FCI Ashland Medical Care

Aug, 14 11 Post by: admin | No Comments


Policy


To effectively deliver medically necessary health care to inmates.

Clinic Hours and Appointment Procedures


Routine and Urgent medical care (commonly known as “SICK CALL”) is provided routinely and as clinically necessary based upon the Primary Care Provider Team Model. All inmate care will be assigned to a Mid-Level Provider (Physician Assistant), based upon their inmate registration number. Routine ambulatory clinic patient appointments are scheduled Monday through Friday, excluding Holidays.

The procedure to obtain an appointment is to request a “Sick Call Request Form” from the Unit Officer. The inmate must complete this form and bring it to the Health Services Unit before 7:00 a.m. Monday – Friday and deposited in the box located on the mail corridor wall, just outside of the Satellite Pharmacy window. All Request forms will be reviewed and appointments will be prioritized based upon the clinical need for care and the Health Services’ Triage Guidelines. If routine Clinic hours are disrupted due to an unforeseen event, medical complaints will be addressed via telephone. As with any unusual or unforeseen medical problem that occurs, inmates will need to report their medical complaints to Unit Staff or their Work or Detail Supervisors who will in turn notify Health Services staff for a determination of care needed. All clinical complaints will be addressed and evaluated. However, if the complaint is not categorized as an emergency by the clinical provider or require immediateintervention, the inmate will be instructed to obtain an appointment for routine care by submitting a Sick Call Request Form. If an inmate is evaluated and identified as needing specialty care, which falls within the Bureau of Prisons policy of providing medically mandatory or medically necessary care, this request will be reviewed by a Utilization Review Committee and make are commendation to the Clinical Director. Her decision will be based upon the clinical need for such specialty evaluation based upon the requirements of policy.

Inmate Co-Pay


The inmate co-pay fee has been established at $2.00 per visit. A co-pay fee is charged when an inmate initiates a health care visit, is found responsible for the injury of another inmate, when a medical evaluation is requested by non-clinical staff if the condition is not an emergency or any other non-emergent visit as outlined in P. S.6031.02. Inmates will not be denied healthcare services due to indigent status.

Clinic Appointments and Call Outs


Call-outs posted in the Units must be checked on a daily basis. It is the inmate’s responsibility to report to all scheduled appointments or call out in the Health Services Unit. Additionally, all inmates are expected to be on time and to bring all medications with them to all appointments. All call outs (scheduled appointments through the SENTRY computer system) are posted in the Units and should be checked on a daily basis. Call outs are scheduled to coincide with the controlled movements. Appointments will be scheduled on the hour. A missed call out or appointment may be reason for disciplinary action. If an inmate arrives late for an appointment it will be at the Provider’s discretion whether or not the inmate can still be seen at the appointed time.

Eyeglasses and Contact Lenses


In order to be evaluated for eyeglasses, all inmates must report to sick call for an evaluation by the MLP. If the visual problem meets the criteria for referral to the Eye Care Specialist, you will be scheduled. Contact lenses are permissible for use instead of glasses only when ordered by an Ophthalmologist and approved by the Health Services staff and it is determined that your medical condition is best treated with contact lenses.

X-Ray/Laboratory Results


To receive results from routine diagnostic tests, you need to send a cop-out to the provider who ordered the test. If an inmate is scheduled for a Lab Call-out at 6:30 AM, present to Health Services before eating breakfast. The staff will make arrangements with the Food Service staff to ensure that breakfast will be available when the laboratory test collection is completed.

Intake Screening


Upon arrival at FCI Ashland, you will be interviewed by a member of the Health Services staff. It is absolutely necessary to cooperate with them in supplying all requested medical data. If medications are taken daily or routinely, these will be continued until evaluated by a clinical provider. All inmates will be given a medical screening upon their arrival, to include a TB Screening Examination. If a TB skin test is administered, the test site will need to be checked in two days. Failure to return for this Call-out in two days will mean a repeat of the test. If any portion of the medical screening for communicable diseases is refused, the inmate may be subject to disciplinary action. Those individuals who require long-term chronic care which cannot be provided at this facility, will be referred to one of the Federal Medical Centers.

Physical Examinations


A physical examination will be completed within 14 days of your arrival, if indicated. If an inmate transfers from another institution and a current physical examination is in the medical record, this will not be repeated. A medical duty status will be assigned and work clearance obtained at the time of the physical examination or medical record review. Inmates can request an updated age-specific physical examination by sending a cop-out to the Health Services Unit and the inmate will be scheduled according to the Preventive Health Guidelines. If an is being released from the system and the discharge date is not within one year of the previous examination, a release physical can be requested. This should be requested at least two months prior to your anticipated release date.

