Inmates incarcerated within the Federal Bureau of Prisons are entitled to a certain level of medical care throughout the duration of their incarceration. This level of medical care is not the same as one would have access to in the community, but does include credentialed health care professionals who can provide access to health services that are in line with the BOP’s limited treatment protocols and limited staffing levels (a common excuse for lack of timely health care).
According to the Federal Bureau of Prisons’ website, “The Bureau’s professional staff provides essential medical, dental, and mental health (psychiatric) services in a manner consistent with accepted community standards for a correctional environment. The Bureau uses licensed and credentialed health care providers in its ambulatory care units, which are supported by community consultants and specialists. For inmates with chronic care or acute medical conditions, the Bureau operates several medical referral centers providing advanced care.” These medical referral centers are called Federal Medical Centers (e.g., FMC Butner, FMC Devens, FMC Carswell).
In actuality, medical care provided to prisoners incarcerated in the Federal Bureau of Prisons is generally lacking, although not completely deficient. Inmates who require medical, dental, or psychiatric treatment have access to a sick call or request process which will at least have them evaluated by a health care professional. From here is where the problems usually result. If the prisoner has an acute problem (e.g., a stroke or a heart attack), they will most certainly be provided with emergency care. But, if the federal inmate has a non-acute medical condition (e.g., a torn or damaged ligament, an injured hip, neurological problems, gender identity disorder, etc.), care will not generally be forthcoming to an acceptable standard of care. Common experience indicates that a plethora of medical ailments are either not treated by Federal Bureau of Prisons’ health services staff or are treated through less expensive, and less effective, means (e.g., Ibuprofen to treat migraines, fractured bones, torn ligaments, neurological problems, etc.).
The Federal Bureau of Prisons divides health care concerns into five levels: Medically Necessary-Acute or Emergent (e.g., heart attack, stroke, etc.), Medically Necessary-Non-emergent (e.g., diabetes, hypertension, etc.), Medically Acceptable-Not Always Necessary (e.g., skin tags, lipomas, etc.), Limited Medical Value (e.g., cosmetic surgery, removal of non-cancerous skin lesions, etc.), and Extraordinary (e.g., organ transplant, etc.). Depending upon the category an ailment is categorized as, the inmate will either receive treatment, not receive treatment, or will receive treatment, but the treatment will take years on end to be provided. For example, FCI Petersburg currently has a waiting list in excess of two years to see the optometrist, and this isn’t even for actual glasses, but merely to see the optometrist to obtain a prescription. Likewise, the current waiting list at FCI Petersburg to have a cavity treated is in excess of 18 months. One would be hard-pressed to assert that this is equivalent to the level of care in the community, where patients are recommended to see their dentist once or twice a year. In fact, according to one Federal Bureau of Prisons’ Mid-Level Practitioner (MLP) at FCI Petersburg, disorders such as Attention Deficit Hyperactive Disorder (ADHD) and Attention Deficit Disorder (ADD) are not treated by the BOP at all. This is irrespective of both disorders being quantified in the Diagnostic Statistics Manual (DSM-IV), which is used to determine and quantify legitimate psychological disorders and provide treatment protocols for them.
The Federal Bureau of Prison’s website continues, “Health promotion is emphasized through counseling provided during examinations, education about the effects of medications, infectious disease prevention and education, and chronic care clinics for conditions such as cardiovascular disease, diabetes, and hypertension. The Bureau promotes environmental health for staff and inmates alike through its emphasis on a clean-air environment and the maintenance of safe conditions in inmate living and work areas. The Bureau’s food service program emphasizes heart-healthy diets, nutrition education, and dietary counseling in conjunction with certain medical treatment. . . . Health Services at all eligible BOP institutions are accredited by the Joint Commission, except Care Level 1 facilities, which are excluded because they serve healthy inmates.”
The truth about health care in the Federal Bureau of Prisons is simple. It is best to avoid it if possible. Federal prisoners are advised to monitor their own weight, exercise, and do what they can to stay healthy and not in a position where care is required from BOP medical personnel. If they find themselves in a position where care is needed, but not being provided, they are advised to seek the counsel of a competent jailhouse litigator and pursue the matter through the administrative remedy process. Sometimes health care in the Federal Bureau of Prisons comes down to knowing one’s rights and asserting them, sad as this might be. If a medical problem presents itself, this might be the only way to obtain adequate treatment.