Category Dr. M Blatstein’s Blog

COVID-19: BOP News

Focus: 6′ of Separation (Unlikely), Overall testing and contact tracing is not yet available for either the general public or those incarcerated as of this post update 5/9/2020.

COVID-19 in Prisons (Federal, State) and  Jails, like Cruise Ships, unfortunately, act as perfect breeding grounds for any kind of virus and especially one that currently has no treatment protocols.
May 22, 2020 (

A Federal Bureau of Federal Prisons truck drives past barbed wire fences at the Federal Medical Center prison in Fort Worth, Texas, Saturday, May 16, 2020. Hundreds of inmates inside the facility have tested positive for COVID-19 and several inmates have died with numbers expected to rise. (AP Photo/LM Otero) (Copyright 2020 The Associated Press. All rights reserved.)

Federal prison system to begin moving nearly 7K inmates to one of three designated quarantine sites — FCC Yazoo City in Mississippi, FCC Victorville in California, and FTC Oklahoma City — or to a Bureau of Prisons detention center.

May 16, 2020 (The Review)

Of the 399 accumulated COVID-19 cases in Columbiana County, the health department reports nearly 25 percent, 94 of the cases, have been inmates from FCI-Elkton, totaling 118 for inmates and 12 corrections staff.

May 11, 2020

Inmates, families fear worst for Fort Worth Federal Medical Center – as the prison is ‘consumed’ by coronavirus where 636 inmates — 43% of the total population — had tested positive, and five have died.

May 10, 2020 (CBS DFW)

Tarrant County Public Health (TCPH) reported 485 new cases of the coronavirus Sunday, of which 423 were caused by the Texas Fort Worth Federal Medical Center prison outbreak. So far, the county has seen 3,695 positive cases and 780 recoveries.

May 9, 2020 (FCI Lompoc):

But covid-19 at FCI Lompoc is straining the relationship with LOMPOC, Calif. residents, part of this central California agricultural community.

70% of inmates test positive for coronavirus at Lompoc federal prison.

May 8, 2020 (KTLA5):

As of Friday 5/8/2020, 823 inmates tested positive in FCI Lompoc (2 have died), and another 644 at FCI Terminal Island (6 have died at the San Pedro facility).

May 8, 2020 (The Appeal):

FCI Hazelton is one of 11 federal prisons designated quarantine facilities. When new people are convicted or otherwise brought into the federal system, they will be sent to one of the facilities for a two-week quarantine period, BOP spokesperson Justin Long told The Appeal.

May 5-6, 2020 (Lex 18):

70 inmates test positive at the Lexington Federal Medical Center (FMC) in Lexington, Kentucky, however “communication with [FMC Lexington] has been sporadic, and sometimes it’s non-existent,” Lexington Health Department Spokesman Kevin Hall

May 5-6, 2020 (Lex 18):

LEXINGTON Federal Medical Center is quickly emerging as a hot spot for Coronavirus in Kentucky, without providing the needed communication with Lexington Fayette County Health Department.

May 1, 2020 (Penn Live Patriot-News):

LEWISBURG – Lewisburg Federal Penitentiary will transition into a medium-security facility is complete (and every unit will have multiple rooms with televisions, computer stations, and telephones).

May 1, 2020 (The Marshall Project):

COVID-19 continues to spread through Ohio prisons, with the FCI Marion and Pickaway correctional institutions combining for nearly 2,500 confirmed cases of the coronavirus. That is an estimated 80 percent of the inmates in those two prisons.


April 30, 2020 (The Marshall Project):

Texas prison system failed for years to equip employees with personal protective equipment…

Over 70 percent of tested inmates in the federal prison system have COVID-19. AP

COVID-19 outbreak at FCI Terminal Island is now the largest within the Bureau of Prisons system…


April 28, 2020 (ABC, WQAD8)

Thomson USP is one of 11 facilities designated as a “quarantine location,” now concerns over-testing.

April 23, 2020

…a federal judge dismissed a class-action lawsuit that was aimed at getting medically vulnerable prisoners released from the federal prison in Oakdale, Louisiana.


April 22, 2020 (Forbes):

Bureau Of Prisons Removes Webpage FAQ Home Confinement On COVID-19. BOP Website Displays…..


April 20, 2020 (Government Executive):
Union Files National Grievance Over Alleged Safety Violations at Federal Prisons During Coronavirus Pandemic. Forced leave, lack of protective gear, and privacy breaches are among the allegations.
April 18, 2020 (NYT):

‘Something Is Going to Explode’: When Coronavirus Strikes a Prison. An oral history of the first fatal outbreak in the federal prison system, in Oakdale, La.