Medical Duty Status Determination

 
Most Medical Duty Statuses are deleted upon arrival from another institution. All Medical Duty Statuses (Bottom Bunk, Special Medical Footwear, Athletic Restrictions, etc.) are assigned according to specific criteria set by the Clinical Director at FCI Ashland based upon BOP policy. All inmates will be evaluated based on these criteria. Work assignments are made by the Unit Team. A duty status given for convalescence or quarters must be immediately reported to the inmate’s Work Supervisor and Unit Team member and a copy of the restriction provided to them.

Equipment Loans


If medical equipment is provided to an inmate for use as a result of illness or injury from the Health Services Department such as: crutches, canes, walkers, etc. this inmate will sign for it upon receipt. If this equipment is not returned, the inmate may be subject to disciplinary action and/or be required to pay for these items.

Pharmacy


All prescriptions can normally be picked up from the Pharmacy immediately following your clinic appointment, unless you are instructed otherwise. Prescriptions are also available for pick-up from the outside Pharmacy window at the designated times noted on the sign posted by the Main Pharmacy and Satellite Pharmacy area. Medication instructions will be provided with a new prescription. The Pharmacist will provide information regarding the medication and how it is to be taken. Further medication education counseling is available when requested via cop-out.

REFILLS: It is the inmate’s responsibility to notify the Health Services personnel when a prescription requires renewal. Plan ahead for this. To obtain refills, leave the medication bottle in the box on the main corridor wall, just outside of the Satellite Pharmacy window prior to 0700 at both theFCI and FPC or report to the Pharmacy during open movement if questions occur regarding medications or refills.

OVER-THE-COUNTER MEDICATIONS: Medication like: Motrin (Ibuprofen) Aspirin, Tylenol (Acetaminophen), Allergy Medication, Liquid Antacids, Acid Reflux Medications, Hemorrhoidal and Antifungal Cream (Athlete’s Foot Cream, etc.) are available for purchase in the Commissary. Unless the medical provider determines that a prescription of these or some other over-the-counter medications is clinically indicated, the inmate will be expected to purchase them in the Commissary.

PILL LINES: If restricted medications (those which cannot be taken back to your unit) or insulin injections are ordered, the Pharmacist will advise of the times and method of receiving these medications. The routine Pill Line times are posted outside of the Health Services Unit and above the satellite pharmacy window. Before any medication can be administered or dispensed, th inmate must provide a photo ID(Commissary card) for identification purpose and recite his name and register number.

Glucomoter


A glucometer will be provided for personal use or one will be available for blood sugar checks at the Morning and Evening Insulin Line for Insulin-dependent Diabetics.

Dental Services


Dental sick call sign-up is conducted in the same manner and time as the Medical sick call. All inmates arriving at the institution will receive a routine dental screening within 30 days of arrival. In order to receive routine dental care or cleaning, you must submit a cop-out to the Dental Clinic for each and you will be placed on the Waiting List. If a “dental emergency” should develop, the inmate must inform his detail supervisor or unit officer and arrangements will be made for an evaluation.

Infectious Diseases


Remember, YOU are the single most important factor in protecting yourself from infection and hand washing is the single best way of preventing the spread of infections.

  • HIV There is an increased personal risk factor to contract this virus by behaviors which includes: IV drug use, tattooing, and homosexual behavior. You are discouraged from engaging in such activities which transfer blood and body fluids. All inmates who have engaged in any of these high risk behaviors are encouraged to have an HIV test performed. This can be requested and risk factors discussed during your physical examination or on routine sick call.
  • HEPATITIS The Hepatitis Virus is contracted in the same manner as HIV. Testing is not mandatory, but diagnosis is determined by a blood test. Testing is done when clinically indicated.
  • TUBERCULOSIS The Tuberculosis bacteria is transferred through the respiratory tract following prolonged exposure. All inmates are required to be screened, usually by a skin test, at least annually and according to the Bureau of Prisons policy. Since this is a matter of public health, you are subject to disciplinary action, if refused. This disease is treated by antibiotic therapy. If you were to have a positive screening test, you will be evaluated and possibly offered a prophylactic treatment regimen of Isoniazid (INH) and Vitamin B 6. This program will be explained to you by the Clinical Providers and the Pharmacist.
  • METHICILLIN RESISTANT STAPHAUREUS (MRSA) The term Methicillin Resistant Staph Aureus refers to those strains of staph aureus bacteria that have acquired resistance to certain antibiotics. MRSA is spread through direct physical contact, not through the air. Healthy people have very little risk of becoming infected with MRSA . If you should have open sores or ulcers that do not heal, you should make sick-call to be tested. Although it is resistant to some antibiotics there are several treatments available.
  • SYPHILIS The syphilis bacteria is transmitted by sexual contact and is screened for on admission by a blood test for those with at risk behavior. It is treated by antibiotic therapy.


Medical Records Review and Copies


Any inmate wishing to review or have copies made of his medical record should submit a cop-out to the Health Services Medical Records Department. The inmate will be advised if there is any other action that must be taken prior to copies being made. No information containing the HIV status of the inmate or information containing another inmate’s name will be released. These documents can be obtained after the inmate is released from custody by written request from the Freedom of Information Act (FOIA) Office. This address is available from the Unit Team.

