MEDICAL SICK CALL
Request for Sick Call is the method to be used by inmates to obtain medical care for routine, non-emergency conditions. Sick Call is held in Health Services on Monday, Tuesday, Thursday, and Friday from 6:30 a.m. to 7:00 a.m. You will come to health services to be screened by the triage nurse. This time is not for treatment. After your assessment by the triage nurse you will be schedule for a complete assessment by a provider via call out.
Inmates who request medical appointments will be charged $2.00 co-pay. Inmates will not be charged a fee for referrals from medical staff, prescribed follow-up appointments, treatment of injuries, emergency medical problems, treatment of infectious disease, chronic care clinics, or periodic health assessments, or when you meet indigent as determined by TRUWEB and indigent guidelines. When placed on call out for a requested appointment, you must be prompt and possess your ID card. If you are late or do not show up, your appointment will be cancelled. The purpose of sick call is to triage or assign a priority to your illness or injury.
Many over the counter (OTC) medications are available in the commissary for your purchase. Inmates are encouraged to prepare for the flu and allergy seasons, recreational injuries, and other minor ailments by purchasing comfort medications ahead of time. Inmates, who are on indigent status, carrying a balance of less than $6.00 in their accounts over the previous thirty days, may request OTC medication through Sick Call. To purchase OTC medication on days other than your scheduled shopping day, you must report to the commissary in the morning.
Inmates in Special Housing will utilize the same general procedure to request sick call appointments; Clinical staff will make rounds every morning to collect triage request forms and will schedule appointments with your assigned provider according to the national scheduling guidelines. Policies regarding PCPT, co pay and use of OTC medications generally apply to inmates in Special Housing with the exception of only one night of commissary shopping.
DENTAL SICK CALL
Inmates with dental emergencies can be seen during dental sick call on Mondays, Tuesdays, Thursdays, and Fridays. Inmates can fill out a sick call triage form and place it in the triage box. Appointments will be given vial call out. Examples of dental emergencies include swelling, pain that interferes with normal eating and sleeping, and injuries. Dental sick call is for emergencies only, and treatment goals will be to relieve the symptoms.
Emergency medical and dental care is provided through an established system of on-site personnel, on call staff and the cooperation of the local hospital based emergency room, on a 24 hour per day basis. An emergency is defined as a suddenly occurring medical or dental condition which, without immediate attention, may result in permanent disability or death. Example of a medical emergency may include: heart attack, inability to breathe, an allergic reaction, or a serious injury due to recreation or work related circumstances. Immediate notification to a staff member of a medical emergency is necessary to activate our procedures. Emergency medical care will be provided in the Health Services Department, and if necessary, you will be transported to a local hospital for further care.
ROUTINE DENTAL CARE
Anyone desiring routine dental care may have their name added to the waiting list by sending an Inmate Request to Staff Member (“cop-out”) to the dental clinic. Appointments for a “prophy” (cleaning) and a dental examination will be posted using the call-out system. A written treatment plan will be developed during the examination appointment. Needed treatment, such as a “prophy”, fillings, extractions, or dentures, will be performed at subsequent visits. Treatment options will be discussed during the treatment planning visit, and reasonable accommodations made. However, if the patient refuses what the dentist determines to be significant portions of the treatment plan, the dentist may terminate all but
emergency dental care. Likewise, refusal of necessary diagnostic tests (such as x-rays) may be grounds to halt treatment.
Dental patients are seen in the order that their requests are received. In order to be fair to everyone, no individual will be moved ahead of another who has been waiting longer. A missed appointment will require the re-submission of the request.
All necessary supplies to maintain good oral hygiene are available for purchase through the commissary.
The dental clinic does not supply toothbrushes, toothpaste, or dental floss. Inmates are required to demonstrate they are practicing adequate and proper oral hygiene prior to the delivery of non-emergency treatment. The dentist may discontinue care at any time if it becomes apparent the inmate is not practicing proper oral hygiene. Inmates will still have access to emergency dental care.
Partial dentures will be made only if the patient is missing a significant number of teeth (as determined by the dentist)
Patients who desire an annual cleaning and dental exam must submit a new Inmate Request to Staff Member six months to one year after their initial cleaning.
CHRONIC CARE APPOINTMENTS
During your intake physical 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. During this clinic visit your condition will be assessed and you will be prescribed medications, testing 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 and make adjustments as needed. When you come to a clinic visit, you will need to bring all of your medications and restriction documentation.
Pharmacy hours are normally 7:30 a.m.-4:00 p.m., Monday through Friday except on federal holidays. Current pill line times are:
Monday – Friday 6:30 -7:00 a.m., The evening pill line will start when the evening mainline opens.
Saturday and Sunday: 9:00-9:45 a.m., The evening pill line will start when the evening mainline opens.
A “diabetic only” pill line is held at 6:20 a.m. Monday-Friday and after the 4:00 p.m. count. Tuberculosis prophylaxis pill lines are on Tuesdays and Fridays. You may pick up a new prescription after the evening pill line Monday-Friday only. There is no pick up line on weekends or holidays. YOUR ID IS REQUIRED AT ALL PILL LINES
No over the counter medication will be given at pill line.
