Emergency medical care is available 24 hours a day. Any emergencies that occur when Health Services is closed may be reported to any available staff member. INTRODUCTION FCC Victorville has a wide range of medical and dental services available. Emergency Medical Care is available 24 hours a day. The Medical staff are available from 6:00 a.m. to 10:00 p.m., Monday through Sunday and holidays. From 10:00 p.m. to 6:00 a.m. on Monday through Sunday and holidays, the Health Services Staff Physicians are on call. Any emergencies outside these times will be reported to the Custody Staff responsible for you. PRIMARY CARE PROVIDER TEAMS The Primary Care Provider Teams (PCPT) has been established to improve health care services delivery by enhancing continuity of care and promoting preventive health care measures. The PCPT is designed to function in the same manner as a medical office in a community setting. Under the PCPT model, each inmate is assigned to a medical team of health care providers and support staff who are responsible for managing the inmate’s health care needs. All the inmate population at the FCC Victorville has been assigned to a specific Health Services Provider, based on the inmate Register Number. Therefore, every new commitment inmate will be assigned to his/her Practitioner Provider.
INMATE CO-PAYMENT PROGRAM
Pursuant to the Federal Prisoner Health Care Co-payment Act (FHCCA) of 2000 (P.L. 106-294, 18 U.S.C. § 4048), the Federal Bureau of Prisons and the FCC Victorville provide notice of the Inmate Co-payment Program for health care, effective October 3, 2005. A. Application: 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. B. Health Care Visits with a Fee: 1. 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 -29- 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 co-pay fee for that visit. 2. You must pay a fee of $2.00 for health care services, charged to your Inmate Commissary Account, per health care visit, or 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: 1. Health care services based on health care staff referrals; 2. Health care staff-approved follow-up treatment for a chronic condition; 3. Preventive health care services; 4. Emergency services; 5. Prenatal care; 6. Diagnosis or treatment of chronic infectious diseases; 7. Mental health care; or 8. Substance abuse treatment.
If a health care provider orders or approves any of the following, we also will not charge a fee for:
• Blood pressure monitoring;
• Glucose monitoring;
• Insulin injections;
• Chronic Care Clinics;
• TB testing;
• Wound Care; or
• Patient education.
Your health care provider will determine if the type of appointment scheduled is subject to a co-pay 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. through the Bureau’s Administrative Remedy Program (see 28 CFR part 542).
Daily Sick Call sign up is achieved by filling out a Sick Call form, which can be obtained in and returned to the Health Services Unit. You may sign up for both medical or dental Sick Call. You will be triaged and scheduled to be seen the same day or later in the week. If you have an emergency situation (i.e., bleeding, chest pain, nausea, and vomiting), contact the Unit Officer and have him/her call the Duty PA. The Duty PA will assess your condition and see you immediately, if necessary. Failure to report to your scheduled Sick Call appointment or any other Call Out will result in an incident report being written. Your Sick Call appointment may not be scheduled on the same date as you present your form. You are responsible for notifying your Detail Supervisor or Unit Officer of your upcoming appointment. It is your responsibility to arrive for your appointment on time. If you arrive more than fifteen (15) minutes late, your scheduled appointment may be cancelled. Wednesdays are set aside for Special Housing Unit inmates. Only inmates with emergencies are seen on Wednesdays and after normal working hours. If you have an emergency, a Detail Supervisor or Unit Officer must notify the Medical staff of such. Routine headaches, pulled muscles, backaches, etc. are not emergencies. For such conditions, you should wait until the next Sick Call to be seen by a Medical staff. Should you come to the Health Service Unit during non-Sick Call hours, you will be triaged, and if your complaint is determined by the Medical staff to be a non-emergency, you will be referred to your unit to return to the Health Services Unit the following day. The dental and optometry waiting lists are posted in the waiting area of the Health Services Units.
