The Health Services Department consists of a Clinical Director, Staff Physician, several Physician Assistants, a Health Services Administrator, a Pharmacist, and other specialist positions, to include contractors.

Physician Assistants provide coverage from 5:30 a.m. to 10:00 p.m. Monday – Friday and 6:00 a.m. to 10:00 p.m. weekends and holidays, with staff on call 24 hours a day.

Pursuant to the Federal Prisoner Health Care Copayment Act (FPHCCA) of 2000 (P.L. 106-294, 18 U.S.C. § 4048), the Federal Bureau of Prisons and FCI Bastrop provide notice of the Inmate Copayment Program for health care, effective October 3, 2005.
A. Application:

The Inmate Copayment Program applies to anyone in an institution under the Bureau’s jurisdiction and anyone who has been charged with or convicted of an offense against the United States, except inmates in inpatient status at a Medical Referral Center (MRC). All inmates in outpatient status at the MRCs and inmates assigned to the General Population at these facilities are subject to copay fees.
B. Health Care Visits with a Fee:

1. You must pay a fee of $2.00 for health care services, charged to your Inmate Commissary Account, per health care visit, if you receive health care services in connection with a health care visit that you requested, except for services described in section C below.
These requested appointments include Sick Call and after-hours requests to see a health care provider. If you ask a non-medical staff member to contact medical staff to request a medical evaluation on your behalf for a health care service not listed in section C below, you will be charged a $2.00 copay fee for that visit.
2. You must pay a fee of $2.00 for health care services, charged to your Inmate Commissary Account, per health care visit, if you are found responsible through the Disciplinary Hearing Process to have injured an inmate who, as a result of the injury, requires a health care visit.

We will not charge a fee for:
Health care services based on health care staff referrals; Health care staff-approved follow-up treatment for a chronic condition; Preventive health care services; Emergency services; Diagnosis or treatment of chronic infectious diseases; Mental health care; or Substance abuse treatment.

If a health care provider orders or approves any of the following, we will also not charge a fee for: Blood pressure monitoring; Glucose monitoring; Insulin injections; Chronic care clinics; TB testing; Vaccinations; Wound Care; or Patient education.

Your health care provider will determine if the type of appointment scheduled is subject to a copay fee.

Indigence:

An indigent inmate is an inmate who has not had a trust fund account balance of $6.00 for the past 30 days.
If you are considered indigent, you will not have the copay fee deducted from your Inmate Commissary Account.
If you are NOT indigent, but you do not have sufficient funds to make the copay fee on the date of the appointment, a debt will be established by TRUFACS, and the amount will be deducted as funds are deposited into your Inmate Commissary Account.
E. Complaints:
You may seek review of issues related to health service fees through the Bureau’s Administrative Remedy Program (see 28 CFR part 542).

FCI Bastrop will stock at least 25 OTC medications as referenced in the Trust Fund/Warehouse/Laundry Manual. During institution triage/sick call, medical staff will refer inmates to the commissary in response to complaints related to cosmetic and general hygiene issues or symptoms of minor medical ailments.

A. Inmates will have access to OTC medications in the commissary.

B. Personal resources will be used by inmates to obtain OTC medications that are indicated for general hygiene issues or symptoms of minor medical ailments. Examples of such complaints are: Occasional Constipation Seasonal Allergies GI (stomach) Upset Dandruff Athlete’s Foot Muscle Aches From Exertion

C. Inmates will purchase OTC medications from the commissary with their personal funds.

D. Indigent Inmates:

1. An inmate without funds is an inmate who has had an average daily trust fund account balance of less than $6.00 for the past 30 days.
2. An inmate without funds may obtain additional OTC medications at sick call if Health Services staff determines that he has an immediate medical need which must be addressed before the inmate may again apply for OTC medications.
3. All indigent inmates must come to the pharmacy on Wednesday between the hours of 8:00 a.m. – 8:30 a.m., to request medication. (Form BP-S788)
4. One request per inmate per week will be accepted.
5. Inmates will select no more than two items on the OTC Medication Request form. If he needs more than two items, he must attend triage/sick call.
6. When the pharmacy staff receives the form, they will verify the requesting inmate is without funds (indigent) by reviewing the TRUFACS browser-based application report for inmates without funds (indigent inmates).
7. Pharmacy will maintain a record of the OTC items issued to a given inmate for 30 days.