Prescriptions written at a sick call visit will normally be filled and dispensed the same day. Instructions and information about the medications will be provided. Prescriptions that have been authorized for refills can be turned in Monday through Friday at the 6:30 – 7:00 a.m. pill line. A pharmacy open house will be conducted every Thursday between 11:30 a.m.-12:00 p.m. This open house is available for you to discuss any medication concerns and questions.
There are two types of prescription medications that can be provided to you by Health Services Staff. The first is a medication you can carry and take on your own. This medication must be kept in the container it is issued to you in. Do NOT put more than one medication in any container. The second is a medication that is not authorized to be taken outside of the Health Services Department (i.e. Pill line medication). Below are the procedures you must follow to receive a pill line medication.
PILL LINE PROCEDURES
You will be assigned to a specific pill line to receive medication not authorized to be on the compound. You are to report to pill line when pill line is announced with your inmate ID card. This card will be utilized to identify you and the specific medications you take. If you have lost your ID card, you must get a temporary card from the Lieutenant’s office. You can take a cup from the window and get water from the fountain next to the pill line window. Your medication will be crushed and then floated in water by the medical staff and then handed to you. You must take and swallow your medication in front of the medical staff. All medication and water cups will be disposed of in the trash bin next to the pill line window. You cannot remove either cup or any pill line medication from the Health Services area. Prior to leaving the area you will be required to open your mouth and hands to show that your medication is not being concealed. If it is determined you have failed to follow the above procedures, you will be held accountable through the inmate disciplinary process. If you decide you do not want to take your pill line medication, you must report to the pill line to refuse the medication until you have signed a medical refusal form. You must make an appointment through the normal sick call procedures to sign the refusal form.
Inmates are required to purchase Over The Counter (OTC) medications from the commissary for the symptomatic treatment of minor conditions; complaints of occasional constipation, seasonal allergies, gastro-intestinal upset, dandruff, uncomplicated athlete’s foot, acne, vitiligo, chapped lips, dry hands, muscle aches due to exertion. Indigent inmates will be referred to the OTC program established by Health Services for minor ailments in lieu of going to the commissary. A list of indigent inmates will be retrieved on a daily basis by Health Services Staff. Inmates who average a daily account balance of less than $6.00 over the previous 30 days will be considered indigent for these purposes. Inmates in the Special Housing Unit will be allowed to purchase OTC medications one day per week.
To purchase OTC medications only on days other than your scheduled shopping day you must report to commissary in the morning. A completed commissary list is required.
TUBERCULOSIS (PPD) TESTING
All inmates new to the Bureau of Prisons are tested for tuberculosis exposure via the placement of a PPD. All inmates with previous negative results from a PPD test will be re-tested annually. Those inmates with a history of a positive PPD skin test will have an annual chest x-ray. Inmates will be placed on call-out for their appointments for testing or chest x-ray.
The Bureau of Prisons follows the recommendations of the Centers for Disease Control (CDC) regarding immunization schedules and doses. Influenza (FLU) vaccinations are made available to all inmates each fall. Notification of the immunization availability and procedures for obtaining it is posted in each housing unit prior to the dates of immunization.
Inmates reporting for an appointment or call-out, sick call, or picking up prescriptions during normal daytime hours, must be dressed in institution greens or approved work clothing. Recreation attire, including sweat pants, shorts, and tennis shoes are not approved for visits to Health Services. Except in emergency situations, inmates reporting to health services will be refused care if dressed in non-approved clothing, and requested to return wearing appropriate attire. Inmates must have their institution identification card with them during each visit to Health Services.
PHYSICAL AND PERIODIC HEALTH EXAMINATIONS
An Initial A & O medical examination, including physical and dental examinations, laboratory testing, PAP smears, mammograms, pregnancy testing and vision screening will be offered when clinically indicated. Those inmates transferring from other institutions will not undergo these initial tests again, unless a review of the medical record indicates that the tests are necessary for preventive healthcare or clinical indications.
Age specific preventive health examinations (e.g. cancer screening) will be available to inmates based on national clinical practice guidelines. Inmates may request an initial preventive health assessment through the triage process.
A pre-release physical may be requested if an inmate has not had a physical in the year prior to release. Once the request is received, the physical will be scheduled within two months of the release date, and the inmate will appear on call-out.
MEDICAL DUTY RESTRICTIONS
Medical staff may restrict certain activities due to medical conditions. This may be done during a physical examination or sick call appointment. Medical staff may also apply recreation restrictions as medically indicated. Special authorization from medical staff is necessary for canes, crutches, or other medical appliances, including ACE wraps. Medical restrictions initiated in previous institutions are not automatically continued at this facility. Each request for a work restriction will require re-evaluation from a member of our medical staff.
A medical idle or “lay in” removes you from your job duty for up to three days. During that time, you are restricted to the unit except for meals, visits, call-outs, law library visits, and religious activities. You will be considered out of bounds if you are in the gymnasium or outside recreation areas. You may receive an incident report and be returned to work status.