New commitments to the Bureau of Prisons will receive a complete physical examination within fourteen (14) calendar days, if they have not been medicaly cleared by another BOP facility. This examination includes eye screening. Dental screening exam is done within 30 days of your arrival, if you were not cleared at another BOP facility. The Health Services Staff will schedule all physicals for those inmates requesting these examinations. METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) INFECTION Within the federal prison system, community-onset MRSA infections have been associated with illicit, unsanitary tattoo practices and poor inmate hygiene. MRSA infections often present as mild skin or soft tissue infections, such as furuncles, that occur spontaneously without an obvious source. Inmates with MRSA skin infections commonly complain of “an infected pimple,” “an insect bite,” “a spider bite,” or “a sore.” Many MRSA infections cause minor inflammation without pain and infected inmates may not seek medical attention. Persons with complicating medical conditions, such as diabetes, HIV infection, chronic skin conditions, indwelling catheters, post-surgical wounds, and decubit are at an increased risk of MRSA infections; however, even otherwise healthy individuals can develop very serious MRSA infections, such as cellulitis, deep-scated abscesses, necrotizing fasciitis, septic arthritis, necrotizing pneumonia, and sepsis. If you are considered indigent, you will not have the co-pay 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 ANNUAL TB SKIN TESTING Annual TB skin testing (PPD) is mandatory for all inmates except those who had a previously documented positive TB skin test and a history of INH treatment which can be verified. A chest X-ray will be ordered for these inmates to determine the presence of active TB disease. Inmates who have a positive TB skin test will be followed up in the Infectious Disease Chronic Care Clinic. PILL LINES Pill Line will be offered two (2) times daily. Times will be posted in the units and in the Health Services Unit. (Diabetic lines will be offered at 6:15 a.m. – 6:30 a. m. and approxiately 5:15 p.m. -5:30 p.m.). Any medication received via the Pill Line will be subject to being crushed, according to Policy, and the inmate will be under direct observation during the administration of the medication. A pick up medication Pill Line is available at 10:30 a.m. at all of the Institutions, Monday thru Friday. You will not be able to pick up medication at any other time, nor on the weekends. It is the responsibility of the individual to be present at the Pill Lines to receive his/her medication. Over the counter (OTC) medications are available for purchase at the Complex Commissary Department. Consult the Commissary Shopping List for the OTC medication available. Note: Inmates may request OTC medications based on an urgent medical need. In such circumstances, inmates will be allowed access to the Commissary on a day other than that regularly scheduled for the housing unit. Inmates requesting OTC medication will be allowed to fill a Commissary slip request; Commissary will process the order the same day. During this process, inmates will not be allowed to request any other items beside OTC medication. Indigent inmates will be allowed to request OTC medication through the Health Services Pharmacy using the regular Sick Call procedure. Also inmates requesting OTC medication through Commissary can obtain the OTC medication through the Health Services Department during Commissary closures (FCC Victorville Commissary is closed every Friday). To pick up any medication, you must show your ID card.
Those inmates requiring to see the Optometrist must make a Sick Call appointment for an initial eye screening and a referral. You will be scheduled at the earliest possible date. After the optometry exam, all glasses will be ordered by the Health Services Unit staff from Unicor. Inmates will be placed on call-out to receive these glasses when they arrive at the Complex (usually within 6 to 8 weeks). Any inmate wishing to purchase personal glasses must do so through the Unit Counselor. Glasses mailed in from outside the Complex must be shipped from the manufacturer of the glasses.
Inmates reporting to the Complex with contact lenses will be evaluated for the medical need to have contact lenses. If contact lenses are not needed, the inmate will be required to purchase eyeglasses from home or have the Complex provide him with glasses. Upon the arrival of these glasses, the inmate will be required to send his contact lenses home. If contact lenses are medically indicated, the Health Services Unit will purchase these contacts and provide the cleaning solution for their upkeep. MEDICAL DIETS Inmates will pick and choose from available items on the serving lines. The Federal Bureau of Prisons does not have or offer Medical Diets. INJURIES Injuries will be seen by the on-duty Physician Assistant, or the Duty medical staff if after normal working hours. The inmate must report the injury to his Work Supervisor or Unit Officer. The Supervisor will contact the Health Services Unit staff and the inmate will be evaluated.
UNAUTHORIZED VISITS TO THE HEALTH SERVICES UNIT
All inmates who are in the Health Services Unit must be on the daily call out list or have an appointment to be there. If you are found to be in this area without an appointment or are not on the call out list, an incident report will be completed indicating that you are “out of bounds.”
If you wish to see the doctor specifically, you must submit a copout requesting that the physician place you on his call out. Otherwise, you will be referred to Sick Call and will be evaluated by one of the Physician Assistants. Also by Policy you have the right to see the Physician if your Physicians Assistant is unable to resolve your health issues after three visits with the same complaint. HEALTH SERVICES ADMINISTRATOR If you have a problem with any of the Health Services Unit staff, or you wish to discuss a medical condition, you can visit with the Health Services Administrator or the Assistant Health Services Administrators without an appointment during Mainlines. If you wish to make an appointment to see the Health Services Administrator for any other reason or at another time, you must submit a copout to the Medical Records Office staff. LOWER BUNKS, EXTRA MATTRESS OR SOFT SHOES Housing assignments are the responsibility of the Unit staff. If you have a medical condition which you feel requires a lower bunk, extra mattress or soft shoes, you may make a Sick Call appointment to discuss this with the Medical staff, who will determine your need for a lower bunk, extra mattress or soft shoes. Only insulin-dependent diabetics are authorized for a short Mainline, all other medical conditions requiring short Mainline will be evaluated by your medical provider.