Friday, April 17, 2020 (ABC):

Butner ( a BOP Federal Medical Center) has more COVID-19 cases than any other prison in the federal system: 66 inmates and 25 staff members have tested positive for COVID-19 at Butner; four inmates have died


April 15, 2020 (Forbes):

COVID-19 Positive Tests in Bureau of Prisons Institutions (April 14, 2020) W PAVLO

Federal Bureau Of Prisons Institutions Not Showing Any Signs Of “Flattening Curve”, By Walter Pavlo

The continued inaction of the BOP to swiftly reduce the population of inmates, particularly the elderly and those with underlying health conditions, is an unfolding story with tragic consequences.

April 14, 2020 (Marshall Project):

Nearly 600 prisoners and staff members are infected with COVID-19 in the federal system. Thirteen prisoners have died. Bureau of Prisons


April 8, 2020 (The Appeal):

Don’t Look to the DOJ to Keep Federal Prisons and Their Surrounding Communities Safe During the COVID-19 Pandemic. By  Shon Hopwood/Felon turned Georgetown Law Professor, Apr 08, 2020

April 8, 2020 (NYT):

…1,324 confirmed coronavirus cases are tied to prisons and jails across

Prisoners hung signs pleading for help in a window of the Cook County jail on Tuesday.Credit…Jim Vondruska/Reuters

the United States


April 7, 2020 (News Observer):

The Federal Correctional Complex at Butner is moving to the top of the list of prisons for early release 

April 6, 2020 (NPR):

Inmates, Staff On Edge As COVID-19 Spreads Through Federal Prisons  The Federal Bureau of Prisons says 138 inmates and 59 employees have tested positive and at least seven inmates have died.

April 4, 2020 (FEDweek):


Brooklyn, NY - Feb 2019: Protest over inmate conditions in front of the Brooklyn Metropolitan Detention Center which partially lost power and heat, resulting in a lockdown.

Brooklyn, NY – Feb 2019: Protest over inmate conditions in front of the Brooklyn Metropolitan Detention Center which partially lost power and heat, resulting in a lockdown.

Bureau of Prisons Implements Partial Lockdown to Halt Spread; The challenge is that prisons and jails are not built to provide 6′ of separation to inmates and correction staff.  I have to assume that PPE, cleaning materials and testing for all parties are not diligently implemented.

April 2, 2020:

Marshall ProjectCoronavirus Tracker By State: How Justice Systems Are Responding in Each State; Coronavirus Published 03.17.2020 Updated 2:03 P.M. 03.25.2020

April 1, 2020 (Gov Exec Daily):

Federal Prison System Goes Into ‘Modified Lockdown’.

The Metropolitan Detention Center in Brooklyn, N.Y., had the first known case of coronavirus in the federal prison system. The facility is shown here in February 2019. KATHY WILLENS / AP

New procedures due to coronavirus concerns will last 14 days, after which the agency will re-evaluate. By COURTNEY BUBLÉ

Mar 31, 2020 (The Appeal, MedPage):

BOP Halfway House Residents Describe ‘A Scary Situation’ As Coronavirus Sweeps The U.S. By Lauren Gill. These halfway houses appear ill-prepared for the influx of those who may have (or haven’t yet contracted), COVID-19.


wearing a basic face mask in the community setting to augment our protection against SARS-CoV-2, the virus that causes COVID-19, is biologically plausible, and potentially impactful.

wearing a basic face mask in the community setting to augment our protection against SARS-CoV-2, the virus that causes COVID-19, is biologically plausible, and potentially impactful.

Could Wearing a Face Mask Be a COVID-19 Game Changer?— Augmenting protection during a global pandemic. by Rossi A. Hassad Ph.D., MPH

An easy and cheap option for all inmates and correction staff, in either Jail, Halfway House, State, Federal or Private facility. We can argue the efficacy benefit later.

Mar 30, 2020 (Vice News, NYT):

Inside the Federal Prison, That’s ‘Ground Zero’ For the Coronavirus Outbreak, By Keegan Hamilton

Mar 27, 2020 (The Marshall Project):


No such thing as social distancing in prison. From THE MARSHALL PROJECT



Mar 26, 2020 (The Hill):

COVID-19 gives us an urgent argument for compassionate release

Mar 24, 2020 (wbur):
A medical exam room in the Worcester County jail in West Boylston

A medical exam room in the Worcester County jail in West Boylston

Pain And Profits: Sheriffs Hand Off Inmate Care To Private Health Companies; By Christine Willmsen  and Beth Healy

Federal Sentencing, COVID-19 and Compassionate Release

(1) Federal Sentencing in the age of COVID-19, where possible, requesting compassionate release for home confinement or from the U.S. National Library of Medicine – Diversion Sentencing.

  • This is critical as prisons are perfect petri dish incubators for contagions to multiply as in the cruise ship; e.g., Diamond Princess.
  • With ~600K inmates released each year with no current treatments available;
(2) Compassionate Release  /COVID19; while to my understanding it’s been difficult-impossible to get in past years, with COVID19, these examples just appear cruel:
  • People with severe obesity (body mass index [BMI] of 40 or higher).
  • People with diabetes.
  • People with chronic kidney disease undergoing dialysis.
  • People with liver disease.
  • I recommend the website UpToDate, an excellent resource tool for clinicians, hospitals, and hospital systems.

