| Program Statement | 6010.06 |
|---|---|
| Subject | Health Services Administration |
| Current edition | September 3, 2026 |
| Change notices | None |
| Supersedes | Program Statement 6010.05, Health Services Administration (6/26/2014) — rescinded |
| Governing regulation | The Program Statement cites none. BOP medical care is regulated at 28 C.F.R. part 549 (Medical Services), subparts A–H |
| Governing statute | 18 U.S.C. § 4042(a)(2); 18 U.S.C. § 4005 (Public Health Service officers) |
| Related BP forms | BP-A0101 Request for Purchase; BP-A0135 Major Equipment Justification; BP-A0352 Inmate Injury Assessment and Follow-up; BP-A0793, BP-A0794, BP-A0823 (staff agreements) |
| Official PDF | https://www.bop.gov/policy/progstat/6010_006.pdf |
Checked against the BOP policy set · 2026-09-19 · How we verify
Program Statement 6010.06 is the Bureau of Prisons’ organizational chart for medical care: who is in charge, how many hours a day someone with medical training has to be in the building, and what accreditation each institution has to hold. It does not tell you how to get seen for a specific problem — for that, start with medical and dental care in federal prison — but it is the document that explains why care at one facility looks nothing like care at another.
This is an umbrella policy, and we treat it as one. Each specific subject below is covered in depth on its own page, linked where it comes up. What this page does is give you the structure, the two numeric rules that actually constrain an institution, and a map of where everything else lives.
The rule itself: health services administration
Most of Program Statement 6010.06 is internal administration — budgets, procurement, staff training funds. Two sections contain rules that bear directly on the care a person receives, and both are short enough to reproduce whole.
Hours of medical coverage
This is the answer to “is there a doctor there at night?”, and it is more nuanced than either yes or no.
14. CONTINUOUS HEALTHCARE COVERAGE
Each institution will devise a method to provide access to 24-hour medical, dental, and mental health care that meet the following conditions:
– Suitable arrangements have been made with a local medical facility for coverage when the Medical Officer of the day is not available. – An emergency transportation system must be available for an inmate requiring emergency care. – The CD and HSA will develop and implement an Institutional Supplement that establishes standard procedures for responding to emergencies that will include Cardiopulmonary Resuscitation (CPR) certified staff in the institution for the hours medical staff are not available. Refer to the Program Statement Patient Care regarding procedures for responding to emergencies 24 hours a day, to include CPR and Automatic External Defibrillator (AED), as well as on-call coverage.
Minimum security institutions and Federal Prisons Camps meeting the criteria listed above may provide 12-hour on-site coverage. This does not include Satellite Prison Camps.
– Scheduling will be in compliance with Program Statement Human Resource Management Manual for schedule types. – All Advance Practice Providers and physicians will be placed on an on-call schedule/rotation that is fair and equitable to provide in-person response or phone support to nurses/paramedics on duty, or custody staff. – Physicians will be scheduled to be available to provide input into more complex inmate cases.
Reproduced from Program Statement 6010.06 at p. 19.
Health care standards
10. HEALTH CARE STANDARDS
Health Services Unit Accreditation. Accreditation will be met by the current accrediting body contracted with the Bureau.
Reproduced from Program Statement 6010.06 at p. 17.
Reading those two rules together
“Access to 24-hour medical, dental, and mental health care” does not mean staffed around the clock. The requirement is that the institution devise a method to provide access at all hours, meeting three conditions: an arrangement with a local medical facility, an emergency transportation system, and an Institution Supplement that puts CPR-certified staff in the institution when medical staff are not. Minimum-security institutions and federal prison camps (not satellite camps) meeting those conditions may limit on-site coverage to 12 hours a day, and every physician and advanced practice provider is on an on-call rotation to respond in person or by phone. The express 16-hour on-site option in the 2014 edition no longer appears. For the hours when no clinician is on site, the medical response is a CPR-certified staff member, a call to the on-call provider, and an ambulance.
