FCI Elkton Medical Care

Sep, 19 11 Post by: admin | No Comments


Health Services Department


The overall Bureau health care delivery system includes local medical facilities, as well as the major medical facilities. On-site medical care is available 16 hours a day. For routine care, inmates who wish to be seen on sick call for evaluation of medical problems are required to report to a prescribed location for sign-up. Inmates must have their ID available for positive identifications, sign-up for sick call from 6:30 to 6:45 a.m. on Mondays, Tuesdays, Thursdays and Fridays except on Holidays. Inmates who become ill after the regular sick call appointment sign-up period should ask their work supervisor or Unit Officer to call the Health Services Unit for further instruction. Inmates in detention or segregation units are unable to sign up for this procedure. For that reason, a staff member from Medical Services tours these housing units daily. During the A&O Lecture the Health Service Administrator will provide additional information regarding medical services.

Infection Control


The number one way to prevent the spread of infection and protect yourself from infections is to WASH YOUR HANDS, with soap and water and towel dry. In the housing unit it is expected that you use your personal soap and towel. The Health Service Department in conjunction with the Safety Department had placed waterless soap dispensers in high volume, high risk areas such as Food Service, this is to provide you protection in areas that do not have access to soap and water, it does not replace soap and water. Respiratory etiquette, it is expected that when you cough or sneeze, you cover your nose and mouth with a tissue, however, it is acceptable to sneeze or cough into the crease of the elbow, afterwards, you must wash your hands. Many infections/viruses are spread through contract with shared items, such as, door knobs, common surfaces, and personal hygiene items. You should never share razors, tooth brushes, was cloths, etc. Blood borne infections are spread by coming in contact with blood or body fluids from another individual. You should avoid contact with another individuals blood at all times. Tattoos are one of the biggest causes of infections such as MRSA. You should never receive a tattoo while incarcerated. During the A&O Lecture, the Health Service Administrator will provide additional information regarding medical services.

ID Card


You must bring your ID picture card and verify your ID number each time you visit Health Services. This ensures compliance with the double check ID system.

Out of Bounds


Inmates should not be in the Health Services area unless they:

  • Have an appointment or are scheduled for call out,
  • Have obtained approval from their detail supervisor or block officer, or
  • Are making use of the time period set aside for sick call sign up or pill line.

Inmates who come by Health Services without prior approval are out of bounds and may receive an incident report.


Categories of Care


The Bureau of Prisons assigns medical problems to one of five categories of care:

  • Medically Necessary – Acute or Emergent: A condition that, if not immediately treated, is life-threatening, likely to cause blindness, or irreversible loss of function.
  • Medically Necessary – Non-Emergent. A condition that, if untreated, will result in premature death, or interfere with the possibility of later repair; or creates a level of pain or discomfort which impairs the ability to conduct activities of daily living.
  • Medically Acceptable – Not Always Necessary. Medical conditions whose treatment may be delayed without jeopardizing the life, sight, or bodily function of the patient.
  • Limited Medical Value. Medical conditions in which treatment provides little or no medical value, are not likely to provide substantial long-term gain, or are expressly for the inmate’s convenience.
  • Extraordinary. Medical interventions are deemed extraordinary if they affect the life of another individual, such as organ transplantation, or are considered investigational in nature.


Triage


  • Triage is the determining what category of care a patient should be placed in. The purpose of Triage is to make sure that truly urgent conditions are given priority treatment.
  • During triage the following will occur: The inmate will provide a brief history by completing the Chronological Record of Medical Care form; vital signs will be taken, if indicated; an appointment will be scheduled within a time frame appropriate for the inmate’s medical needs; or, if no follow-up appointment is warranted, the inmate will be advised of other options (e.g. obtaining over-the-counter medications from the Commissary, submitting an Inmate Request to Staff Member, etc).


Scope of Services


  • The Bureau of Prisons will treat all Medically Necessary Emergent & Non-Emergent Conditions.
  • Medical problems falling within Medically Acceptable – Not Always Necessary Category are essentially Elective Procedures. These procedures require approval of the Institution’s Utilization Review Committee. The Committee considers such factors as: the risks and benefits of the treatment; available financial resources; available medical consultant resources; medical treatment received prior to incarceration; prognosis in the absence of treatment; the effect the intervention is likely to have on the inmate’s ability to conduct activities of daily living; the likely effect delay in care would have on subsequent treatment, etc.
  • Medical problems falling within the Limited Medical Value or Extraordinary Categories are ordinarily not treated by the Bureau of Prisons.
  • Consultants and Referrals: All care that is provided by the Bureau of Prisons will be consistent with community standards of care. When available, and when required, community consultants will be contracted for commonly needed services such as cardiology, dermatology, endocrinology, general surgery, ophthalmology, optometry, orthopedics, psychiatry, radiology, urology. Additionally, patients may also be referred to Bureau of Prisons Medical Referral Centers