(3) 5-15-2020; Halfway House photos show no 6′ social distancing or masks being used.


BOP/ COVID-19 / Hydroxychloroquine / The Science

4-7-2020 (Marshall Project)

BOP buys $60,000 worth of hydroxychloroquine, the un

White House economic adviser Peter Navarro reportedly clashed with the National Institute of Infectious Diseases director Dr. Anthony Fauci over the efficacy of hydroxychloroquine as a coronavirus treatment.

proven COVID-19 treatment drug;

Many Trump-friendly pundits, however, are convinced of the drug’s effectiveness, most notably those on Fox News shows from which the president is known to take policy cues.


Malaria (not recommended for the treatment of complicated malaria.)

Lupus Erythematosus

Rheumatoid Arthritis: the treatment of acute and chronic RA  in adults.

Common side effects of Hydroxychloroquine include:


Clinical Effectiveness COVID-19 Resources Available to All

UpToDate (Medical Experts for Physicians)

Clinical Effectiveness COVID-19 Resources


Coronavirus disease 2019 (COVID-19): Management in adults


I) Hydroxychloroquine/chloroquine— 

There are insufficient data thus far to know whether hydroxychloroquine or chloroquine has a role in the treatment of COVID-19. For this reason, we strongly recommend that patients should be referred to a clinical trial whenever possible.

If hydroxychloroquine or chloroquine is used outside of a clinical trial, the potential for adverse effects should be carefully assessed. (See “Coronavirus disease 2019 (COVID-19): Arrhythmias and conduction system disease”, section on ‘Monitoring for QT prolongation’.)


Ia) Azithromycin and hydroxychloroquine –

We do not routinely use azithromycin in combination with hydroxychloroquine for treating COVID-19. Although one study suggested the use of azithromycin in combination with hydroxychloroquine was associated with more rapid resolution of virus detection than hydroxychloroquine alone [62], this result should be interpreted with caution…


II) Remdesivir (Testing canceled,, not because the drug wasn’t working, but because it proved too difficult to enroll the required number of patients. (Endpoints News))

…is a novel nucleotide analogue that has activity against SARS-CoV-2 in vitro [43] and related coronaviruses (including SARS and MERS-CoV) both in vitro and in animal studies [44]. Several randomized trials are underway to evaluate the efficacy of remdesivir for moderate or severe COVID-19 [45].

IIa) The WHO is launching a trial to further evaluate:

…remdesivirhydroxychloroquine/chloroquine, and lopinavir-ritonavir with and without interferon beta [76]. Various other antiviral and immunomodulating agents are in various stages of evaluation for COVID-19. A registry of international clinical trials can be found on the WHO website and at


III) Convalescent plasma — 

In the United States, the Food and Drug Administration (FDA) is accepting investigational new drug applications for use of convalescent plasma for patients with severe or life-threatening COVID-19 [50]; pathways for use through these applications include clinical trials, expanded access programs, and emergency individual use.


IV) Tocilizumab

…is an interleukin (IL)-6 receptor inhibitor used for rheumatic diseases and cytokine release syndrome. Elevated IL-6 levels have been described in patients with severe COVID-19, and case reports have described good outcomes with tocilizumab [66-69].

Prisons and Jails are unprepared; COVID-19

COVID- 19 in Prisons and Jails are unprepared and may now be forced to recommend, in some cases alternative diversion sentences and/or home confinement.
I can only believe that the PSR could play a significant roll in this process.

Six feet apart, unlikely

6' apart, unlikely

COVID-19 in Prisons (Federal, State) and  Jails, like Cruise Ships, unfortunately, act as perfect breeding grounds for any kind of virus and especially one that currently has no treatment protocols.
Summary: COVID-19 In Prisons
If at all possible for defendants facing their sentencing hearing, the PSR properly completed may be able to provide the court with another option, as opposed to being incarcerated. Because once detained, it may be too late should the defendant be older than 55/60, along with having other medical compromising factors.
John Hopkins has a Live Interactive Dashboard
Provides Current Reported Cases of COVID-19. Use our interactive web-based map to track cases of the virus around the world

UpToDate/Coronavirus disease 2019 (COVID-19)


Recent Press Releases:
May 15, 2020 (Marshall Project)

For Mentally Ill Defendants, Coronavirus Means Few Safe Options

While their mental health deteriorates, some are stuck in jail as hospitals are decreasing admissions to prevent the spread of infections

April 17, 2020                                                                                           

Inadequate access to medical care poses a severe threat to a population that is already more vulnerable to coronavirus: there are about 10,000 people over 60 in federal custody, and about a third have pre-existing conditions. Photograph: Jonny Weeks/The Guardian

In prisons and jails across the deep south, coronavirus threatens to overwhelm

chronically underfunded, understaffed and overpopulated facilities

Mar 21, 2020;