Each inmate will be assigned to a medical team that takes full responsibility for managing the inmate’s health care needs. Inmates are assigned to a provider based on their registration number. Reg. Numbers 00-33 – PA 1 Reg. Numbers 34-66 – PA 2 Reg. Numbers 67-99 – PA 3

All patient care, except for emergencies, will be scheduled by appointment only. To request an appointment, report to medical for triage at 6:30 a.m. to 7:00 a.m., Monday, Tuesday, Thursday, and Friday (except on holidays observed by the federal government). At sick call, you will be given an appointment to be seen and an appointment slip. You will report to your assigned work details after making the sick call appointment. The sick call appointment slip will be given to your work detail supervisor, who will allow you to leave the work site ten minutes before the time of your appointment. Inmates who are ten minutes late for their appointment will have their appointment canceled, will be required to sign up again for sick call, and are subject to disciplinary action. Inmates who become ill after the regular sick call sign-up period shall ask their work supervisor or the Unit Officer to call the Health Services Unit. If it is determined an evaluation is necessary, an appointment will be made based upon the discretion of the Health Services staff.

Inmates in the Special Housing Unit will submit a folded sick call sign up sheet to the Correctional Services staff. The Health Services staff will collect the sick call requests during their rounds in the morning and will determine whether an evaluation will be made in the Special Housing Unit or the Health Services Unit the same day.
Inmates at the Satellite Prison Camp will fill out a sick call sign-up sheet the evening before the above mentioned days for sick call, and the slips will be brought to the front entrance the following morning. Sick call at the Satellite Prison Camp will begin at 6:30 a.m

All emergencies or injuries will be given priority for treatment. An initial medical assessment will be provided by Health Services staff upon your arrival. Medical coverage after normal working hours, weekends, and holidays is for treatment of acute medical conditions only.

Dental Sick Call – Dental sick call is made by appointment only. You must obtain this appointment by notifying your work detail supervisor or the unit officer between 7:45 a.m. – 8:00 a.m., on Monday, Tuesday, Thursday and Friday. Your work detail supervisor or the unit officer will call the dental clinic and you will receive an appointment for the next available time frame, usually the same day. The dental staff will treat any emergency or answer any questions you may have. If you fail to report on time for your appointment, you should notify the dental clinic immediately, or otherwise make a sick call appointment the next available day.

After normal working hours, weekends, and holidays, dental emergencies will be seen by the medical staff. They will determine the nature of the emergency and treat accordingly. In the event of a true dental emergency, the on call MLP and the Chief Dental Officer will be notified. Excessive bleeding from the surgical procedure, and traumatic injuries or accidents, will be considered an emergency.

If you wish to be assisted by the institution’s comprehensive dental program, you should submit a BP-148, Inmate Request to Staff Member form, addressed to the Chief Dental Officer, requesting routine dental treatment. The dental staff provides a complete dental care program in general dentistry, which includes prevention (maintenance of oral hygiene), restorative (dental fillings), and prosthetics (limited to partial and full dentures). The goal of this program is to advise and help you achieve optimum oral health. We encourage all patients to request treatment by promptly filling out the request form and sending it to the dental department. Upon receipt of this form, you will be placed on the waiting list.

Controlled medications are dispensed from the pharmacy weekdays at 6:15 a.m., 11:30 a.m., 3:30 p.m., and 8:00 p.m. On weekends, controlled medications are dispensed at 7:00 a.m. Inmates in the Special Housing Unit or at the Satellite Prison Camp will have their medications brought to them by Health Services staff.

New commitments to the Bureau of Prisons will receive a complete admission physical examination within 14 calendar days of their arrival to the institution. This examination also includes a medical history and physical examination, laboratory tests, immunizations, a dental screening, and if clinically indicated an audiogram, and chest x-ray.

The Medical Director will ensure the availability of age-specific preventive health examinations (e.g., cancer screening) for the inmate population.

Information regarding these examinations will be posted in the HSU.

In all cases, decisions a competent inmate expresses supercede any previously executed advance directive to the contrary.

DNR orders will never be invoked while an inmate is housed at a general population institution. Emergency resuscitative measures must always be performed on an inmate who suffers cardiopulmonary arrest at a general population institution.

Competent inmates may produce an Advanced Directive for future eventualities, in accordance with Texas law and Bureau of Prisons procedures. The Living Will will be maintained in Section 5 of the Medical Record under the Advanced Directives divider. Living Wills are not used in general population institutions to withhold resuscitative services. The Advanced Directive is only to be implemented once the inmate falls into a terminal condition and is deemed incompetent or lacking the capacity to make health care decisions.

