ROUTINE MEDICAL APPOINTMENTS: (Sick Call)
Should you need medical or dental attention, triage sign up is conducted Monday, Tuesday, Thursday, and Friday, from 7:00 a.m. to 7:30 a.m. in Health Services. Inmates with medical concerns or those requesting an appointment must complete the Inmate Sick Call Triage Sheet upon arrival at Health Services. Inmates must present with their identification card and the form filled out to obtain a triage visit. During triage, your medical or dental needs will be evaluated and you will be assigned a medical priority visit. Medical staff on duty will make a medical determination concerning the complaint and take the appropriate action. Emergent and urgent issues will receive an evaluation the same day. Issues that are assigned a routine ranking, will have their appointment scheduled in the future or in conjunction with chronic care clinic visit. Sign up for dental care in the dental area. There will be no triage on federal holidays. During triage sign up, your medical or dental needs will be evaluated and you will be given an appointment time. Other appointments with health service providers are scheduled and callout sheets are posted on the bulletin boards in the units. It is your responsibility to monitor the callout sheet on a daily basis. Except for emergencies, you will not be permitted in Health Services without an appointment. You must present your inmate identification card each time you come to Health Services for triage, callout, or pill line.
In addition to being responsible for reporting, on time for any scheduled appointment, the inmate is also responsible for advising his detail supervisor of any medical appointments and his medical status. The detail supervisor will release the inmate to Health Services and the scheduled appointment time. Appointments will be scheduled in conjunction with the controlled movement system during regular inmate work hours, Monday through Friday.
CHRONIC CARE APPOINTMENTS
During your intake or your physical examination all medical conditions will be assessed by the Health Services staff to determine if your medical conditions require regular monitoring. If so, you will be placed into a chronic care clinic for your specific condition. You will be scheduled every 6 months, or more often if appropriate. During this clinic visit your condition will be assessed and you will be prescribed medications, request for testing will be submitted, and if needed restrictions given. Your clinic visit is very important because this allows for both you and our staff to assess the success of your treatment plan or make adjustments as needed.
As part of the Admission and Orientation process, you will be seen in the dental clinic for a full dental exam. If routine dental treatment is needed, you will need to submit an Inmate to Staff Request. Dental problems may occur during your stay here, and in the event you need to see the Dentist, please report to sick call. You may request other dental services, such as annual checkups, cleaning, etc., through an “Inmate Request to Staff Member” form addressed directly to the Dentist. If transferred to the Special Housing Unit (SHU) you will be allowed to make sick call requests only (NO ROUTINE DENTAL CARE IS PERFORMED IN SHU). If your placement in SHU lasts for more than one year, then routine care can be requested.
The Federal Prisoner Health Care Co-payment Act (FPHCCA) of 2000, PL 106 294, 18 U.S.C. § 4048 requires inmates pay a $2.00 co-payment for health care visits they initiate.
Co-payments are charged when:
1. An inmate requests a health care visit, for example: visits as a result of triage (formerly known as sick call) including both medical and dental; requests for routine dental care; after-hours evaluations that are not a medical emergency.
2. An inmate is found responsible through the disciplinary process to have injured an inmate who then requires a health care visit.
3. Inmates in the Special Housing Unit will not be charged for daily rounds, but will be treated the same as general population for other visits.
4. Only one charge per visit for the same complaint, even if the inmate is seen by multiple providers.
5. If seen by medical staff for one problem, and dental staff for another problem, even if on the same day, is considered two visits.
6. Will be charged a co-payment if a visit is requested by any non-medical staff member (Supervisor, Lieutenant, Executive Staff, and Warden)
No co-payment is charged when:
1. Based on health care staff referrals, e.g., MLP to Physician, RN to physician, outside consultants, pre and post-operative assessments or wound care.