Forbes; Can US Prisons React Fast Enough To COVID-19? By Walter Pavlo


March 22, 2020; 

Assistant U.S. Attorney Tanya Hajjar –  – wrote that no inmates at the Metropolitan Detention Center (MDC) in Brooklyn, NY or any other federal facility had tested positive for the coronavirus. What she failed to mention is that the BOP was not doing any testing of prisoners. ByJ.J. O’Hara



At least 38 people in New York City jails have contracted the virus. Associated Press

First federal prisoner, in Brooklyn, tests positive for COVID-19. Associated Press

Florida beaches covered with 1000’s on spring break, 2020.
All of this while COVID-19 is spreading across our country and the world. As a growing number of state governors urged all of us to Shelter in Place, in Florida, their beaches were covered with 1000’s on spring break.
You ask why and I have no idea. But these revelers are now on their way home to spread the virus throughout their families, friends and fellow workers’ personal space. Yet another vector.
The spread of COVID-19 from these beaches will ultimately whether direct or indirectly impact our society and prison system.
The Marshall Project, 3-19-2020

‘Those 55 and older are a growing share of the people in prisons. They’re also the most at risk as coronavirus spreads.’ By WEIHUA LI and NICOLE LEWIS

Couple this with the unprecedented delay of the federal government to act in any manner to assist state governors since January 2020, COVID-19 has exploded across the country exponentially! These same prisons and jails are already overcrowded, resulting in a healthcare disaster ready to get out of control.

Marshall Project: Jails are perfect incubators for COVID-19.” By Cary Aspinwall, Keri Blakinger, Abbie VanSickle and Christie Thompson

ICE Now could be another vector waiting to explode, impacting immigrants and ICE officers alike. While ICE claims to “have a plan”, the horse has already left the barn.


#covid19 #Covid19Prison #covidBOP

Federal Prison Placement Preparation

Incorporate these federal prison placement data points:

Federal prison placement includes Medical and Mental Healthcare needs to be implemented through the BOP CARE LEVELS I-IV Structure

Psychological Treatment

  • I) Brave Program A first-timer young male offender 32 years of age or younger, facing a sentence of 60 months or more
  • II) Challenge Program A male inmate facing a high-security penitentiary with a current diagnosis of either: Mood, Anxiety, Schizophrenia, Delusion and/or a Substance-induced Psychotic Disorders
  • III) Mental Health Step Down A male or female who lacks the skills to function in a general population prison setting and is willing to work with Psychiatry Services.
  • IV) Resolve A male or female with a current diagnosis of a mental illness related to physical, mental and/or intimate domestic violence or traumatic PTSD
  •  V) Skills A significant functional impairment due to intellectual disabilities, neurological and/or remarkable social skills deficits such as Autism Spectrum Disorder, Obsessive Compulsive Disorder, Epilepsy, Alzheimer’s, Parkinson’s or Traumatic Brain Injuries (TBIs) to mention just a few.
  •  VI) Stages  A male inmate with a serious mental illness and a primary diagnostic of Borderline Personality Disorder, along with a history of unfavorable institutional adjustment.
  • VII) Sex Offender Non-Residential Single Sex Crime; or first time Internet Sex Offense
  • VIII) Sex Offender Residential Multiple sex crimes.
  • IX) Butner’s Commitment and Treatment Program for Sexually Dangerous Persons, Page 12Is considered for sexually dangerous persons with the possibility of criminal recidivism
  • X) Female Integrated Treatment Is a female with substance abuse (RDAP Eligibility Possible), trauma-related disorders, and other mental illnesses. (FIT) Program

Medication availability falls into 3 tiers:

  1. On the BOP Formulary (available).
  2. Non-Formulary; these require a lengthy preauthorization process.
  3. Last: these are just not available. While similar medications are substituted, how is their efficacy verified?

Security Requirements

  1. Offense Level vs Criminal History Calculation
  2. Criminal History Calculation
  • +3 points for each prior sentence > 1 Year + 1 Month.
  • +2 points for each prior sentence > 60 days, not counted above.
  • +1 point for each prior sentence, <= 60 days not counted above; for up to a maximum of 4 points in this category.
  • +2 points for each revocation that has a new charge or occurs under federal supervision.
  • + 1 point for each prior sentence resulting from a conviction of a crime of violence that did not receive any points as noted above because such sentence was treated as a single sentence, up to a total of 3 points for this subsection.