PRE-EXISTING MEDICAL CONDITIONS
In accordance with Bureau of Prisons Policy, if you are incarcerated with a pre-existing medical condition (i.e., hernia, hearing deficiency, etc.), and it will not be detrimental to your health and well being during your confinement, the Bureau of Prisons will not take action to correct that problem. If it becomes a detriment to your health during your confinement, then corrective action will be taken. This determination will be made during the Weekly Utilization Review Committe Meeting and must be approved by the Central Office. This include Dental Procedures. JOB ASSIGNMENTS Job assignments are the responsibility of the Unit staff who make specific job assignments. The Health Services Unit staff issue information regarding any physical duty restrictions to the Unit staff. The Unit staff are then responsible for placement in a position which takes these limitations into consideration. If you have a problem with your job assignment, see the Unit staff, not the Health Services Unit staff. If any inmate has job restrictions placed on him during confinement at this Complex, athletic restrictions also will be considered, if medically indicated.
MEDICAL STATUS DEFINED MEDICAL IDLE STATUS
An inmate on medical idle status will remain in his assigned quarters for the duration of this status. Exceptions are: meals, regularly scheduled church services, necessary call outs, and medical appointments. Medical idles are given for minor medical problems and will not be given for more than three (3) days. WORK STATUS: There are three (3) conditions for work status. NO DUTY: Inmates placed on a no duty status will not be assigned to a work detail.
REGULAR DUTY WITH RESTRICTIONS
Inmates with restrictions will be assigned to a work detail, but will be restricted from certain activities, based on their medical condition. REGULAR DUTY: As indicated, inmates will be assigned to a work detail without restrictions.
CONVALESCENT STATUS: An inmate assigned to convalescent status will have regular compound privileges, but will not be required to work. He may not participate in sports or other strenuous activities. Convalescence will be given for a period of not less than three (3) days, and not more than thirty (30) days. MEDICALLY UNASSIGNED: In the event of a serious medical problem or disability which would require an extensive period of convalescence, the inmate will be recommended for transfer to a long-term care facility. HEALTH PROMOTION/DISEASE PREVENTION (HPDP) PROGRAM The HPDP program guidelines established by the Health Services Unit will address health promotion as well as primary and secondary disease prevention. Those inmates with risk factors (e.g., smoking, obesity, hypertension, diabetes, etc.) will be identified and appropriately referred for counseling/ treatment. The overall success of this program depends on active participation of both the inmates and staff at this Complex.
PREVENTING SEXUAL ASSAULT IN FEDERAL PRISONS
What is Sexual Assault? According to the Federal Bureau of Prisons, sexual assault is any forceful or threatening sexual behavior forced on you by one or more inmates. This includes pressure, threats, or other actions and communications to force you to engage in a partial or complete sexual act. Your Right to be Safe from Sexual Assault While you are incarcerated, no one has the right to pressure you to engage in sexual acts. You do not have to tolerate sexual assault or pressure to engage in unwanted sexual behavior, regardless of your age, size, race or ethnicity. Whether you are straight, gay, lesbian or bisexual, you have the right to be safe from unwanted sexual advances and acts. About Your Safety If you feel that your right to be left alone sexually is being violated, the Bureau of Prisons staff are available to help you deal with this problem. You should feel free to discuss your concerns about sexual assault with any staff member. Some staff, like Psychologists, are specially trained to help you deal with problems in this area. If you are in an emergency situation, approach any staff member. It is part of their job to ensure your safety. You do not have to name other inmates to receive assistance, but specific information may make it easier for staff to help you. If you are sexually assaulted, you should immediately ask for medical treatment. Even though you may want to clean up after the assault, it is important to be seen by the medical staff before you shower, wash, drink, eat, change clothing or use the bathroom. The medical staff will examine you for injuries which may or may not be readily apparent to you.
They also can examine you for sexually transmitted diseases and gather any physical evidence of assault. Avoiding Sexual Assault Here are some things you can do to protect yourself against sexual assault: Do not accept gifts or favors from other inmates. Most gifts or favors from other inmates come with strings attached to them. Be alert! Do not use contraband substances, such as drugs or alcohol. These can weaken your ability to stay alert and make good judgments. Be direct and firm if other inmates ask you to do something you do not want to do. Do not give mixed messages to other inmates regarding your wishes for sexual activity. Avoid out-of-the-way or poorly-lit areas of the Complex. Choose your associates wisely. Look for people who are involved in “safe,” positive activities within the Complex, like educational programs, psychology groups or religious services.
Get involved in these activities yourself. Trust your instincts. If you sense that a situation may be dangerous, it probably is. Counseling Services Related to Sexual Assault Most people need help to recover from the emotional effects of sexual assault. If you are the victim of a sexual assault, whether it is recent or in the past, the Psychology Services staff are available to counsel you. If you feel that you need help to keep from sexually assaulting someone else, psychological services are available to help you gain control over these impulses. Before You Attack Another Inmate, Remember . . . Sexual assault is a serious crime. The Bureau of Prison staff will investigate all reported sexual assault incidents. If you are found guilty of sexual assault, you will be subject to disciplinary action which may include loss of good time, time in disciplinary segregation, and/or additional criminal charges and time in prison. If you are interested in more information on this topic, the Psychology Services staff are available to assist you.