That is not a scandal; it is the written rule, and knowing it is the difference between a useful complaint and a futile one. A complaint that “there was no doctor on duty at 2 a.m.” describes ordinary compliance. A complaint that no CPR-certified staff member was in the institution, that there was no arrangement with a local facility, or that there was no emergency transportation system describes a departure from the three conditions on which reduced coverage depends.
Note also the two words that limit everything else: medically necessary. The policy’s stated purpose is “[t]o deliver medically necessary health care to inmates effectively in accordance with proven standards of care without compromising public safety concerns inherent to the overall mission of the Federal Bureau of Prisons (Bureau)” (PS 6010.06 at p. 1). That phrase, not a general entitlement to treatment, is the Bureau’s own framing of what it owes. What counts as medically necessary, and how care is rationed by level, is set out in the patient care policy and in medical designations and care levels.
On accreditation. The 2026 edition no longer names the accrediting bodies; it requires only that accreditation “be met by the current accrediting body contracted with the Bureau” (PS 6010.06 at p. 17). The 2014 edition had required Joint Commission accreditation at Medical Referral Centers, Joint Commission Ambulatory Care accreditation — the standard for an outpatient clinic — everywhere else, and American Correctional Association accreditation for every health services unit. An ordinary federal prison’s health services unit is still a clinic, because that is what it is. Anyone expecting hospital-standard care at a general-population institution is measuring against a standard the Bureau does not claim to meet there.
On this page
Who actually runs health care at a federal prison
The Program Statement sets a chain that is worth knowing by title, because the titles are what you write to.
| Role | What they control | Pin-cite |
|---|---|---|
| Assistant Director, Health Services Division | Holds the Director’s delegated authority for the care and treatment of federal prisoners; directs all activities related to physical and psychiatric care | PS 6010.06 at p. 3 |
| Medical Director | “[T]he final authority for clinical medical health care issues” for the entire Bureau, responsible for all health care delivered by Bureau practitioners and Public Health Service officers (the Clinical Specialty Consultants are now privileged by the Regional Medical Director) | PS 6010.06 at pp. 3–4 |
| Regional Health Systems Administrator (RHSA) | Principal health-care advisor to the Regional Director — and the person who prepares responses to Regional Administrative Remedies (BP-10s) on medical issues | PS 6010.06 at pp. 4–5 |
| Clinical Director (CD) | Oversight of clinical care at the institution; clinical supervisor for advanced practice providers, pharmacists with collaborative practice agreements and other clinical staff (the HSA or AHSA is the APPs’ administrative supervisor); reviews, initials and dates all outside hospital and operative reports | PS 6010.06 at pp. 5–7 |
| Health Services Administrator (HSA) | All administration of the department — supervision, procurement, supply, health records, and the ancillary departments (pharmacy, unless placed under the Clinical Director, laboratory, radiology, therapy services and social work) | PS 6010.06 at pp. 7–8 |
Compiled from Program Statement 6010.06 at the pages cited.
Three practical points follow.
The Clinical Director and the Health Services Administrator report to the Warden or Associate Warden, and the policy names them as “the direct avenues of communication between Health Services and the Warden or designee, Regional Office, and Central Office” (PS 6010.06 at pp. 5, 8). They are the correct addressees for a health-care problem inside an institution.
The RHSA writes the medical BP-10s. That single line at p. 5 tells you something useful: when a medical administrative remedy goes to the region, it is not a warden or a lawyer answering it but a regional health administrator. Framing a BP-10 in clinical terms — what was ordered, what was not done, what the record shows — speaks to the person who will actually read it. See administrative remedy program.
The patient’s medical needs are supposed to win, and the policy says so. “On occasion, there may be incompatibility between medical and correctional guidelines; conflicts related to medical care should be resolved, as far as practical, to meet the inmate’s primary medical needs. At the same time, medical staff must remain committed to the correctional mission of the institution” (PS 6010.06 at p. 2). That is the Bureau’s own instruction to its staff. It is a useful sentence to quote back in a remedy where a clinical recommendation was overridden for correctional convenience — while remembering it is policy, hedged with “as far as practical,” and not an enforceable right.