The BOP and Prison Security Level Placement

  1. (Program Statement P5100.08, Chapter 4: Pages 5-13 and Chapter 5: Pages 12-13)

Helpful articles in preparation for the sentencing hearing;

  1. Judges are interested in placement recommendations; By Alan Ellis, • THE FEDERAL LAWYER • September 2017
  2. When recommending a facility placement; BY ALICIA VASQUEZ AND TODD BUSSERT, How Federal Prisoners Are Placed, Published in Criminal Justice, Volume 31, Number 1, Spring 2016. © 2016 by the American Bar Association
The Presentence Report – A Medical, Medication, and Security Requirement Referral

As found in my LinkedIn 2/29/2020 post

A Broad Overview Outline of the Federal Sentencing and Placement Process

1st: Federal Defendants once indicted, >80% likely will be sentenced to federal prison

2nd: The defendant’s 1st appearance in court

  • ~80%, can result in either a plea or verdict of guilty
  • Between the Defendants 1stand, 2nd court appearance; a resume or CV of the defendant’s background is developed: called the Presentence Report (PSR).
  • The PSR is where the Defense Team Can make a Placement Request, while documenting the defendant’s medical, criminal, work & education histories, etc.

3rd: The defendants 2nd court appearance is for the Sentencing Hearing

  • The details of sentencing are not taught in most law schools
  • Judges determine the length of time the defendant is imprisoned
  • Judges can also make a placement request to the BOP

4th: The BOP determines placement

  • Some of the factors that affect placement (BOP Policy Statement P5100.08 (Chapter 4 Pages 5-13 and Chapter 5 Pages 12-13):
    • Judges recommendations
    • Public Safety Factor (PSF) Variables
      • Accepting Responsibility
      • Age
      • Criminal History
      • Education Level
      • Legal Release Residence
    • Management Variables; Pre-determined Security levels
      • Disruptive Group-confirmed member
      • Greatest Offense Severity #
      • Greatest Severity Offense
      • Prison Disturbance
      • Serious escape
      • Serious Telephone Abuse
      • Sex Offender
      • The threat to Government Officials
    • Medical CARE LEVELS I-IV Structure
    • Mental Healthcare CARE LEVELS I-IV Structure
    • Psychology Treatment Programs
    • Medication Availability
      • On Formulary, or available
      • Non-Formulary requires a lengthy preapproval process
      • Or Just Not Available, where a similar substitute may be implemented

BOP Psychology Programs and Mental Healthcare   240-888-7778

PSR/Sentencing and Placement Preparation: BOP Mental Healthcare Programs

If your client has replied ‘Yes’ to the questions (I- IX) below, one of these 9 BOP Mental Healthcare Programs may provide the best mental illness placement option for your client.

RDAP eligibility and an overview are covered in section VIII.

I) Is your client a first-timer young male offender 32 years of age or younger, facing a sentence of 60 months or more?

  • If yes, would your client be interested in participating in a program that teaches how to create a smoother adjustment to federal Prison?
  • Will they be sentenced to a medium-security facility?
  • If all three answers are yes, this program may help □;
Brave Program- Facility Locations:
    • FCI Victorville, CA-Medium
    • FCI Beckley, WV-Medium

II) Is your client a male inmate in (or facing) a high-security penitentiary setting with a history of substance abuse/dependence or a major mental illness as evidenced by a current diagnosis of a Psychotic Disorder that may include; Mood, Anxiety, Schizophrenia, Delusion and/or a Substance-induced Psychotic Disorder?

  • If the answers are yes, this program may help □;
Challenge Program – Facility Locations:
    • USP Big Sandy, KY-High
    • USP Hazelton, WV-High
    • USP Lee, VA-High
    • USP McCreary, KY-High
    • USP Allenwood,PA-High
    • USP Canaan, PA-High
    • USP Beaumont, TX-High
    • USP Coleman I, FL-High
    • USP Coleman II, FL-High
    • USP Pollock, LA-High
    • USP Tucson, AZ-High
    • USP Atwater, CA-High
    • USP Terre Haute, IN-High
    • USP Coleman I, FL (H)
    • USP Coleman II, FL (H)

III) Is your client a male or female with a serious mental illness, but who does not require inpatient treatment?

  • Do they lack the skills to function in a general population prison setting?
  • Would they be interested in a mental healthcare program that works closely with Psychiatry Services to ensure they receive appropriate medication and have the opportunity to build a positive relationship with the treating psychiatrist?
  • If your answers are yes, this program may help: □;
Mental Health Step Down Program- Facility Locations:
    • FCI Butner, NC-Medium
    • USP Atlanta, GA-High

* Male inmates with a primary diagnosis of Borderline Personality Disorder are referred to the STAGES Program

IV) Is your client a male or female with a history of mental illness related to physical, mental, intimate domestic violence or traumatic PTSD?

  • Would your client be interested in a mental healthcare program that focuses on the development of personal resilience, effective coping skills, emotional self-regulation, and healthy interpersonal relationships?
  • If both answers are yes, this program may help: □;
Resolve Program- Facility Locations:
    • FPC Alderson, WV-Minimum (F)
    • SFF Hazelton, WV -Low (F)
    • SCP Lexington, KY-Minimum (F)
    • SCP Greenville, IL-Minimum (F)
    • FCI Aliceville, AL-Low (F)
    • SCP Coleman, FL-Minimum (F)
    • SCP Marianna, FL-Minimum (F)
    • FCI Tallahassee, FL-Low (F)
    • FCI Dublin, CA-Low (F)
    • SCP Victorville, CA-Minimum (F)
    • ADX Florence, CO-Maximum (M)
    • FCI Waseca, MN-Low (F)
    • FCI Danbury, CT-Low (M)
    • SCP Danbury, CT-Minimum (F)
    • FSL Danbury, CT-Low (F) (Activating)
    • FFPC Bryan, TX-Minimum (F)
    • FMC Carswell, TX-Adm. (F)

V) Does your client have a significant functional impairment due to intellectual disabilities, neurological deficits, and/or remarkable social skills deficits?

