The institution does not have 24 hour clinical coverage. However, a system has been established to ensure immediate care will be provided in emergency situations. Inmates who wish to be seen for routine care or evaluation of a health problem must report to Triage. Triage services are Monday, Tuesday, Thursday, and Friday from 6:30 a.m. until 7:00 a.m. in the Health Services lobby. Triage is defined as the classification of patients according to priority of need for examination and/or treatment. Triage allows urgent conditions to be addressed adequately on the same day, while also allowing more routine conditions or concerns to be addressed at a scheduled appointment. All medical complaints and symptoms must be indicated on the triage form. This form will be reviewed and an appointment will be given and posted on the call-out roster or you will be seen the same day you report for triage. If the inmate is more than ten minutes late for the appointment, without verification from the supervisor, the appointment will be canceled. Another triage form must be submitted to reschedule the appointment. Inmates will have a primary care provider assigned based on their register number.
All inmates have a right to execute an Advanced Directive (Living Will). This directive is only implemented if an inmate is diagnosed with a condition and/or is deemed incompetent or lacks the capacity to make health care decisions while admitted to the local community hospital or designated to the Medical Referral Center at Carswell.
Emergency Health Treatment
All emergencies or serious injures will be given priority treatment. Appropriate health care will be provided by institution health staff. Inmates may be referred to local community hospitals when appropriate care cannot be provided at the institution. Health coverage during evening, weekends, and holidays is for the treatment of acute health problems only.
Over-the Counter Medications
At least 25 OTC medications are available in the Commissary. During institution triage, health service staff may refer inmates to the Commissary in response to complaints related to cosmetic and general hygiene issues and any symptoms of minor medical ailments. It is your responsibility to take an active role in your health care.
Inmates will purchase OTC medications from the Commissary with personal funds. For a complete listing, see the institution commissary sheet.
An indigent inmate is one who has had an average daily Trust Fund account balance of less than $6.00 for the past 30 days. An indigent inmate may obtain OTC medications at sick call if health services staff determine that she has an immediate medical need which must be addressed before the inmate may apply for OTC medications. All indigent inmates must come to the pharmacy on Wednesday between 8:00 a.m. – 8:30 a.m. to request medication. One request per inmate per week will be accepted. Inmates will select no more than two items on the Over-the Counter Medications Request form. If she needs more than two items, she must attend Triage.
When the pharmacy staff receive the request, they will verify whether the requesting inmate is indigent by reviewing the inmate’s Commissary account information. Pharmacy will maintain a record of the OTC items issued to a given inmate for 30 days.
Controlled medications are dispensed from the pill line in Health Services at the following times each day:
8:00 a.m. – 8:30 a.m., and 3:00 p.m. – 3:30 p.m.
Insulin lines are each weekday at 6:10 a.m., holidays/weekends at 7:00 a.m., and immediately after the 4:00 p.m. count.
Inmates scheduled for furlough, halfway house, and mandatory release will receive an Exit Summary when they depart. An exit summary lists current and past health problems, current medications, and TB status.
An Inmate Request to Staff Member must be submitted to your Primary Care Provider if you wish to have an HIV Test.
Contact lenses are only authorized if medically necessary. If you arrived with only contact lenses you will be scheduled to see the Optometrist as soon as possible to have prescription glasses made.
Female Health Care
Quality health care is available at the female institutions, with specialized treatment programs available at some facilities. The institution provides comprehensive health care and the following services to female inmates:
1. A complete physical examination to include the following within fourteen (14) days.
Gynecological and Obstetrical history
Breast and pelvic examination
Laboratory tests if indicated
Measles, Mumps, and Rubella (MMR) vaccine is available to all sentenced female inmates of child bearing age.
2. A baseline mammogram is generally obtained at age 40. Mammography is suggested every three to five years for women between the ages of forty (40) and fifty(50) years. It is suggested annually for women over fifty (50) years of age. You must submit an Inmate Request to Staff Member (cop-out) requesting this procedure.
3. Routine pregnancy screening (urine or serum) shall be performed during the initial examination.
4. Baseline audiometric examinations are performed if indicated on initial physical examinations.
Dental Triage Services
Dental sick-call is provided for patients who are experiencing emergencies. Any inmate with a dental emergency should report to Health Services at 6:45 a.m., Monday, Tuesday, Thursday, and Friday. An Inmate Request to Staff Member (Cop-Out) may be submitted to the Dentist for any other dental request.
Dental Emergencies are:
2. Swelling in the jaw or gums that is painful or distorts the face.
3. Broken dentures that lacerate the mouth.
4. Traumatic wounds.
5. Complications from previous treatment and other conditions that, in the opinion of the examiner, require immediate attention.
Conditions that are Not Treated on Sick-Call are:
1. Lost fillings without pain.
2. Pain when eating or drinking hot or cold foods.
3. Bleeding gums.
4. Teeth cleaning.
5. Lost Tooth on Denture;
6. Fabrication of Crowns.
Patients who require non-emergency dental treatment are taken from treatment lists. A patient requesting treatment should submit an “Inmate Request to Staff Member” to be added to the treatment list. It is occasionally necessary to restrict an inmate’s activities for health reasons, without hospitalizing the inmate. In such cases, the inmate will be placed on “Idle” or “Convalescent” status. Guidelines will be as follows:
1. “Idle” -An inmate must remain in her quarters except to go to meals, medication line, religious services, approved visits, health call-outs, Triage Services, clothing exchange, and commissary on the scheduled day. The inmate is prohibited from participating in any recreational activities outside her quarters. In such cases when the idle slip is marked “bed rest,” the inmate is restricted to her bed for health reasons.
2. “Convalescent” -The inmate does not participate in any work assignment, but she is not restricted to her quarters. She may not participate in activities such as softball, basketball, or any other strenuous activity. She may engage in activities such as chess, checkers, and cards. If the inmate is enrolled in a school program, she may attend class only if indicated she may do so on the Medical Duty Status form.
3. Health Restriction -If medically indicated, an inmate will be placed on work/athletic restriction following her initial physical examination, or upon discovery of a change in health status (i.e., disease or injury).
INMATE CO-PAYMENT PROGRAM
Inmate Co-payment Program: The Inmate Co-payment 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 co-pay fees.
Health Care Visits with a Fee:
1. Inmates must pay a fee of $2.00 for health care services, which are charged to the inmate’s commissary account, per health care visit. These scheduled appointments include Triage and after-hours to see a health care provider. If an inmate asks a non-medical staff member to contact medical staff to request a medical evaluation on her behalf for a health services visit, a charge of $2.00 co-pay fee will still apply for that visit.
2. Inmates must pay a fee of $2.00 for health care services, charged to their Inmate Commissary Account, per health care visit, if found responsible through the Disciplinary Hearing Process to have injured an inmate who, as result of the injury, requires a health care visit.
Health Care Visits with no Fee:
1. Health care services based on health care staff referrals;
2. Health care staff-approved follow-up treatment for a chronic condition;
3. Preventative health care services;
4. Emergency services;
5. Prenatal care;
6. Diagnosis or treatment of chronic infectious diseases;
7. Mental health care;
8. Substance abuse treatment.
A fee will not be charged for the following, if the health care provider orders or approves these treatments:
1. Blood pressure monitoring;
2. Glucose monitoring;
3. Insulin injections;
4. Chronic care clinics;
5. TB testing;
7. Wound Care;
8. Patient education.
If an inmate is considered indigent, she will not have a co-pay fee deducted from her Inmate Commissary Account. If an inmate is not considered indigent, but do not have sufficient funds to make the co-pay 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 the Inmate Commissary Account.