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Contract health care services; reimbursement and Medicare allowable rates--Bureau of Prisons, Dept. of Justice. Notice.

The Bureau of Prisons is issuing this Statement of Policy to inform the public that when it becomes necessary to supplement the direct delivery system of health care the Bureau provides to persons committed to its custody, the Bureau ordinarily will contract to purchase health services only with those hospitals, physicians and other health care providers which agree to accept, as payment in full, reimbursement at rates no higher than the prevailing Medicare allowable rates (including deductibles and co-payments). This encompasses those rates established by the Health Care Financing Administration as "sole community providers" or "regional referral centers". The Bureau will phase this policy into the administration of its contract health services program.

Contract Services↗

Pharmaceutical services at a U.S. Bureau of Prisons facility.

This article describes a typical Bureau of Prisons (BOP) medical department at a medium-security federal correctional institution. Details of the daily activities of a pharmacist-practitioner--performing the traditional pharmaceutical services and providing primary patient care to the inmate population--are recounted. The author shows that practicing this unique dual role of a pharmacist-practitioner in a BOP medical facility is a valuable asset to the medical staff and is not only an experience in medicine, but an experience in life as well.

Medication Systems↗

Evaluation of The Federal Bureau of Prisons protocol for selection of which hepatitis C-infected inmates are considered for treatment.

The Federal Bureau of Prisons limits hepatitis C therapy to those inmates with certain biochemical abnormalities. To evaluate this protocol, an analysis was done on data collected on hepatitis C infected inmates in the Louisiana Department of Corrections. A quality assurance database of hepatitis C infected inmates evaluated in the Louisiana Department of Corrections was reviewed for liver biopsy and laboratory results. Patients were compared as to whether they would have been biopsied under the Federal Bureau of Prisons protocol and if there were histologic differences between those who would and those who would not have been biopsied. Of 490 inmates biopsied, 26% (129) had an alanine aminotransferase level between one and two times the upper limit of normal without other biochemical abnormalities. If treating stages 2-4, 48% of these would qualify for treatment (15% if treating stages 3-4). There was no statistical difference between this group and either the group with an alanine aminotransferase level between one and two times the upper limit of normal and with other laboratory abnormalities or the group with an alanine aminotransferase level greater than or equal to two times the upper limit of normal and without other abnormalities. In the Louisiana Department of Corrections, the Federal Bureau of Prisons protocol was neither sensitive nor specific enough at identifying those that should be considered for hepatitis C therapy.

Adult↗

Inmate fees for health care services. Final rule.

The Bureau of Prisons (Bureau) finalizes rules describing procedures we will follow for charging inmates fees for certain kinds of health services, as required under the Federal Prisoner Health Care Copayment Act of 2000 (Pub. L. 106-294, October 12, 2000, 114 Stat 1038, codified at 18 U.S.C. 4048).

Civil Rights↗

Tuberculosis and HIV infection in new inmates in Federal Bureau of Prisons facilities.

A significant change in the manner in which medical data were managed in the Federal Bureau of Prisons (BOP) occurred in calendar year 1992 (CY 92). Prior to CY 92, all BOP medical data were stored only as hard copy medical records. Beginning with CY 92, medical records data for all inmates have been transcribed to magnetic tape using the BOP SENTRY system. This study was an initial attempt to determine if this innovation would permit the development of meaningful infectious diseases data on BOP inmates. Our objective was to define the prevalence of tuberculosis (TB) skin test positivity, active TB, and HIV infection in new BOP inmates in CY 92 and to compare the new inmate population with the total BOP 1992 prisoner population. This initial study is important for two reasons: (1) the BOP SENTRY system for demographic and medical data was found to be a feasible tool for disease surveillance purposes; and (2) the 1992 new inmate population had much greater prevalences of purified protein derivative positivity, active TB, and HIV infection compared to the total BOP population. These findings may signal an increase in serious infectious diseases in BOP prisoners.

AIDS Serodiagnosis↗

Self-reported tuberculin skin testing among Indian Health Service and Federal Bureau of Prisons dentists, 1993.

Surveillance of health-care workers (HCWs) for tuberculosis (TB) and assessment of TB transmission through routine periodic screening with tuberculin skin tests (TSTs) are essential components of effective TB-control programs in health-care settings (1). Based on TST results, risk for acquiring new infections can be assessed and infection-control practices modified accordingly. In 1993, a self-administered mail survey was conducted to characterize the TST practices and results among dentists in the Indian Health Service (IHS) and the Federal Bureau of Prisons (FBoP). This report summarizes the findings of the survey.