  • For example, do any of these apply to your client: Autism Spectrum Disorder, Obsessive- Compulsive Disorder, Epilepsy, Alzheimer’s, Parkinson’s or Traumatic brain injuries (TBIs) to mention just a few?
  • Would your client be interested in improving their institutional adjustment and likelihood for successful community reentry?
  • If your answers are yes, this program may help: □;
Skills Program- Facility Locations:
    • FCI Coleman, FL-Medium
    • FCI Danbury, CT-Low


New Drug Improves Empathy And Social Skills In People With Autism; 2 May 2019, 7:00 am EDT By Rina Doctor Tech Times

Dental care is tough to find for people with autism
Inmate patients (who need specified dental procedures) with autism and other developmental disorders require general anesthesia for non-routine dental work. Most dentists are not equipped to provide it, and insurers will not cover general anesthesia for root canals.

VI) Is your client a male inmate (or facing prison) with serious mental illnesses and a primary diagnosis of Borderline Personality Disorder, along with a history of unfavorable institutional adjustment linked to this disorder?

  • Would they be willing to volunteer for this mental healthcare program?
  • If both answers are yes, this program may help: □;
Stages Program- Facility Locations:
    • FCI Terre Haute, IN-Medium
    • USP Florence, CO-High (Effective 9/ 2014)

VII) Sex Offender Conviction(s)

VIIa) Sex Offender Treatment Program: Nonresidential (SOTP -NR)

  • Is your client considered a low to moderate risk sexual offender?
  • Does your client have a history of a single-sex crime; or are they serving a sentence for first time Internet Sex Offense?
  • If both answers are yes, this program may help: □;
SOTP-NR Program- Facility Locations:
    • FCI Petersburg- Medium
    • FCI Englewood,CO-Low
    • USP Marion, IL-Medium
    • FCI Elkton, OH-Low
    • FMC Carswell, TX-Med. Ctr.(Females)
    • FCI Seagoville, TX-Low
    • FCI Marianna, FL-Medium
    • USP Tucson, AZ-High

VIIb) Sex Offender Treatment Program: Residential (SOTP -R)

  • Is your client considered a high-risk sex offender?
  • Does your client have a history of multiple sex crimes (re-offense sex offender), extensive non- sexual criminal histories, and/or a high level of sexual deviancy or hyper-sexuality?
  • Does their criminal history include; rape, sodomy, incest, carnal knowledge, transportation with coercion, a force for commercial purposes or sexual exploitation of children, unlawful sexual conduct with a minor and/or internet pornography?
  • If your answers are yes, this mental healthcare program may help: □;
SOTP-Residential Program– Facility Locations:
    • USP Marion, IL-Medium
    • High FMC Devens, MA-Med. Ctr.

VIIc) New: Commitment and Treatment Program for Sexually Dangerous Person’s.

  • Is your client a candidate for psychological treatment, implementation of a behavior management plan, and coordination of a multidisciplinary treatment team?
  • Can your client be considered sexually dangerous with the possibility of criminal recidivism?
  • If both answers are yes, this program may help □;
Butner ‘New’ Commitment and Treatment Program – Facility Location:
    • FCC Butner, NC

To verify RDAP eligibility, in addition to drug and alcohol abuse, prescription medications along with other medications available over the counter are also included.

According to the American Bar Association: there must be a verifiable, documented pattern of substance abuse or dependence within the 12-month period preceding arrest.

IX) NEW: The Female Integrated Treatment (FIT) Program

  • Is your client a candidate for cognitive-behavioral treatment for females with substance use disorders, mental illness, and trauma-related disorders to female inmates.
  • Would your client also qualify for RDAP and those treatment plans which would also address substance use in this residential program may qualify for the early release benefit associated with RDAP.
  • If your answer is yes, this program may help □;
FIT Locations:
    • FSL Danbury, CT-Low – The New (FIT) Program


A Medical Resource


An evidence-based clinical decision support resource (one of many), that is authored and peer-reviewed exclusively by physicians who are recognized experts in their medical specialties.

Healthcare in the Federal Bureau of Prisons (BOP)


Federal PSR / Sentencing Preparation 



I.              Medical CARE LEVELS I-IV

How and where inmates are placed according to their medical and mental healthcare needs is via the BOP’s CARE LEVEL I-IV structure.

