The information in this series and on PPRSUS.com (and PPRSUS Resources) is readily accessible and completely Free to all. Should you wish to engage my services, my contact information is at the end.

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Long before the Presentence Interview (PSI),

·      Preparation includes understanding the four levels of medical care and providing all relevant information clearly defined before your interview.

·      No matter how insignificant or long-ago the medical care was provided, it should be seriously considered to be included.

BOP COVID-19 Modified Operational Level Indicators are raised or lowered after 48 hours of respective sustained increases or decreases in the following indicators:

·      Level 1 Minimal, No isolation required

·      Level 2 {Yellow}, Medical isolation rate from 2% to less than 7%, Facility vaccination rate from 50% to less than 65%, or Community transmission rate is 50-99 per 100,000 over the last seven days.

·      Level 3, Medical isolation rate greater than (or equal to) 7%, Facility vaccination rate less than 50%, or Community transmission rate greater than (or equal to)100 per 100,000 over the last seven days.

BOP CARE LEVELS Range from ‘I’ (the healthiest) to CARE LEVEL  ‘IV’ (those needing inpatient care.)

• Inmates are generally healthy but may have limited medical needs that can be easily managed by clinician evaluations every six months.
• Inmates are less than 70 years of age.
• Examples: mild asthma or diet-controlled diabetes not requiring medications.
• Community Hospital Medical centers may be located over one hour away.

Medical Health CARE LEVEL II (the majority of BOP facilities)

• Inmates are stable outpatients who require at least quarterly clinician evaluations.
• It can be managed in chronic care clinics, including mental health issues.
• Examples: medication-controlled diabetes, epilepsy, and emphysema.
• Hospital Medical centers may be located within one hour of the facility.

Medical Health CARE LEVEL III

• Inmates are fragile outpatients who require frequent clinical contact to prevent hospitalization.
• They may require some assistance with activities of daily living (BOP Program Statement 5200.05, page 2) but do not need daily nursing care.
• Examples: cancer in remission of less than one year, advanced HIV disease, severe mental illness in remission on medication, severe congestive heart failure, and end-stage liver disease.
• The designation is done by BOP’s Office of Medical Determinations and Transportation (OMDT).

Medical Health CARE LEVEL IV

• Functioning is severely impaired.
• Cannot perform Activities of Daily Living (ADL), such as caring for oneself, performing manual tasks, eating, sleeping, walking, standing, sitting, reaching, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, bathing, and cleaning oneself.
• Requires 24-hour skilled nursing care or nursing assistance.
• Examples: cancer on active treatment, dialysis, quadriplegia, stroke or head injury patients, major surgical patients, acute psychiatric illness requiring inpatient treatment, and high-risk pregnancy.
• BOP’s OMDT does the designation.
• There are seven Federal Medical Centers.
  • FMC Butner (North Carolina), the BOP’s cancer center, provides inpatient medical/surgery, mental healthcare, and sex offender treatment programs, as well as housing at all security levels.
  • FMC Carswell (Texas) is 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) is for lower security.
  • FMC Rochester (Minnesota); contracted with the Mayo Clinic, providing all levels of complex medical care and inpatient mental healthcare.
  • FMC, Springfield (Missouri); higher security, dialysis, and inpatient mental healthcare.

The BOP also determines whether a defendant has any medical or mental healthcare needs that will affect their placement. To the extent it will happen, continuity of care in the BOP depends on comprehensive preparation for the Presentence Interview, followed by verifying the final Presentence Report for accuracy.

·      FMC houses all security levels; therefore should not be requested without careful consideration

To engage my services or to have your concerns answered, Call me Today at 240.888.7778. This is my Cell, and I personally answer and return all calls.

You can also get additional information on my website @: PPRSUS.com.