A bed rest restriction means that you must remain in your room. You may not wander around the unit or watch television.
Soft shoes are authorized only when medically necessary. Clinical practitioners refer to a specific set of criteria when determining the need for soft shoes. Institution issued shoes have been approved as both an orthopedic shoe and a diabetic shoe and are designed to provide maximum comfort for those with special needs while meeting the need for a safety shoe as required in work areas.
Lower bunks are authorized only when medically indicated. Clinical practitioners refer to a specific set of criteria for issuance of these permits. You will not automatically have a lower bunk continued from a previous institution. If you meet the criteria for a lower bunk one can be issued by your clinician.
If you are having difficulty with your vision, please sign up for sick call triage. Inmates under 40 years of age may request an eye examination every two years. Inmates age 40 years and older may request an eye examination every year. If you are interested, submit a request (cop-out) to Health Services.
If you arrive at the institution with unauthorized eyewear (contact lenses valued over $100), you will be examined by the optometrist and either provided institution glasses or authorized to purchase an alternative pair of glasses noted below.
If corrective lenses are indicated, the Bureau of Prisons will provide you with one pair of eyeglasses every two years. Tinted, dark, or transitional lenses are not approved for use in the institution, unless medically indicated. The cost of any glasses purchased must not exceed $100.00. Contact lenses are not authorized, unless medically indicated and approved by an ophthalmologist and the Clinical Director.
Sunglasses are not authorized for wear inside any building unless approved by Health Services. Everyone is encouraged to wear sunglasses outside and clip on sunglasses are available for purchase in the commissary.
MEDICAL RECORDS – RELEASE OF INFORMATION
You may review your medical record in the presence of a clinical member of the Health Services staff. With receipt of an Inmate Request to Staff Member (cop-out) form to the Health Services Administrator or the Medical Records Administrative Specialist, you may request copies of your medical record. Portions of your medical record may be Freedom of Information exempt. You will be informed of exempted materials and provided information on how you may obtain these additional copies. The first 240 pages of your record are provided at no cost. Copies in excess of the 240 free pages are charged at the rate of ten cents per page after the first 100 and deducted from your commissary account. In order to maximize time effectiveness, please be specific when requesting materials, referencing either a particular time frame of care or specific documents.
LIVING WILLS AND ADVANCED DIRECTIVES
Living wills and advanced directives allow a competent person to make binding declarations regarding medical treatment and care provided, in the event that the patient is no longer competent to make such decisions. Assistance with living wills and advanced directives can be obtained through the Health Services Administrator or through your private attorney.
HIV AND AIDS
HIV stands for Human Immunodeficiency Virus. It is the virus that causes AIDS – Acquired Immunodeficiency Syndrome. HIV is spread from one person to another through sex and blood-to-blood contact. When someone becomes infected with HIV, the virus attacks that person’s immune system. A person develops AIDS when her immune system becomes so damaged that it can no longer fight off diseases and infections. These diseases and infections can be fatal. Most people get infected with HIV by having sex or sharing needles with someone who already has the virus.
It may take up to ten years or more for people who are infected with HIV to develop AIDS. They may look and feel healthy for years after becoming infected. They may not know they are infected. Even so, they may infect others.
If you think that you may be infected with HIV, or have risk factors you may request a blood test and receive counseling both before and after the testing. These tests look for the presence of HIV antibodies in the blood as a sign of the virus. Often it takes weeks or months to develop antibodies, and therefore be detected in the blood.
The following categories are used for HIV testing:
1. All inmates leaving a Federal prison for a RRC;
2. All inmates leaving on a furlough;
3. All inmates assigned to work cadres working in the community;
4. All inmates assigned to random screening for HIV;
5. All newly committed inmates assigned to HIV screening.
1. Any inmate may request an HIV test annually.
HEALTH PROMOTION AND DISEASE PREVENTION
While you are in the custody of the Bureau of Prisons, every effort will be made to provide you with medical care of a similar level and quality that you would receive from the same type of clinic in the community. One of the most important changes occurring nationwide, both in the Community and within the prison system, is an increasing emphasis on maintaining health and preventing disease rather than merely treating disease after it develops. Many of the leading causes of disease and death are conditions that can, at least to some degree, be prevented. The goal of a health promotion and disease prevention program is to assist those interested (and encourage those who aren’t interested) to work toward attaining and maintaining a state of “wellness.”
What is “wellness?” It is a state of well being in all the important areas of one’s life, including the physical, mental, emotional and spiritual. Recreation has excellent programs at FCI Waseca to assist you in starting on your own road to wellness. If you have questions about specific programs or about health promotion and disease prevention, you may direct them to any member of the Heath Services or Recreation staff. Health Services offer open house. Health Services general open house conducted by the Health Services Administrator and Assistant Health Services Administrator is conducted every Tuesday and Thursday at 9:30 a.m. This open house is to address concerns and questions about care and administrative questions.