Dentists↗

Drug abuse treatment programs in the Federal Bureau of Prisons: initiatives for the 1990s.

Developing high-quality treatment programs is a foreboding challenge in any setting, particularly within a correctional setting. The groundwork has been established for one of the most comprehensive, longitudinal evaluations ever conducted with correctional populations regarding the effectiveness of professionally managed treatment programs. The long-term outcome evaluations should provide information regarding the effectiveness of a multitiered intervention strategy within the correctional setting. This kind of evaluation is reflected in the proposal for the evaluation of the BOP Drug Abuse Treatment Programs, submitted to NIDA (Federal Bureau of Prisons 1990). In the months and years ahead the study is expected to yield important information that will advance knowledge of substance abuse treatment.

Humans↗

Substance abuse treatment options: a federal initiative.

Pervasive drug enforcement efforts and new federal sentencing guidelines have led to an increase in substance abusers entering the federal prisons. Although the Federal Bureau of Prisons (BOP) has been committed to providing substance abuse treatment since the 1960s, a comprehensive expansion of its programs was necessary so that quality services could be provided for the growing drug-offender population. This article describes the BOP's six-part drug treatment strategy, which includes screening, education, residential treatment, nonresidential treatment, transitional treatment, and evaluation. The programs entail a biopsychosocial model and a multiphasic approach to comply with the BOP's goal of preparing inmates for a successful reentry into the community, free from criminal and substance-abusing behaviors.

Humans↗

Hepatitis B vaccination practices in state and federal prisons.

OBJECTIVE: Incarcerated populations are a group at high risk for hepatitis B. About 30% of people experiencing acute hepatitis B virus infection (HBV) have a history of incarceration. Offering routine HBV vaccinations to incarcerated individuals could have a significant effect on public health. The objective of this study is to identify current vaccine practices and the perceived feasibility of routine vaccinations for hepatitis B within correctional settings. METHOD: The authors surveyed the medical directors of state correctional facilities in all 50 states and the federal prison system regarding current HBV vaccine practices. Surveys were faxed or mailed between July 1 and September 1, 2000. RESULTS: Thirty-five states and the federal system responded (response rate = 70.6%). These systems account for 77% of all inmates in federal or state prisons and jails. Two states give hepatitis B vaccine routinely, nine states offer no hepatitis B vaccine, and 26 states and the Federal Bureau of Prisons offer hepatitis vaccine to some inmates. Most states do not spend enough money to vaccinate even those prisoners at highest risk. Under the Vaccine for Children program, 19,520 youths could receive vaccine immediately. According to the respondents, if vaccine were available at no-cost, 25 states and the Federal Bureau of Prisons would routinely offer vaccination to all inmates. CONCLUSIONS: Most correctional systems do not routinely offer vaccine to their incarcerated populations, but would if funds were available. There exists now a unique public health opportunity to prevent a significant proportion of new hepatitis B infections.

Adolescent↗

The Federal Prisons' Mental Health Program 1930-1985.

This administrative history study examines the evolution of the Federal Bureau of Prisons Mental Health Program from an initial functional reliance on the medical model to expanded parameters of quasi-scientific behavioral and custodial administrative management of inmates.

History, 20th Century↗

Results of a 29-state survey of tuberculosis in nursing homes and correctional facilities.

A survey of the 15,379 cases of tuberculosis reported to the Centers for Disease Control and Prevention by 29 State health departments in 1984 and 1985 revealed that 7.7 percent of the victims older than age 64 were living in a nursing home at the time of diagnosis and 1.8 percent between the ages of 15 and 64 were living in a correctional institution at the time of diagnosis. Incidence rates of tuberculosis for residents of nursing homes and for inmates of Federal and State prisons and local jails were estimated using denominators derived from institutional population counts provided by the National Center for Health Statistics and by the Department of Justice, Bureau of Justice Statistics, and Bureau of Prisons. The aggregate tuberculosis incidence rate for nursing home residents in the 29 States was 1.8 times higher than the rate seen in elderly persons who were living in the community (95 percent confidence interval on the relative risk 1.64, 2.02). The aggregate tuberculosis incidence rate for inmates in correctional facilities was 3.9 times higher than the rate for persons of a similar age who were not incarcerated (95 percent confidence interval on the relative risk 3.35, 4.49). Strengths and limitations of the design and implications of the first survey of tuberculosis incidence, in a large number of States, among residents of nursing homes and correctional facilities are discussed.

Adolescent↗