Where each medical subject actually lives
Federal prison medical care is regulated at 28 C.F.R. part 549, titled Medical Services, which contains eight subparts. Program Statement 6010.06 is the administrative wrapper; each subpart has its own implementing Program Statement and its own page here. If you arrived looking for a specific answer, this table is the fastest route to it.
| 28 C.F.R. part 549 subpart | Subject | Where we cover it |
|---|---|---|
| A | Infectious Disease Management (§§ 549.10–549.15) | Infection Prevention and Control (PS 6190.05) |
| B | Over-The-Counter (OTC) Medications | Over-the-counter medications (PS 6541.03) |
| C | Psychiatric Evaluation and Treatment | Psychiatric services (PS 6340.04) and mental illness treatment and care |
| D | Plastic Surgery | No dedicated page yet |
| E | Hunger Strikes, Inmate | Hunger strikes (PS 5562.05) |
| F | Fees for Health Care Services | Inmate copayment program (PS 6032.01) |
| G | Authority To Conduct Autopsies (§ 549.80) | Autopsies (PS 6080.02) |
| H | Civil Commitment of a Sexually Dangerous Person | Civil commitment of sexually dangerous persons |
Subpart titles verified against 28 C.F.R. part 549 as published on ecfr.gov.
Several major subjects sit outside part 549 entirely and have their own policies: patient care (PS 6031.06 — the core clinical policy), dental services (PS 6400.03), pharmacy services (PS 6360.03), medical records access (PS 6090.04, Health Information Management), medical designations and care levels (PS 6270.02), and psychology services (PS 5310.17).
What inmate workers are forbidden to do — and why it matters for your privacy
Every federal prison staffs its health services unit partly with inmate orderlies. Program Statement 6010.06 draws the boundary, and the list is unusually specific. The Bureau’s policy directs that inmates will not be assigned to:
(1) The pharmacy and medical storeroom, or jobs involving the handling or processing of, or having potential for access to, pharmaceuticals and medical supplies. Inmates may perform janitorial services in these areas under direct supervision.
(2) Areas where they will have access to health records, including blank copies of records or records to be shredded, forms, or documents that will become part of the health record. This includes any assignment where reasonable potential for access to a health record exists, not only assignments located in the health records section, but also assignments such as clerks to physicians, laboratory and x-ray clerks, and similar areas.
(3) Functions involving the scheduling of appointments or any other tasks with potential for determining access to medical care.
(4) Jobs as clinic assistants or other medical assistants involving responsibility for direct treatment procedures such as administering medication, applying liquids or ointments, administering medical soaks, dressing changes, irrigating tubes, removing sutures, venipuncture, providing inhalation therapy, obtaining vital signs, etc.
(5) Duties as scrub nurse or assistant, or any other duties that involve physical presence in the operating room during surgery.
(6) Carry out clinical tests or measurements, such as audiometric testing, pulmonary function studies, electrocardiograms, refractions, etc. Inmates may not have access to the reports of such tests. Additionally, inmate workers may not be present during any x-ray procedure, including positioning inmates on the x-ray table and setting the dials for exposure. This prohibition includes inmate workers developing x-rays as well as having access to x-rays and x-ray reports.
(7) Situations involving formal clinical contacts between staff and inmates, such as triage/sick call visits and other medical appointments. Exceptions would include emergency treatment or testing in which assistance of inmate workers is necessary, or interpretation when no staff member can speak the inmate’s native language.
(8) Inmates will not assist consultants in any way.
Reproduced from Program Statement 6010.06 at p. 13.
The policy adds that inmates “with skills as physicians, dentists, nurses, and any other health care areas will not be assigned to the HSU,” that “[a]t no time are inmates permitted to document anything in the medical record,” and that inmates “with an active mental health diagnosis undergoing treatment must be cleared by both health services and psychology prior to being assigned as an inmate attendant” (PS 6010.06 at pp. 13–14).