Requests to See the Physician


Any inmate wanting to see the physician must send a cop-out stating the specific reason for their request. The physician will make the determination as to whether he will be scheduled and when.

Administrative Remedies


This is a formal process by which an inmate can seek a solution to their problems or complaints. However, this is enacted after all other attempts to communicate an inmate’s concerns with the affected staff have been exhausted. Communication with the medical staff is vital to understanding the treatment plan for injuries or disease processes. As has been related by the Health Services Administrator (or her designee) during the initial orientation lecture, this department provides health care on a NEED versus a WANT basis. All necessary clinical care will be provided.

Advanced Directives and Living Wills


This is  legal document prepared by an individual in order for sensitive medical decisions about having extraordinary means of care and life support withheld or withdrawn in cases of a terminal condition or irreversible illness put into place prior to anysuch occurrence. Refer to the Institution Supplement for specific Kentucky Law and a sample document. However, as long as an inmate is housed in a general population institution, such as FCI Ashland, all means to sustain life will be used. Such a document will only become effective when an inmate enters the community hospital or a Federal Medical Referral Center.

Health Care Rights and Responsibilities



Your Health Care Rights: Your Responsibilities:
1. You have the right to access health care services based on the local procedures at this institution. Health services include medical, dental, and all support services. 1. You have the responsibility to comply with the health care policies of this institution and follow recommended treatment plans established for you by the health care staff.
2. You have the right to know the name and professional status of your health care providers and to be treated with respect, consideration, and dignity. 2. You have the responsibility to treat these providers as professional and follow their instructions to maintain and improve your overall health.
3. You have the right to address any concerns regarding your health care to any member of the institutional staff including the physician, the Health Services Administrator, members of your Unit Team, the Associate Warden, and the Warden 3. You have the responsibility to address your concerns in the accepted format, such as the Inmate Request to Staff Member form, at main line, or the accepted Inmate Grievance Procedures.
4. You have the right to provide the Bureau of Prisons with Advance Directives or a Living Will that would provide the Bureau of Prisons with instructions if you are admitted as an inpatient to a hospital. 4. You have the responsibility to provide the Bureau of Prisons with accurate information to complete this agreement.
5. You have the right to be provided with information regarding your diagnosis, treatment, and prognosis. 5. You have the responsibility to keep this information confidential.
6. You have the right to obtain copies of certain releasable portions of your health record. 6. You have the responsibility to be familiar with the current policy and abide by such to obtain these records.
7. You have the right to be examined in privacy. 7. You have the responsibility to comply with security procedures should security be required during your examination.
8. You have the right to participate in health promotion and disease prevention programs, including those providing education regarding infectious disease. 8. You have the responsibility to maintain your health and not to endanger yourself, or others, by participating in activities that could result in the spreading or catching of infectious diseases.
9. You have the right to report complaints of pain to your health care provider, have your pain assessed, managed in a timely manner, be provided information about pain management as well as information on the limitations and side effects of pain treatments. 9. You have the responsibility to communicate with your health care provider honestly regarding your pain and your concerns about your pain. You also have the responsibility to adhere to the prescribed treatment plan and medical restrictions. It is your responsibility to keep your provider informed of both positive and negative changes in your condition to assure timely follow-up.
10. You have the right to receive prescribed medications and treatments in a timely manner, consistent with the recommendations of the prescribing health care provider. 10. You have the responsibility to be honest with your health care provider(s), to comply with prescription treatments and follow prescription orders. You also have the responsibility not to provide any other person with your medication or other prescription item.
11. You have the right to be provided healthy and nutritious food. You have the right to instructions regarding a healthy diet. 11. You have the responsibility to eat healthy and not abuse or waste food or drink.
12. You have the right to request a routine physical examination as defined in the Bureau of Prisons policy.(If you are under the age of 50, once every 2 years, if over the age of 50, once a year and within one year of your release. 12. You have the responsibility to notify medical staff that you wish to have an examination.
13. You have the right to dental care as defined in the Bureau of Prisons policy to include preventative services, emergency care, and routine care. 13. You have the responsibility to maintain your oral hygiene and health.
14. You have the right to a safe, clean, and healthy environment that includes smoke free living areas. 14. You have the responsibility to maintain the cleanliness of personal and common areas and safety in consideration of others. You have the responsibility to follow smoking regulations.
15. You have the right to refuse medical treatment in accordance with the Bureau of Prisons policy. Refusal of certain diagnostic tests for infectious diseases can result in administrative actions against you. You have the right to be counseled regarding the possible consequences of refusing medical treatment. 15. You have the responsibility to notify health services regarding any ill-effects that occur as a result of your refusal. You also accept the responsibility to sign the treatment refusal form.


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