Co-Pay


Pursuant to the Federal Prisoner Health Care Copayment Act (FHCCA) of 2000 (P.L. 106-294, 18 U.S.C. ‘ 4048), The Federal Bureau of Prisons and FCI/FSL ELKTON, provide notice of the Inmate Copayment Program for health care, effective October 3, 2005.

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 assigned to the General Population are subject to co-pay fees.

Health Care Visits with a Fee:

You must pay a fee of $2.00 for health care services, to include dental, will be 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 service not listed in section C., below, you will be charged a $2.00 co-pay fee for that visit.

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.

Health Care Visits with no Fee:

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;
  • Prenatal care;
  • 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 co-pay 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 co-pay fee deducted from your Inmate Commissary Account.

If you are NOT indigent, but you do not have sufficient funds to make the co-pay fee on the date of the appointment, a debt will be established by TRAFFICS, and the amount will be deducted as funds are deposited into your Inmate Commissary Account.

Complaints

You may seek review of issues related to all health service issues including co-payment fees through the Bureau=s Administrative Remedy Program (see 28 CXR part 542).


Obtaining Health Care


Emergency Care

All emergencies or injuries will be screened for priority of treatment and then will be examined accordingly. Appropriate medical care will be provided by institutional Health Services staff. Medical treatment on evenings, mornings, weekends, and federal holidays is limited to treatment of acute problems only. Treatment needs will be determined by the medical staff. Access to emergency medical care is obtained by notifying any staff member or activation of the inmate duress system. Any emergency or injury, must be reported to Bureau of Prisons staff immediately.

Other Care

  1. All other Non-Emergency requests require completion of the CHRONOLOGICAL RECORD OF MEDICAL CARE.
  2. These triage forms are obtained and filled out by you, the inmate appropriately during sick-call sign-up, which begins at 0630 hours-0645 hours on Monday-Tuesday-Thursday-Friday.
  3. The PA will triage your sick call form, may choose to have you come back at a later time or another date. He/she will give you an appointment slip and also have you put on call out.
  4. You must turn the form in yourself so the PA can ask any questions he/she may have about your problem.


Medical Records


Medical Records will conduct Open House every Wednesday between the hours of 11:00 a.m. and 1:00 p.m.

Dental Sick-Call


Is for conditions, such as toothaches, abscesses, temporary fillings, etc. All routine appointments will be scheduled via institutions call-outs.

Special Housing Inmates


Inmates placed in Special Housing will be seen by a medical staff ( Nurse/Physician=s Assistant) during daily morning rounds. Inmates with routine medical and dental care concerns will be addressed by their primary care clinician on Mondays, Tuesdays, Thursdays, and Fridays.

Physical Examinations


All new commitments to the Federal Bureau of Prisons System will be scheduled for a complete physical examination, which is mandatory, within 14 days of arrival at this institution.

An inmate being released from custody may request a medical evaluation if he or she has not had one within one year prior to the expected date of release. One should be conducted within two months prior to release.

Periodic visits to review the inmate=s need for and receipt of preventative health care services is recommended at least at the following intervals:

  • Every three years, for sentenced inmates under age 50
  • Annually, for inmates 50 years of age and older.

The frequency of monitoring inmates should be patient-specific, and adjusted as clinically necessary to monitor significant changes in a parameter such as weight or blood pressure.


Annual Immunization and Screening


All inmates will be scheduled for the tuberculosis screening on an annual basis. This screening will be in the form of the tuberculin skin test. An inmate may not request to substitute a chest radiograph for a screening tuberculin skin test. (P6190.03) the date of these screenings will be based on the inmate’s previous test date.

During the flu season which is typically in early winter, inmates will have the influenza vaccination or “flu shot” on an availability basis. Since some seasons cause the supply of this vaccination to be short, it will depend on the availability of the vaccine and the inmate=s medical priority. This optional vaccination requires an inmate to submit a Request to a Staff Member (Cop-Out) to the Health Services Department requesting the flu shot vaccination.


Pharmacy


You must bring your ID picture card and verify your ID number each time you pick up medication from the pharmacy. This ensures compliance with the double check ID system.