What inmates may do is narrow: janitorial work under direct observation in sensitive areas, work in the dental clinic under the dental policy, service as trained attendants doing things like feeding patients, assisting with transport, changing linen and cleaning rooms, service as suicide-watch companions under the Suicide Prevention Program, work as hospice workers at institutions with hospice programs, and participation in the Medical Inmate Companion Program (PS 6010.06 at pp. 13–14).
This section is the answer to a question people ask constantly and rarely get answered: can another inmate see my medical file, or find out why I was at sick call? Under the Bureau’s own policy, no — an inmate is not supposed to have access to health records, to appointment scheduling, or to be present during a clinical encounter except as an emergency helper or an interpreter. If any of those things is happening, it is a departure from written policy and it is documentable.
Applied Insight — Christopher Zoukis, JD, MBA, Managing Director: When a client tells us their medical information is circulating on the compound, the productive question is not who talked. It is which of the eight prohibited assignments in this section is being staffed by an inmate at that institution — the records area, the scheduling function, the x-ray clerk desk. Those are duty rosters, and duty rosters are records. A remedy that names the assignment and cites the section is answerable; one that alleges a rumor is not.
What Health Services has to produce for a compassionate release request
The 2014 edition of this policy told families what the medical half of a compassionate release packet had to contain. The 2026 edition drops that list: section 13 now says only that institutions may request a reduction in sentence for “extraordinary and compelling medical conditions” and refers staff to the compassionate release policy (PS 6010.06 at pp. 18–19). The requirement now lives there: the Warden’s referral must include “[a]ll pertinent medical records if the reason for the request involves the inmate’s health,” including “at a minimum, a Comprehensive Medical Summary by the attending physician, which must also include an estimate of life expectancy, and all relevant test results, consultations, and referral reports/opinions” (PS 5050.51 at p. 10). For reference, the 2014 edition said the Health Services Unit “must provide a comprehensive medical summary that will include”:
– An estimate of life expectancy or a statement that life expectancy is indeterminate. – The level or degree of functionality. – All relevant test results. – All relevant consultations. – Referral reports/opinions from which the medical assessment was made. – The level of self-participation in activities of daily living.
The 2014 edition added that other helpful information “may” include whether the person is in a hospice program, what pain medication is being taken and how often, weight loss, frequency of hospitalization, mental status, mobility status, and any requirement for supplemental oxygen.
Reproduced from the rescinded Program Statement 6010.05 (June 26, 2014) at p. 20.
That list is worth having in front of you when a request stalls. If a warden’s referral packet lacks a life-expectancy estimate or the relevant test results and consultations, the Bureau’s own compassionate release policy says they should be there. Nothing about that makes a reduction likely, and no one can tell you whether any particular request will succeed — but an incomplete medical summary is a concrete, fixable defect rather than a mystery. The substantive law and procedure are covered on our compassionate release pages, and the first procedural step is the request to the warden and exhaustion.
One caution about this section. Its statutory citation is out of date, and materially so — see “What changed” below.
What health services administration means for you
If you are the person inside: know your coverage package
Two things here are usable. First, know your institution’s coverage pattern. If the health services unit closes at a fixed hour, that is probably reduced on-site coverage under the institution’s method for 24-hour access, and it is permitted — but only if the three conditions are met. Second, address problems to the Clinical Director for anything clinical and the Health Services Administrator for anything administrative (missed appointment, records, supply, an ancillary department). Sending everything to the warden slows it down. An Inmate Request to Staff addressed by title is the ordinary first step, and it is also what creates the paper trail an administrative remedy later rests on.
If you are the family: the vocabulary this policy gives you
The most useful thing this policy gives you is a vocabulary. When you call an institution, “I would like to speak to the Health Services Administrator” and “has the Clinical Director reviewed this?” are questions that route. “The doctor” is not a title at a federal prison and often does not exist as a full-time on-site position.
