The BOP has developed and issued the following program statements that provide BOP policy and guidance related to the provision of medical, dental, and mental health services to BOP inmates.

P6010.02 Health Services Administration — requires the BOP to deliver necessary health care to inmates effectively in accordance with proven standards of care without compromising public safety concerns inherent to the BOP’s overall mission.

P6013.01 Health Services Quality Improvement —requires the BOP to establish an outcome-based quality improvement system in the health care programs at every BOP institution.

P6031.01 Patient Care — requires the BOP to effectively deliver medically necessary health care to inmates in accordance with proven standards of care without compromising public safety concerns inherent to the agency’s overall mission. The statement requires every BOP institution to establish a Utilization Review committee chaired by the Clinical Director to review:

• outside medical, surgical, and dental procedures;
• requests for specialist evaluations, in-house or escorted trips to the specialist’s office;
• requests for “Limited Medical Value” treatments and procedures;
• retrospective review of all cases sent to the community hospital during hours when no health care provider was on duty at the institution;
• case considerations for extraordinary care;
• concurrent review of inpatients at community hospitals; and
• other services the primary care provider or the Clinical Director have recommended.

P6031.02 Inmate Copayment Program — provides that the BOP may under certain circumstances charge an inmate under the BOP’s custody, a fee for providing inmate health care services. However, inmates are not to be denied access to necessary health care because of the inmate’s inability to pay the copay fee.

P6270.01 Medical Designations and Referral Services for Federal Prisoners — specifies procedures and criteria for transporting inmates who require medical care. The Central Office Medical Designator, Office of Medical Designations and Transportation, makes medical designations, referrals, and denials based on:

• urgency of need;
• cost-effectiveness;
• BOP institution capabilities;
• expected service period, including recuperation;
• current bed space availability;
• security; and
• consultation with BOP physicians at the sending and receiving institutions.

P6090.01 Health Information Management — provides guidance for ensuring that accurate and complete health records and qualified health record practitioners are available for delivering health services.

P6400.02 Dental Services — requires the BOP to stabilize and maintain the oral health of inmates in BOP institutions. Dental care is to be conservative, providing necessary treatment for the greatest number of inmates within available resources. Dental care should be provided to inmates by health care providers, who provide quality care consistent with professional standards.

P6340.04 Psychiatric Services — requires the BOP to provide psychiatric services that address the physical, medical, psychological, social, vocational and rehabilitative needs of inmates in the BOP’s custody who suffer from mental illnesses and disorders.

P6360.01 Pharmacy Services — requires the BOP to provide inmates access to quality, necessary, cost-effective pharmaceutical care.

P6370.01 Laboratory Services — provides guidance to ensure that laboratory services will be regularly available to meet the needs of inmates at all BOP institutions.

P6541.02 Over-the-Counter Medications — establishes a program allowing inmates improved access to over-the-counter medications. The statement provides that inmates may buy over-the-counter medications that are available at the institution commissary. Inmates may also obtain over-the-counter medications at sick call if the inmate does not already have the medication and if: (1) health services staff determine that the inmate has an immediate medical need which must be addressed before his or her regularly scheduled commissary visit, or (2) the inmate does not have funds to purchase the medication at the commissary.

P6027.01 Health Care Provider Credential Verification, Privileges, and Practice Agreement Program — provides that each Health Services Unit will ensure that professional credentials for all health care providers inside the institution are verified at the primary source (the issuer of the credential). Providers include BOP staff, Public Health Services (PHS) staff, part-time staff, contract and consultant staff, and those who provide a diagnosis or treatment using tele-health.

P6021.04 Commissioned Officer Student Training Extern Program (COSTEP) — encourages all BOP institutions to actively consider the COSTEP Program of the PHS as a viable recruitment supplement. The objectives of using COSTEPs are:

• eligible COSTEP students will be recruited for health care work in BOP facilities, and

• some COSTEP students will return to careers in the BOP after graduation.

P6190.03 Infectious Disease Management — provides that the BOP will manage infectious disease in the confined environment of a correctional setting through a comprehensive approach which includes testing, appropriate treatment, prevention, education, and infection control measures.

P6070.05 Birth Control, Pregnancy, Child Placement and Abortion — establishes guidance for BOP institutions to provide inmates with medical and social services related to birth control, pregnancy, child placement, and abortion.

P6590.07 Alcohol Surveillance and Testing Program — requires the BOP to maintain a surveillance program to deter and detect the illegal introduction or use of alcohol in its institutions.

P6080.01 Autopsies — provides that the Warden of a BOP institution may order an autopsy and related scientific or medical tests to be performed when:

• in the event of homicide, suicide, fatal illness or accident, or unexplained death, the Warden determines that the autopsy or test is necessary to detect a crime, maintain discipline, protect the health or safety of other inmates, remedy official misconduct, or defend the United States or its employees from civil liability arising from the administration of the facility; or

• the Warden obtains the written consent of a person (coroner, next-of-kin, the decedent’s consent in the case of tissue removed for transplanting) authorized to permit the autopsy or post-mortem operation under the law of the State in which the facility is located.

P6311.04 Plastic Surgery and Identification Records — provides that the BOP does not ordinarily perform plastic surgery on inmates to correct preexisting disfigurements (including tattoos) on any part of the body. In circumstances where plastic surgery is a component of a presently medically necessary standard of treatment (for example, part of the treatment for facial lacerations or for mastectomies due to cancer) or it is necessary for the good order and security of the institution, the necessary surgery may be performed.

6010.01 Psychiatric Treatment and Medications, Administrative Safeguards for — provides guidelines for providing administrative safeguards for psychiatric treatment and medication.

P6060.08 Urine Surveillance and Narcotic Identification — requires that BOP institutions must establish programs of urine testing for drug use to monitor specific groups or individual inmates who are considered as high risk for drug use, such as those in community activities, those with a history of drug use, and those inmates specifically suspected of drug use.