2. Staff approved follow-up appointment for a chronic condition (chronic care clinics, lab or x ray studies).
3. Preventive health services (vaccinations, TB testing, dental prophylaxis).
4. Emergency services (injuries, evolving MI, strangulated hernia, etc.)
5. Mental health care
6. Substance abuse treatment.
7. Staff ordered BP monitoring, wound care, patient education, insulin administration, and scheduled finger sticks.
8. The Federal Prisoner Health Care Co-payment Act (FPHCCA) of 2000, PL 106 294, 18 U.S.C. § 4048 requires inmates pay a $2.00 co-payment for health care visits they initiate. Indigent inmates will not be charged a co pay. Health care will not be denied to an inmate just because they are indigent. An indigent inmate is an inmate who has not had a trust fund account balance of $6.00 for the past 30 days.
PHARMACY – MEDICATION (PILL LINE)
Pill line hours are posted. Prescriptions that are not “pill line” medications can be obtained during listed prescription pickup times at the pharmacy. Instructions are listed on the prescription bottles. It is your responsibility to take the medication as ordered. Medication found in your property that has expired will be confiscated. When a medication is ordered to be taken on pill line, report according to the posted times. You must present your identification card at pill line. Insulin administration will be done in Health Services according to case by case basis. All prescriptions must be picked up from the Pharmacy within five days of the prescription being ordered.
When you need a refill of a medication, you will fill out the refill request form and place it into the refill box located outside the pill line window in Health Services. Do NOT put your empty pill bottle or tubes in the box. You need to put the refill in the box by 7:30am in order to receive you refill the next day. If you take chronic (i.e. high blood pressure) medications, plan ahead to ensure you do not run out of medication over the weekend. The pharmacy does not do refills on the weekend or holidays.
Medications are not provided. You may purchase OTC medications from the commissary. Indigent inmates can contact medical for specific OTC medications.
Health Services staff conducted an intake screening examination when you arrived at this institution. Within 14 days you will be given a complete physical examination if you have not had one at another Bureau of Prisons facility. You may request an exit physical examination by accessing the Triage process between 60 and 120 days prior to your release.
MEDICAL CARE LEVEL
The BOP has developed a medical care level system to ensure inmates are placed in an institution that can provide them the necessary medical care. There are four care levels. FCI Three Rivers is a Care Level One institution, which allows inmates to have chronic medical conditions, but only if stable and require minimal monitoring. After your physical is completed you will be assigned a medical care level. Your care level may change throughout your incarceration if you experience new medical problems, complications with existing medical conditions, or injuries. If your care level changes you will be transferred to an appropriate institution to meet your needs.
As soon as you have completed the A&O process, you will be assigned a medical classification for duty. Changes in your medical condition may require reclassification of your duty status during your incarceration. Temporary illness or recovery from medical problems may affect your duty status temporarily, when possible you will be cleared to return to work and/or school. The Health Services Department does not recommend job assignments. We provide physical limitations / restrictions only.
EYEGLASSES AND CONTACT LENSES
If you need glasses or have other vision problems, re- quest an evaluation through triage. You will be scheduled for a screening test. If the results of the test indicate a need for an optometric evaluation you will be referred. If glasses are prescribed, a pair of standard issue eyeglasses will be provided. If the optometric evaluation reveals a need for eyewear and you desire other than standard issue glasses, at your own expense, you must submit an Inmate Request to Staff Member (BP-148) to the Health Information Management Department requesting that a copy of the current eyeglasses prescription from your medical record and submit it for approval by the HSA for approval. After approval the request along with the eyeglasses prescription will be sent to the Inmate Systems Management (ISM) staff. ISM staff will place you on callout to complete a Package Authorization Form and issue you a copy.
SAFETY ORTHOPEDIC SHOES
institutional job assignments require you to wear safety (steel toed) shoes on the job. The institutional shoe/boot meets job safety requirements. In the event you have a medical condition that requires special shoes, the Health Services Department will provide you with them. A request for examination can be made by reporting to sick call. You are not permitted to wear an athletic shoe inside the visiting room; therefore no pass will be issued for such a request.
OUTSIDE MEDICAL CONSULTATIONS
There are times when a medical condition may require treatment in a local hospital, a contracted physician’s office, or a Federal Medical Center. Each referral for outside medical care is approved or denied by the Utilization Committee. You will be notified in writing of the committees decision.
