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Control Number: <br />401.06.03.087 <br />Version: <br />2.1 <br />Title: <br />Healthcare for Offenders Housed in <br />Non-Idaho Department of Correction <br />Facilities <br />Page Number: <br />3 of 7 <br /> <br />2. Criteria for Approving Requests for Healthcare Services ................................................ 3 <br />Category 1—Medically Necessary - Acute or Emergent ........................................... 3 <br />Category 2—Medically Necessary - Non-emergent .................................................. 4 <br />Category 3—Medically Acceptable - Not Always Necessary ..................................... 4 <br />Category 4—Limited Medical Value .......................................................................... 5 <br />Non-category—Dental Conditions or Optometry Care .............................................. 5 <br />3. Offender Concerns ......................................................................................................... 7 <br />4. Compliance .................................................................................................................... 7 <br />References ........................................................................................................................... 7 <br />GENERAL REQUIREMENTS <br />1. Guidelines <br />• Offenders who are housed in Non-IDOC facilities shall receive healthcare services <br />consistent with services provided to offenders who are housed in IDOC facilities. <br />• It is anticipated that the scope of healthcare services to be provided shall be <br />delineated in written contractual agreements; however, in the absence of written <br />contractual agreements, the health authority must approve payment for all medical <br />services, including consultant appointments, scheduled hospitalizations, and dental <br />care. Failure to obtain prior approval, except in an emergency, could result in the <br />housing county or entity being held financially responsible. (See SOP 302.02.01.001, <br />Assessment and Placement of State-sentenced Offenders in County Jails.) <br />2. Criteria for Approving Requests for Healthcare Services <br />Requests for authorization of healthcare services shall be submitted using Appendix A, <br />Medical Request for Payment Authorization. All requests for provider visits, medications, <br />diagnostic tests, optometry, dental, or other healthcare service will be reviewed by the <br />Health Services staff (see Appendix A) using the following criteria: <br />Category 1—Medically Necessary - Acute or Emergent <br />This category includes medical conditions that are of an immediate, acute, or <br />emergent nature, which without care (1) would cause rapid deterioration of the offender’s <br />health or significant irreversible loss of function, or (2) may be life threatening. <br />Examples of medical conditions considered a category 1 include, but are not limited to: <br />• Myocardial infarction, <br />• Severe trauma such as head injury, <br />• Hemorrhage, <br />• Stroke, <br />• Status asthmaticus,