The primary purpose of this section is to introduce you to Health Services, to explain the process by which to obtain medical care, and to provide you with basic patient education.
While you are incarcerated, access to medical care is a right, not a privilege. Medical care will never be withheld from you for disciplinary reasons. Medical complaints will always be cared for in a timely and professional manner.
It will be the policy of the United States Penitentiary (U.S.P.), Atwater, California, that all inmates who wish to attend sick call will be allowed to do so.
Upon your arrival at U.S.P. Atwater, you will be interviewed by a member of the Health Services staff. It is imperative that you cooperate with them in supplying all requested medical data. If you are on maintenance medications, these will be continued until you can be evaluated by the healthcare provider.
Those individuals who require long-term chronic care which cannot be provided at this facility, will be referred to one of the Federal Medical Centers.
Sick call sign up is conducted on Monday, Tuesday, Thursday, and Friday, excluding Holidays, during the breakfast movement time. You must bring your Commissary card when requesting an appointment. For example, at 6:00 a.m., before breakfast, inmates will report for Sick-Call when their Unit is called for the morning meal. Inmates in need of immediate medical attention will be examined accordingly. Inmates who require an appointment, or a medical/dental consultation with a health care provider, will be scheduled according to their medical needs.
If you experience a medical emergency, or if you are injured or ill after clinic hours, you should notify your Unit Officer or Detail Supervisor.
INMATE COPAYMENT PROGRAM
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 United States Penitentiary Atwater provide notice of the Inmate Copayment Program for health care, effective October 3, 2005.
A. 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 at the MRCs and inmates assigned to the General Population at these facilities are subject to copay fees.
B. Health Care Visits with a Fee:
You must pay a fee of $2.00 for health care services, 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 copay 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.
C. 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;
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;
Chronic care clinics;
Wound Care; or
Your health care provider will determine if the type of appointment scheduled is subject to a copay fee.
D. Indigency: 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 copay fee deducted from your Inmate Commissary Account.
If you are NOT indigent, but you do not have sufficient funds to make the copay 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 your Inmate Commissary Account.
E. Complaints: You may seek review of issues related to health service fees through the Bureau’s Administrative Remedy Program (see 28 CFR part 542).
If you are scheduled for a clinic/sick call appointment, your name will be listed on a “CALL-OUT” sheet located in the Unit Officer’s Office window. Date and time will be posted at 0720 or 1215. At the 0720 and the 1215 Work Call this will also be the Medical Movement. You will be excused from your regular work assignment for that day to make your medical appointment. These appointments are mandatory. If you fail to make your appointment, disciplinary action will be taken.
Dental sick call sign up is held at the same time as medical sick call. All inmates arriving at the institution will receive a routine dental examination, unless you had one in the last year performed by BOP institution. In order to receive routine dental care or cleaning, you must submit a cop out to the Dental Clinic and will be placed on the waiting list.
If you are scheduled for a dental clinic appointment, you will be on medical idle for that date, and you will stay in your housing unit until the hospital movement is announced.
If you should develop a “dental emergency”, inform your detail supervisor or unit officer and arrangements will be made to have you evaluated.
All prescriptions can be picked up during the noon meal movement time, and also during the evening meals, Monday thru Friday, unless you are instructed otherwise. If you are on any restricted medications, the pharmacist will advise you of the times and method of receiving these medications.
Over-the-counter medications (Aspirin, Tylenol, Decongestant, Maalox, etc.) are available for purchase in the Commissary. Any inmate who cannot afford to purchase these items can request them through routine sick call. They can be prescribed if medically necessary.
EYEGLASSES AND CONTACT LENSES
In order to be placed on the list to receive an exam for eye glasses, submit your request through sick call. After your exam, if you require eyeglasses, we will order glasses for you. It takes approximately four to six weeks for delivery. Contact lenses will be authorized only by the eye doctor (Optometrist/Ophthalmologist).
A physical examination will be completed within 14 days of your arrival. If you were transferred from another institution and a current physical examination is in your medical record, this will not be repeated. You will be assigned a medical duty status and be cleared for work at the time of your physical examination (or chart review).
If you are under the age of 50, you can request a physical examination once every two years by sending a cop out to the Health Services Unit. If you are over the age of 50, the physical examination can be requested once a year.
If you are being released from the system and your discharge date is not within one year of the previous examination, you can request a release physical. This should be requested at least four months prior to your anticipated release date.
If you refuse any medical screening for communicable diseases, you will be placed in Administrative Detention until all requirements have been completed.
SPECIAL PROCEDURES AND TESTS:
HIV: There is an increased personal risk factor of being exposed to the Human Immunodeficiency Virus by behavior which includes: I.V. drug use, tattooing, and homosexual behavior. You are discouraged from engaging in such activities. All inmates who have engaged in any of these high risk behaviors are encouraged to have an HIV test performed. This can be requested during your physical examination or on routine sick call. All inmates must have an HIV test prior to release or any community activity; i.e. community corrections center, furloughs.
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. Here are some other reasons for HIV testing:
Release -HIV testing must be completed prior to release to a CCC facility, and prior to full term expiration of sentence. The HIV test is good for one year and does not need to be repeated if tested within one year of release.
Clinical Indications -Fungal infections of the mouth, persistent swelling of the lymph nodes, bleeding, unexplained weight loss or fevers.
Your Request -To request the test, submit an “Inmate Request to Staff Member” form. Testing is encouraged. It is not necessary to explain why the test is being requested.
By policy, you will be counseled before the test and when you receive the results. You will be scheduled by Health Services for pre or post-test counseling. Test results are strictly confidential.
If you are scheduled to take the HIV test participation is mandatory, refusal to participate will result in disciplinary action.
If you are HIV positive, you will be discreetly scheduled into a specialty clinic to carefully monitor your condition. You will be given regular housing and work assignments unless your condition warrants a duty restriction.
Smoking cessation programs for inmates will be offered through the Recreation, Psychology and Health Services Departments. These programs will assist inmates in areas of learning and acquiring skills and knowledge pertaining to nutrition, exercise, and stress management. The Chief Psychologist or designee will offer literature and implement, with the Supervisor of Education, Recreation, a viewing schedule for healthy living video tapes.
USP Atwater is a no-smoking facility. All areas of the facility are considered “No Smoking” zones. Any inmate found smoking will be charged with the prohibited act of Smoking Where Prohibited. Additionally, you may not possess tobacco or related paraphernalia.
ACTIVITY OR DUTY RESTRICTIONS
Restrictions applying to your level of activity or work are authorized by the medical staff at the time of your appointment or the approval from the medical review committee. This same method is used in acquiring or maintaining orthodontics/orthopedic appliances, such as braces, crutches, canes, prosthesis, etc.. Any questions regarding duty status assignments/restrictions or the use of orthodontics/orthopedic appliances should be directed to the authorizing medical staff member or via a sick call appointment.
CONSULTANTS AND NON-BUREAU STAFF
Referrals to consultants are made through the physician who serves as the Clinical Director.
MEDICAL RECORDS REVIEW OR COPIES
Any inmate wishing to review or have copies made of his medical record should submit a cop out to the Medical Records Office. If the amount of copies exceeds the allowable limit, the inmate will be charged for the requested copies (in accordance with the Health Services Manual).
Inmates who wish to have a living will, may contact a private attorney to prepare the documents at the inmates expense. The inmate can provide their living will to medical records, and it will be included in the inmate’s medical record.