The second most useful thing is calibration. A general-population federal prison runs an accredited outpatient clinic, not a hospital. If your relative needs a level of care beyond that, the mechanism is not more complaining at the institution — it is a medical designation or referral to a Medical Referral Center, which is a different process governed by medical designations and care levels. See also medical care levels in federal prison and federal medical centers.
If you are counsel: health services administration
This policy is a source of institution-level records that exist independent of any individual medical file. The health services unit maintains a daily health services activity log; at general-population institutions it must contain, at minimum, any outpatient census, admissions to community hospitals, all injuries other than minor requiring care, and any equipment and physical plant failures. At Medical Referral Centers the log additionally records inpatient census at the beginning of each shift, admissions of seriously ill inmates, and admissions with unusual signs and symptoms (PS 6010.06 at pp. 17–18). The HSA also reviews the Health Services dashboard weekly, covering use of healthcare services by category, referrals to specialty consultants, prescriptions written, laboratory and x-ray tests completed, observation room admissions, on- and off-site hospital admissions, and “[s]erious injuries or illnesses, deaths, and off-site transports” (PS 6010.06 at p. 8).
Two further hooks. Section 12 provides that where an institution cannot comply with a health services policy “due to some unique condition, the Warden must request a formal waiver,” which must state the problem and attempted solutions, and that if approved “the documentation will be maintained with each copy of the appropriate health services policy in the institution” (PS 6010.06 at p. 18). A granted waiver is a written document held at the institution. And Section 15 requires a standard written plan for 24-hour emergency medical, dental, and mental health care addressing eight enumerated items, and two emergency mass casualty exercises per year, each critiqued, with summary documentation maintained by the HSA or designee (PS 6010.06 at pp. 19–20). The 2026 edition also requires an Institution Supplement setting standard procedures for responding to emergencies 24 hours a day (at p. 2).
Note finally that this Program Statement cites no 28 C.F.R. provision as its own authority. Its statutory footing is the Bureau’s general duty under 18 U.S.C. § 4042(a)(2) to “provide suitable quarters and provide for the safekeeping, care, and subsistence” of federal prisoners, together with 18 U.S.C. § 4005, which the policy invokes at p. 4 as the authority under which Public Health Service officers are detailed to the Bureau to furnish medical care.
What changed with Program Statement 6010.06
Program Statement 6010.06 took effect September 3, 2026, rescinding Program Statement 6010.05 (6/26/2014). Its Summary of Changes lists three changes:
– Added the requirement of an Institution Supplement regarding standard procedures for responding to emergencies 24 hours a day. – Updated language regarding clinical supervisory functions for APPs. – Updated with additional language for types of nursing positions and responsibilities.
Reproduced from Program Statement 6010.06 at p. 1.
The 2014 edition’s one substantive change had removed the requirement that consulting physicians and dentists be licensed “in the state where services are provided,” which is why the specialist who sees you inside a federal prison may hold a license in a different state entirely. The 2026 edition keeps the core rule that only consultant medical staff “holding an appropriate current license and offering evidence of training or experience, current competence, professional ethics, and health status” be considered, applies it to outside telehealth services not provided by a federal agency, and requires the HSA to ensure primary source verification of each applicant’s license and education (PS 6010.06 at p. 12).
The reissue came after twelve years in which the 2014 edition stood still while everything around it changed: the Bureau reissued Patient Care as 6031.06 effective 22 June 2026, and Autopsies (6080.02), Infection Prevention and Control (6190.05) and the death-notification policy (5553.09) all effective 7 May 2026.
The 2026 reference list names cross-referenced policies by title rather than by number and date (PS 6010.06 at p. 25), so it no longer points to superseded editions the way the 2014 list did (P6031.04 Patient Care, P6270.01 Medical Designations, P6360.01 Pharmacy Services, P6400.02 Dental Services and P5050.49 Compassionate Release). Always check the current edition of a cross-referenced policy.