  • Medical CARE LEVEL I [under 70, healthy, needing limited to no medical contact].
    • Inmates are generally healthy, but may have limited medical needs that can be easily managed by clinician evaluations every 6 months and are located approximately one hour or more from community medical centers.
    • Inmates are less than 70 years of age.
    • Examples: mild asthma or diet-controlled diabetes not requiring medications.
      • FCI Manchester, Medium [Includes Satellite Camp], KY.
      • FCI Three Rivers, Medium [Includes Satellite], TX.
      • FCI Bennettsville, Medium [Includes: Satellite Camp], SC.
      • FCI Williamsburg, Medium [Includes Satellite Camp], SC.
      • FCI Herlong Medium [Includes Satellite Camp], CA.
      • FPC Yankton, SD.
      • FCI McKean, Medium [Includes Satellite Camp], PA.
      • USP Atwater, [Includes Satellite Camp], CA.
      • FCI Oxford Medium [Includes Satellite], WI.
      • USP Big Sandy, [Includes Satellite Camp], KY.
      • FCI Ray Brook,[Includes Detention Ctr], NY.
      • USP Lee,[Includes Satellite Camp], VA.
      • FCI Safford ‘Low’, AZ.
      • USP Pollock,[Includes Satellite Camp], LA.
      • FCI Sandstone Low, MN.
      • USP Yazoo City , Yazoo City FCC[Low-Med] MS.


  • Medical CARE LEVEL II [the majority of BOP facilities, overall healthy with routine medical visits)
    • Inmates are stable outpatients who require at least quarterly clinician evaluations and are located within one hour of major regional medical centers.
    • Can be managed in chronic care clinics, including mental healthcare issues.
    • Examples: medication controlled diabetes, epilepsy and emphysema.

For those inmates with Medical (and Mental Healthcare) Care Levels 3 and 4, the designation decision will be made by The Office of Medical Determinations and Transportation (OMDT).

Example of CARE LEVEL III Requirements

e.g.: Psychiatric Out Patient, Unable to perform their Activities of Daily Living (ADL)

Example of CARE LEVEL IV Requirements

e.g.: Dialysis, or needing inpatient hospital care; 24/7

  • Medical CARE LEVEL III [outpatient care or unable to perform ADL]
    • Inmates are fragile outpatients who require frequent clinical contacts to prevent re-hospitalization, and may be located within Level IV institutions.
    • May require assistance with activities of daily living, but does not need daily nursing care.
    • Examples: cancer in remission less than a year, advanced HIV disease, severe mental illness in remission and on medication, severe congestive heart failure, end-stage liver disease.
    • Designation is done by BOP’s Office of Medical Determinations and Transportation (OMDT).
      • FCC Butner (other than Low, FMC) NC.
      • USP Terre Haute (Minimum, Medium & High) IA.
      • USP Tucson FCC (Female); AZ.
      • FCI Terminal Island (Low) CA.
      • FCI, Med, USP: Allenwood, Pa.
      • FCI Tucson,[Medium w/Detention Ctr] AZ.
  • Medical CARE LEVEL IV [Hospitalization required]
    • Functioning is severely impaired.
    • Requires 24-hour skilled nursing care or assistance.
    • Examples: cancer on active treatment, dialysis, quadriplegia, stroke or head injury patients, major surgical patients, acute psychiatric illness requiring inpatient treatment, high-risk pregnancy.
    • Requesting a CARE LEVEL IV placement should be carefully considered as the inmates there are of all security levels, including both violent and non-violent offenders.
    • There are seven Federal Medical Centers (A brief overview)
      • FMC Butner (North Carolina); the cancer center for the BOP, provides inpatient mental healthcare and houses all security levels.
      • FMC Carswell (Texas); the only facility just for women.
      • FMC Devens (Massachusetts); provides dialysis, one of several facilities that provide a residential sex offender program, along with inpatient mental healthcare.
      • FMC Forth Worth (Texas)
      • FMC Lexington (Kentucky); for lower security inmates.
      • FMC Rochester (Minnesota); contracted with the Mayo Clinic providing all levels of complex medical care along with inpatient mental healthcare.
      • FMC, Springfield (Missouri); higher security, dialysis and inpatient mental healthcare services.

II         Mental Healthcare (MH) – CARE LEVELS I-IV

(Location Levels I-IV are the same as above)

Unfortunately, in general the BOP is not equipped to provide any meaningful treatment for the following underlying disorders, several examples:

□ Post-traumatic stress disorder

□ Major depressive

□ Bipolar

□ (Eye Movement Desensitization and Reprocessing) for treatment of PTSD is not available.

As medical staffing differs from one facility to another, and if the care by chance is available within the BOP; this  may necessitate a transfer to a facility further away from their home.

*Alan Ellis and J. Michael Henderson (July 19, 2018); How To Do Time- Part IV.

