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1 1 (August 26, 2020)

handle is hein.crs/govdbmf0001 and id is 1 raw text is: k ah .- Health Care for Federal Prisoners August26,2020 This In Focus provides abriefoverview of how the Bureau of Prisons (BOP) provides medical care to prisoners in its custody. BOPoperates l22prisons across thecountry, and at of the end ofFY2019 there were approximately 177,000 prisoners under BOP's juris diction, making BOP one of the largest correctional systems in the country. Under 18 U.S.C. Section 4042(a), BOP is required to provide for the safekeeping, care, and subsistenceof all persons charged with or convicted of offenses against the United States, or held as witnes ses or otherwis e. 18 U.S.C. Section 4048 governs fees for health care services provided to prisoners. However, the manner in which BOP provides health care services to prisoners is largely dictated by regulations and policy statements rather than statutory law. The relevant regulations canbe found in Title 28, Part 549 of the Code of Federal Regulations, and the relevant BOPpolicy statements are PS 6010.05, Health Services Administration, and PS 6031.04, Patient Care. MedicaI Care Le-veIs BOP uses a four-tieredsystemto classify the levelof medical care delivered to prisoners. The purpose of this systemis to assign prisoners with greater medicalneeds to those facilities with more comprehensive on-site medical resources. Prisoners classified as Care Level 1 are generally healthy, and the intensity of care increases with each corresponding level. Each prisonerin BOP's custody is assigneda medicalcare levelas apart ofBOP's process of determining where aprisonerwill serve his orher sentence (i.e., designation). The medical care levelis based on each prisoner's medicalhistory and otheravailable information. * Care Level 1: Prisoners are generally healthy, under 70 years of age, and may have limited medicalneeds requiring clinical evaluation and monitoring (e.g., mild asthma ordiet-controlled diabetes). * Care Level 2: Prisoners are stable outpatients, requiring at least quarterly clinical evaluations (e.g., medication- controlled diabetes or epilepsy). * Care Level 3: Prisoners are fragile outpatients who require frequent clinical visits, and/or who may require some assistance with activities of daily living,but do not require daily nursing supervision. This care level may include stabilization of medical or mental health conditions that require periodic hospitalization. Examples of prisoners in this care level include prisoners with cancer in remission less than one year, prisoners with advanced human immunodeficiency virus (HIV) infections, and prisoners with severe congestive heart failure. * Care Level 4: Prisoners are severely physically impaired, and may require daily nursing care. This includes prisoners who are receiving treatment for cancer, prisoners who are quadriplegic, and prisoners who need dialysis. In addition to their security level, BOP institutions are classified basedon the medicalcare levelthat theyprovide. BOP designates an institution's care levelbasedon the medical resources available to meet the needs of each institution's population. Generally, institutions at each care level are designed to house mostly prisoners at that designated medical care level. However, no institution has a prisoner population completely composed of a given care level(e.g., a Care Level 2 institutionmight house prisoners who have a designation of Care Level 1 or Care Level 2). Health Servce Units Each BOP facility has a Health Services Unit (HSU), which is responsible for providing health care services to prisoners of that facility. The primary administrators of the HSU are the Clinical Director (CD) and the Health Services Administrator (HSA). The CD is responsible for oversight of medical care provided at the institution. The CD's responsibilities include reviewing applications and credentials for members of the medical s taff, ensuring that new health care providers are properly trained prior to being allowed to work independently, and implementing and monitoring in-house, continuing professional education training. The HSA plans, implements, and directs the administration ofthe HSU. The HSA's responsibilities include procuring medical supplies and equipment, overseeing maintenance and sanitation at the HSU, and ensuring that staff is properly licensed, registered, or certified. BOP policy also requires each HSU to have a written comprehensive preventive maintenanceplan for all HSU equipment that follows manufacturers' recommendations, which includes a procedure for reporting and documenting equipment failure. Prison Health Clinics BOP provides medically necessary health care treatment to all prisoners housed in BOP-operated facilities. The treatment providedis consistentwith the standards of care for non-incarcerated individuals. Most medical treatment is provided through health care clinics that are operated in each BOPfacility. Most clinics haveexamination rooms, treatment rooms, dental clinics, radiology and laboratory areas, a pharmacy, and adminis trative offices. The following services are offered at prison clinics across all medical levels: pgpg\\\ \\

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