As part of the A&O process, you will receive detailed instructions about HIV and AIDS, how it is contracted, and how it is treated. One of the obvious reasons for testing for the HIV virus is to identify the disease early. Early detection assures the best medical care. All newly committed inmates will receive a presentation of the BOP issued AIDS video during A&O. Here are some other reasons for HIV testing:
Clinical Indications – Fungal infections of the mouth, persistent swelling of the lymph
nodes, unexplained weight loss or fevers.
You may request a HIV test by submitting a request to staff to Health Services. By policy, you will be counseled before the test and when you receive the results. Watch the call out for an appointment for post-test counseling. Test results are strictly confidential.
EMERGENCY MEDICAL PROBLEMS
Medical emergencies should be brought to the attention of the nearest staff member immediately. Emergencies are defined as life-threatening events such as chest pain, severe bleeding, etc. All non-emergencies must be handled through triage procedures listed above.
SPECIAL HOUSING UNIT (SHU) SICK CALL
Inmates confined in SHU will be offered sick call once a day during SHU rounds by a health care provider. Dental services will be limited to dental emergencies only. Pill lines will be conducted twice a day (as necessary).
Each inmate may obtain and fill out an Advance Directive for Health Care for the State of Texas. Inmates may direct, in advance, to withhold or withdraw certain medical treatments when recovery or cure is not possible. Inmates may appoint, in advance, proxy decision makers who will make critical health care decisions for them should they become incapacitated and unable to make such decisions for themselves. The person selected to be the proxy cannot be another inmate or a staff member. Inmates are to understand that DNR orders will never be invoked while an inmate is housed at a general population institution. Emergency resuscitative measures must and will always be performed on an inmate who suffers cardiopulmonary arrest at a general population institution. Advance Directives, including Do Not Resuscitate orders, may only be implemented at community health care facilities or medical referral centers.
Attempt to first resolve all complaints and issues informally. Talk to the medical staff involved with the issue or submit a copout to that staff member or the Health Service Administrator requesting help. If the issues are not resolved, you can file a formal complaint through the Administrative Remedy process.
To obtain copies of your medical record, submit a Inmate Request to Staff Member by institution mail to the Health Information Management Department stating what information is needed. Requests will be processed in the order they are received.
If you are sexually assaulted, you should immediately inform staff. You will be examined and evaluated by appropriate staff. All complaints will be investigated.
HEALTH PROMOTION DISEASE PREVENTION
Health Services fully supports patient education, disease prevention programs and active participation in your health care. Programs are offered through your unit team, psychology, recreation, and health services.
SMOKING CESSATION PROGRAM
The Bureau of Prisons is advancing toward a clean air environment throughout all Institutions. As part of this project, FCI Three Rivers is offering an Inmate Smoking Cessation Program for which you may voluntarily participate in during A&O. To participate, you must complete the following steps:
1. You must complete an Inmate Request to Staff Member to Health Services indicating your desire to participate in the Nicotine Replacement Therapy Program. Inmates requesting nicotine replacement therapy patches must have an initial medical assessment in order to purchase a six-to ten-week supply of nicotine replacement patches. After the medical assessment, the Nicotine Replacement Therapy Approval form (Attachment A) will be forwarded to Psychology Services. Psychology Services will enroll the inmate in a Smoking Cessation Class.
2. You must meet with Health Services to discuss the possible side effects, obtain vital signs, and to obtain the approval form for Commissary to provide the nicotine replacement therapy patches for purchase.
IMMUNIZATIONS: Unless otherwise documented, all inmates are required to receive a tetanus and PPD upon arrival at the institution. Yearly influenza vaccine is offered to the population with emphasis placed on those “at risk.” Hepatitis B vaccine series will be offered to those inmates working in potentially hazardous areas, and Pneumocococcal vaccine is offered when clinically indicated.
HEALTH CARE RIGHTS AND RESPONSIBILITIES
While in the custody of the Bureau of Prisons, you have the right to receive health care in a manner that recognizes your basic human rights, and you also accept the responsibility to show respect when engaging with your health care providers. A copy of the Health Care Rights and Responsibilities is posted in the front lobby of Health Services and is provided for your review in this booklet. It is in your best interest to involve yourself in your care and treatment as prescribed/ordered.