SCOPE OF SERVICES / PHYSICAL EXAMINATIONS
The Health Services Unit at MDC Guaynabo is an ambulatory care facility. We provide an initial screening when you come in to determine if you are free from infectious diseases; if you are currently on medications and which medications you need to continue; and if you can be housed in the general population. You will have a mandatory physical examination performed within 14 days of your arrival and laboratory tests will be performed when indicated. Elective Physical Examinations (PE) are offered every two years for inmates under age fifty, and yearly for those inmates over age fifty. These examinations are requested via Cop-Out to the Medical Records area, who would verify your latest PE.
If you have a medical or mental health condition that requires monitoring, you will be followed in the chronic care clinics. If you require specialized care or testing, your case will be evaluated by a committee. This committee will decide if and when you will be seen by a specialty consultant or sent off-site for an appointment.
Our mission is to give you the necessary medical / mental / dental care that is required to keep you well during your incarceration.
You will be issued an identification card when you arrive at our institution. Remember to always carry this card with you. Patient identification is required before you receive ANY medical /mental / or dental service at this institution.
SICK CALL TRIAGE / ACCESS TO CARE
The sick call screening and scheduling system that will be utilized at MDC Guaynabo, is described. Triage is defined as the classification of patients according to priority of need for examination and/or treatment. Triage allows truly 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. During triage the following will occur:
nurses will go to their assigned units and announce sick call;
the inmate will provide the identification card and a brief history
vital signs will be taken, if indicated.
an appointment will be scheduled, if needed; or
the nurse will utilize hislher protocols to address the sick call complaint;
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 (BP-A148), etc.
Physicians and other health care providers are available four days per week to provide clinical services.
Urgent Care services are available at all times, either through on-site providers or community emergency services.
Based on your complaint the health services department has up to two (2) weeks to see you. You will appear on the call-out list on your appointment date. Once you are on the call-out, the medical practitioner will see you in the unit. It is your responsibility to be available to be seen. Prescribed medication during your visit will usually be issued the same day, during the afternoon or evening hours.
All inmates have access to Bureau health care services. The Bureau will charge a copay fee for inmate requested visits to health care providers.
Generally, you must pay a fee for health care services of $2.00 per health care visit if you:
a. receive health care services in connection with a health care visit that you requested (for example, sick call); or
b. 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.
The charge will be posted into your TRULINCS account and deducted from your funds. If you do not have funds, you will not be charged a health care service fee if you are considered indigent and unable to pay the health care service fee. An inmate without funds (indigent inmate) is an inmate who has not had a trust fund account balance of $6.00 for the past 30 days.
We will not charge a fee for:
Health care services based on clinical staff referrals; 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.
OVER THE COUNTER (OTC) MEDICATION PROGRAM
OTC medications are defined as those medications that can be obtained without a prescription. Any inmate may purchase OTC medications from the commissary with their personal funds either on their own, or after advisement by a medical practitioner. Inmates found to be indigent (without funds), will be given OTC medications at the institution pharmacy. You are encouraged to purchase those OTC medications that you think you may need while you are incarcerated at MDC Guaynabo.
Inmates without funds (indigent) will be provided up to two OTC medications per week. An indigent inmate is an inmate 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 additional OTC medications at sick call if the medical provider determines that helshe has an immediate medical need which must be addressed before the inmate may again apply for OTC medications.
For indigent inmates, OTC medications may be obtained by selecting no more than two items per week from the Inmate Request For Over-The-Counter Medication Form (BP-Form S788). You will then send the form to the pharmacy through the Wednesday morning pill line staff member. The pharmacy staff will verify if you are indigent and will send the medications accordingly. If you need more than two items or you desire an OTC medication or medically-related item not listed on the Inmate Request For Over-The- Counter Medication Form, you must access sick-call triage and request the item. The medical practitioner will determine if the requested item is medically necessary and prescribe an appropriate quantity. Only one request per inmate per week will be accepted by the pharmacy each Wednesday. The requested OTC medications will be sent to you through the evening pill line.
To request Emergency Dental Care for the relief of pain and/or infection in the mouth, inmates must complete and submit an “Inmate request to staff’ BP-A0148. known as “cop-out” form. In this form you will include your personal identification information, the emergency dental complaint for which you are requesting treatment, the pain level of your complaint, and your current medications. Once you complete the form, you will send it through the internal mail system. Based on your complaint, the dental services has up to four (4) weeks to see you and schedule an appointment date which will appear on the call out list of your unit. Once you are on the call out, it is your responsibility to be ready before the scheduled time, waiting by your unit Sallyport door to be escorted to the dental services clinic by the hospital escort officer. If you fail your dental sick appointment, you will need to request again a dental sick-call appointment by following the above mentioned procedure. Prescribed medication during your visit will usually be issued the same day, during the afternoon or evening hours.
Routine (Comprehensive) dental care (amalgarn/silver fillings) and teeth cleaning (oral prophylaxis) are provided only to the sentenced, holdover or inmates housed at MDC Guaynabo over a year pending sentence. To access routine dental care and/or teeth cleaning inmates must complete an “Inmate Request to Staff’ BP-A0148. known as “copout” form. Once you complete this form, you will send it through the institution’s mail. Your Inmate Reauest to Staff (Cop-Out) will be reviewed by the chief dental officer. If you meet the criteria, your name will be placed on the Comprehensive Dental Care Waiting List. You will be scheduled on the dental call out for your routine dental care when your name comes up to the top of the waiting list. Remember that once your name is placed on the dental call out it is your responsibility to be ready on time by your unit Sallyport door to be escorted by the hospital escort officer. If you fail three (3) comprehensive/routine callout appointments, your name will be taken off the list and you will need to request the dental care services following the described procedure. Prescribed medication during your visit will usually be issued the same day, during the afternoon or evening hours.
It is recommended, following your incarceration, that you acquire essential hygiene and health items such as pain relief medication, toothpaste, toothbrush, mouthwash and dental floss. These items can be bought through the institution’s commissary.
FEMALE HEALTHCARE SERVICES
The following will cover policies concerning the gynecological or female care, during your stay at this facility.
I. A complete physical examination will be offered within the first 14 days of your admission at this facility, which shall include at least:
a. A gynecological and obstetrical history, including sexual activity and any recent rape history, breast and pelvic examination (PAP smear, chlamydia & gonorrhea, or other vaginal culture) if clinically indicated;
b. Laboratory tests (syphilis and pregnancy test).
c. Sensibility test and immunization offered: PPD (tuberculosis skin test), MMR (for females of child bearing age), and others like Pneumovax and Influenza whenever applicable.
d. A baseline mammography for sentenced female inmates (or over 12 months at institution) shall be offered to females above 40 years of age or when clinically indicated.
II. Females over fifty years of age may request an annual physical exam.
HIV testing will be offered to all inmates with clinical indications and those with a positive Tuberculosis skin test. Inmates can request testing during a sick call visit, or during specific clinics in the medical area. There must be a year in between each test.