Questions & Answers as You Enter This Correctional Facility
Your health is important to those who work in this facility. Medical staff members are willing to discuss any health concerns you have.

An important health issue is sexually transmitted diseases or STDs. STDs are among the most common infectious diseases in the U.S. Anyone who has unsafe (unprotected) sex can get an STD. If you have had unprotected sex (without a condom) with a woman, you may have come into contact with vaginal fluid, genital sores, or lesions. This contact may have exposed you to an STD. If you have had unprotected sex with a man, you may have come into contact with semen, genital sores, or lesions. This contact may have exposed you to an STD. This information will tell you about common STDs and what their symptoms look like. You may have been infected with an STD in the past. You may have ignored or not noticed the symptoms. Because untreated STDs can cause serious health problems, you may want to be tested.

If you have questions about STDs or think you have any symptoms, sign up for sick call. It is okay to ask questions and talk with medical staff members. This information will be handled confidentially. When you arrive at a Bureau of Prisons (BOP) facility, you are advised in writing of the disciplinary system there. If you engage in sexual acts and/or (high category), you are subject to sanctions as defined in the BOP policy on Inmate Discipline and Special Housing Units.

STAY SAFE: DON’T HAVE SEX WITH OTHER INMATES

Things to know about STDs:
1. Men and women who have any form of unprotected sex are at risk for STDs. This is true regardless of age, race, ethnic background, or income. It is true whether your partners are of the same sex or the opposite sex.
2. You can prevent STDs. The best way is to avoid having sex. Sex with other inmates is not allowed and can be dangerous.
3. Many STDs can be cured with medicine. Other STDs can be treated to avoid more problems. Even after you have been treated for an STD you can become reinfected. Treatment is not a vaccine; it cannot prevent future infections.
4. You may be infected with an STD and not have any symptoms. If you have had unsafe sex and not been tested for STDs, talk to a health care worker.
5. If you have Human Immunodeficiency Virus (HIV), being infected with an STD can make the HIV worse.

Talking to the Medical Staff

If you have had unsafe sex and have not been tested for STDs (or have any reason to think that you may have an STD), talk with the medical staff. Ask any questions you have about symptoms and testing. Even if you were treated for an STD before coming to a correctional facility, if you have had unsafe sex since then, you may be infected. The medical staff can provide more information and help you decide about being tested. If you have an STD and do not get treatment, you may have worse health problems in the future.

If you have an STD, what treatment is offered?

Getting treated right away will help reduce the long-term problems found with STDs. If you have an STD, your health care provider may treat you with pills, liquid medicine, or a shot. If you are given pills, you must take them just like your doctor tells you to. Do not share pills with partners or friends. STDs caused by bacteria, such as Chlamydia, gonorrhea, or syphilis can be treated with antibiotic medicines. STDs caused by viruses, such as HIV and herpes, cannot be cured. You will have these diseases for life. Treatment can help reduce or control these illnesses, but there are no cures.

The Joint Commission has a toll-free hot line to provide patients, families, caregivers, and others with an opportunity to share concerns regarding quality-of-care issues at accredited health care organizations. The toll free number is 800/994-6610 and is available 24 hours a day, seven days a week; however, staff members are available only on weekdays between 8:30 a.m. and 5:00 p.m. Central Standard Time to answer calls.

Upon request from any party, the Joint Commission releases the following aggregate information relating to complaints about an accredited organization for the three-year period prior to receipt of the request: The number of standards-related written complaints filed against an accredited organization that has met criteria for review. The applicable standards areas involved in a specific complaint review. The standards areas in which requirements for improvement were issued as a result of complaint evaluation activities. When an unannounced or unscheduled survey is based on information derived from a complaint or public sources, the standards areas related to the complaint.

The Joint Commission also provides the following information as appropriate to complainants regarding their complaints: Any determination that the complaint is not related to Joint Commission standards. If the complaint is related to standards, the course of action to be taken regarding the complaint. Whether the Joint Commission has decided to take action regarding an organization’s accreditation decision following completion of the complaint investigation. If the Joint Commission has decided to take no action, the complainant is to be so advised. If the Joint Commission has taken action, the complainant is to be advised in conformance with the guidelines for release of complaint information as set forth above. Any change in an organization’s accreditation decision following completion of the complaint investigation.

While in the custody of the Federal Bureau of Prisons, you have the right to receive health care in a manner that recognizes your basic human rights. You also accept the responsibility to cooperate with your health care plans and respect the basic human rights of your health care provider.

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.