Adm inistrator: The contract m edical provider employee, or designee, who
is prim arily respons ible for overs eeing the delivery of m edical s ervices in an Idaho
Departm ent of Correction (IDOC) fac ility.
Health Services Director: The Idaho Departm ent of Correction (IDO C) employee, or
des ignee, who is prim arily responsible for overs ight of auditing and m onitoring services
provided by the contract m edic al vendor.

M ental Health Professional: A person who has s pecialized training and skills in the nature
and treatm ent of m ental illnes s to inc lude, but not limited to, a psychologist, ps yc hiatris t,
clinical s oc ial worker, or clinician who – by virtue of his educ ation, c redentials , and
experienc e – is permitted by law to evaluate and care for patients .
Qualified Health Professional: A physic ian, physic ian assistant, nurs e practitioner, nurs e,
dentist, mental health professional, or other health professional who — by virtue of his
Idaho Departm ent of Correction
Control Number:
401.06.03.001
Ve rsion:
5.0
T itle :
Access to Care
Page Numbe r:
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education, training, credentials, and experienc e — is perm itted by law (within the scope of
his professional practice) to educ ate, train, evaluate, provide services , and c are for patients .
REFERENCES
National Commission on Correctional Health Care (NCCHC), Standards for Health Serv ic es
in Pris ons, Standard P-A-01, Access to Care
Policy 411, Medic al Co-pay
Standard Operating Procedure 316.02.01.001, Grievance and Inform al Res olution
Proc edure for Inm ates
– End of Document –