Medication Pick Up


Monday – Friday. Medications prescribed during sick call can be picked up at the 1100hours to 1200hours pill line. Inform the PA at 0630 the next morning if your medications were unavailable for pick up or if you had some other problem with your medications.

Pill Line Times


For diabetics and patients taking restricted medications are:

Daily Medication Lines at FCI
Monday-Friday
6:00AM AM Insulin line
07:15AM -07:30AM Regular Pill-line
11:00AM 12:00PM Medication Pick-up
5:00PM PM Insulin PM
7:30PM-7:45PM Restricted Pill-line
Weekends at FCI
07:15AM -07:30AM AM Insulin line
12:30AM 12:45PM Medication Pick-up
Restricted Pill-line
Daily Medication Lines at FSL Monday-Sunday
6:00AM AM Insulin line
Medication pick up
Restricted pill-line
3:00PM -3:15PM PM Insulin line
Medication Pick-up
Restricted Pill-line


Restricted Medications


Will be issued only on a dose-by-dose basis and must be taken in full view of the person issuing the drug. You will be required to allow the dispensing individual to inspect your mouth after accepting the medication.

Refills


All refills have an expiration date. Check the lower right corner on the label. If it is expired, you must complete a new Chronological Record of Medical Care form for a new prescription.

All refills have a limited number of refills. Check the lower left corner of the label. If it is expired, you must complete a new Chronological Record of Medical Care for a new prescription.


Over-The-Counter Medications


Over-The-Counter Medications (OTC) P6541.02, 11/17/2004, requires that personal resources will be used by inmates to obtain OTC medications that are indicated for cosmetic and general hygiene issues or symptoms of minor medical ailments.

Patients will be referred to the commissary if their symptoms can be partially controlled by items available through the commissary.

Inmates will purchase OTC items from the commissary with their personal funds. The pharmacist will not dispense OTC medications prescribed by the clinician for non-indigent inmates. Inmates who are listed on the TRUEFACS database as indigent may receive up to two OTC medications per week from the institution pharmacy if a clinician determines that the medications are medically necessary. These requests will be made to the Pharmacist on Wednesday at the 11:00 a.m. to 12:00 p.m pill line.


Idle, Convalescence and Medical Assignments


In situations where it is necessary to restrict the inmates activities due to health concerns, an inmate may be placed on Idle, Convalescence, or Medically Unassigned status. The medical staff will issue you a Medical Duty Status form that identifies your limitations. It is the inmate’s responsibility to deliver one copy to his work supervisor and one copy to his unit officer. The following is a synopsis of restrictions for each type of medical limitation status:

  • Idle: Temporarily disability not to exceed three days duration including weekends and holidays. Restricted to your room except for meals, barbering, religious services, sick-call, visits, and call-outs. No recreation activity.
  • Convalescence: Recovery period for an operation, injury, or serious illness. Not less than four days and not to exceed 30 days, subject to renewal. Excused from work and may not participate in recreation activities.
  • Medically Unassigned/totally Disabled: Totally unemployable and unassigned because of physical or mental handicap for a specific time period or indefinitely.
  • Restricted Duty: Restricted from specific activities because of existing physical or mental handicap for a specific time period or indefinitely.


Lower Bunk Assignments


Lower Bunk Assignments will be issued by medical staff only for the following inmates:

  • Paraplegic with wheelchair
  • Seizure Disorder, on medication OR off medication because of medical non-compliance
  • IDDM/NIDDM with peripheral neuropathy
  • **Arm or leg prosthesis
  • Patients with foot drop and/or AFO brace
  • **Arm or leg casts (90 days after cast removal)
  • Severe DJD/OA
  • Obesity (greater than 100% of ideal weight)
  • Previous laminectomy
  • Patients on multiple psychotropic medications
  • Patients on Coumadin
  • Legally Blind greater than 20/200 (corrected)
  • C-PAP Machine
  • Post hospital patients (up to 90 days)


Special Shoes


Health Services will provide custom shoes or orthotic devices if medically necessary to accommodate inmates with significant foot deformity, or to decrease the chance of injury to feet with decreased sensation.

All requests for inmates to have custom shoes or orthotics will be submitted to the Utilization Review Committee for approval on a Consultation Sheet.

The Clinical Director or his designee must approve all requests for purchase of the custom shoes or orthotics.

All custom shoes and orthotics will be purchased through the Health Services Cost Center.


RIGHTS/RESPONSIBILITY


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.


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