And one citation in it is not merely stale but repealed. Section 13 frames compassionate release under “18 U.S.C. §§ 3582 (c)(1)(A)(i) & 4205(g)”. Section 4205 was part of a block that Congress repealed: the U.S. Code carries the entry “[§§ 4201 to 4218. Repealed. Pub. L. 98–473, title II, § 218(a)(5), Oct. 12, 1984, 98 Stat. 2027]”, with the chapter kept alive only for a transitional period after November 1, 1987 for prisoners sentenced under the old parole regime. See the repeal entry for §§ 4201 to 4218. For anyone sentenced for conduct on or after November 1, 1987 — which is essentially everyone in federal prison today — the operative provision is 18 U.S.C. § 3582(c)(1)(A) alone, as amended by the First Step Act. The § 4205(g) reference is a survival from the “old law” era and is not a second route for a modern sentence.
Where people get stuck when there is no doctor on site
“There is no doctor here.” Often true, and often compliant. Ask instead: is there an arrangement with a local medical facility for the uncovered hours; is there an emergency transportation system; is there an Institution Supplement that puts CPR-certified staff in the institution when medical staff are not, with a provider on call. Those three are the conditions on which reduced on-site coverage depends (PS 6010.06 at p. 19). A grievance that names them is answerable; one that names the absence of a physician at midnight generally is not.
“I keep writing the warden and nothing happens.” Health care problems route through the Clinical Director and the Health Services Administrator, whom the policy names as the direct avenues of communication. Try informal resolution with Health Services staff first, then a BP-9 to the warden, then a BP-10 to the region — where an RHSA, a health administrator rather than a lawyer, prepares the response — then a BP-11 to Central Office. Time limits apply at every step and they are short. The administrative remedy program page sets out the deadlines.
“They told me the policy doesn’t apply at this institution.” That may be literally correct, and there is a document to ask for. Section 12 requires the warden to request a formal waiver to a health services policy, routed through the Regional Director and approved by the Assistant Director, Health Services Division, for areas health services policy authorizes and by the Director for everything else, with the documentation “maintained with each copy of the appropriate health services policy in the institution.” No changes may be made until written approval is received. If an institution says a policy does not apply to it, ask whether a waiver was granted and by whom.
“The care here isn’t good enough for his condition.” That is usually a designation question rather than a complaint question. The care level assigned to a person and the care level a facility can deliver are set under a different policy, and the remedy is a medical redesignation or referral. Start at medical designations and care levels. Where the condition is terminal or severely debilitating, the compassionate release route runs in parallel and on its own clock; the medical summary the compassionate release policy requires is the Health Services piece of it.
Related BOP policy on health services
The policies this one wraps, in rough order of how often people need them:
- Patient Care (Program Statement 6031.06) — the core clinical policy, reissued 22 June 2026. If you only read one, read this one.
- Medical designations and care levels (PS 6270.02) — which facility can manage which conditions.
- Inmate copayment program (PS 6032.01) — the fee for a sick call visit, implementing part 549 subpart F.
- Over-the-counter medications (PS 6541.03) and pharmacy services (PS 6360.03) — medication access.
- Dental services (PS 6400.03) — a separate discipline with its own waiting-list rules.
- Medical records access (PS 6090.04) — how to obtain the file.
- Psychiatric services (PS 6340.04), psychology services (PS 5310.17) and mental illness treatment and care — the mental health side of the division.
- Infection Prevention and Control (PS 6190.05), hunger strikes (PS 5562.05) and autopsies (PS 6080.02) — the three part 549 subparts with their own dedicated policies.
Reader-facing companions: medical and dental care in federal prison, federal medical centers, medical care levels in federal prison, and the Federal Bureau of Prisons hub.
Frequently Asked Questions About Health Services Administration
Reviewed for legal accuracy by Elizabeth Franklin-Best, Esq., Principal Attorney·September 2026