  • MH CARE LEVEL I[under 70, healthy with limited medical visits]
    • No Remarkable Issues, no significant level of functional impairment.
    • No history of regular Mental Illness Interventions, seeking help should there be a returning episode.
  • MH CARE LEVEL II [the majority of BOP facilities, overall healthy with routine medical visits)
    • ‘Routine and/or Infrequent Crisis Oriented Outpatient’ Care.
    • Treatments Controlled with medication.
    • May require suicide watch or brief observation.

For those inmates with Medical (and Mental Healthcare) Care Levels 3 and 4, the designation decision will be made by The Office of Medical Determinations and Transportation (OMDT).

  • MH CARE LEVEL III [outpatient care, not able to perform ADL]
    • ‘More Severe Outpatient’ or Residential Mental Healthcare.
    • May require weekly mental healthcare visits or Residential Psychology Treatments.
  • MH CARE LEVEL IV [Hospitalization required]
    • ‘Inpatient’ Psychiatrist Monitored, includes those who are:
      • Gravely disabled and cannot function in general population as in MH Care Level III.
      • Has a current or recent historical need for inpatient psychiatric care.
      • Requires psychotropic medication control may require MH Care Level IV.
      • Requesting a CARE LEVEL IV placement should be carefully considered as the inmates there are of all security levels that includes both violent and non-violent offenders.


UpToDate – A Medical Resource

An evidence-based clinical decision support resource that is authored and peer-reviewed exclusively by physicians who are recognized experts in their medical specialties.

Probation Officers: their impact on the PSR and final prison placement

Probation officers representing the court will:

  • Receive and evaluate pre-sentence investigation requests.
  • Identify and pursue leads to obtain evidence.
  • Gather and document evidence by interviewing involved parties, obtaining statements, reviewing and analyzing records and files, etc.
  • Gather criminal history, police reports, victim impact statements, criminal complaints and information and review prior to interview with offender.
  • Inform crime victims of their rights.
  • Assist the victim advocates in coordinating victim requests for offender information; victim issues such as recovery from injury, financial losses, or victim mediation; preparation of victim impact statements and reports; communicate offender progress and victim assistance to various local, state, and federal officials, and to treatment staff.
  • Conduct offender criminal history checks, warrant inquiries, and driver’s license abstract checks.
  • Compile and maintain history and case records.
  • Inform offenders of their rights, responsibilities, and purposes of the pre-sentence investigation process.
  • Interview offenders required by the courts to have a pre-sentence investigation completed.
  • Utilize PSI interview guide and the Criminogenic Domains of Criminal History, Education/Employment, Financial, Family/Marital, Accommodation, Leisure/Recreation, Companions, Alcohol/Drug, Emotional/Personal, and Attitude/Orientation.
  • Complete various extensive assessment tools to gauge offender risk and needs.
  • Collect PSI fees.
  • Coordinate investigations with other law enforcement agencies, regulatory agencies, and other relevant entities.
  • Confirm information gathered during interview.
  • Communicate with the appropriate Department of Corrections and Rehabilitation staff, other state agencies, related organizations, other entities, volunteers, and the public to provide information, referral services, technical advice and consultation regarding PSI.
  • Communicate with Courts, attorneys, law enforcement, and other agencies involved in a court-ordered pre-sentence investigation.
  • Document interview and investigation.
  • Prepare investigative reports and recommend administrative, legal, and/or sentencing action.
  • Present evidence to prosecutors, legal staff, or courts.
  • Prepare and present testimony as required for legal proceedings or administrative hearings.
  • Report offender compliance with the presentence investigation to courts.
  • Summarize information gathered during investigation and interview into the pre-sentence format.
  • Make sentencing recommendations based on sentencing guidelines and a thorough analysis of criminal history, medical and mental healthcare history allowing for continuity of care, medication availability, offender risks, resources, and evidence-based practices.
  • Ensure the report is distributed according to Applicable Code standards.
  • Monitor programs for compliance with state and federal laws compliance.
  • Gather, compile, and maintain statistics for required and requested reports.
  • Investigate and confirm the information on offender release plans or interstate compact investigations. Maintain working knowledge of the Department of Correction and Rehabilitation (DOCR) programs and community bases programs that are available for offenders.

Note: The duties of probation officers listed above are not intended to be all-inclusive.

BOP BRAVE Program – For Those New To Federal Prison

BOP BRAVE Program is a 6 month program designed to facilitate favorable initial adjustment to incarceration – for young males new to federal prison, serving their first sentence in a medium facility.  Photo Credit: The Marshall Project


BOP Brave Program – Admission Criteria:

I- Designed for medium security male inmates.

II- The inmate is 32 years old or younger.

III- They will be serving a sentence of 60 months or more, and is their 1st time in the BOP.

IV- The program is assigned at the beginning of their sentence.

The responsibility for your client’s mental and physical health should be safe guarded in order to protect them from themselves (and others), while providing a safe environment for the duration of their incarceration.

This should be the responsibility of legal council, the court and BOP.


The BRAVE Program is located at the following federal prison facilities: * 240.888.7778

  Federal PSR/Sentencing Preparation Software