Medical and Dental Care in Prison

The prison health care system can often seem like a pretty uncaring place. While medical and dental care for both emergency and routine situations are provided to prisoners within the Federal Bureau of Prisons, many inmates complain about the speed and quality of this care. It often seems inadequate and is rarely rendered promptly.

Federal prisoners do have 24-hour access to emergency medical and dental care. What constitutes “emergency” dental care is not well defined. Emergency medical care is warranted if a prisoner suffers from a stroke, hemorrhage, or severe trauma such as head injury or heart attack. In these instances, the prisoner will be immediately transported to a local hospital for care.

The Federal Bureau of Prisons classifies medical problems using five categories of care:

  1. Medically Necessary: Acute or Emergent (e.g., heart attack or stroke)
  2. Medically Necessary: Non-Emergent (e.g., diabetes, schizophrenia, cancer)
  3. Medically Acceptable: Not Always Necessary (e.g., joint replacement)
  4. Limited Medical Value (e.g., cosmetic procedures)
  5. Extraordinary (e.g., organ transplants for other individuals)

While all Medically Necessary: Acute or Emergent category issues will be treated immediately, those in Medically Necessary: Non-Emergent and Medically Acceptable: Not Always Necessary categories are sometimes provided, while issues that fall within the final two categories are rarely provided.

The Federal Bureau of Prisons will address medical issues if they severely affect areas of daily living. This includes walking, breathing, eating, and sleeping. But they won’t provide treatment that is deemed extreme or intended merely for an inmate’s comfort. For example, the removal of non-cancerous skin lesions.

Under dental care, the Federal Bureau of Prisons will treat cavities or other issues that cause pain and problems with sleeping or eating. But non-emergency dental problems can result in prisoners being placed on waiting lists that can span several years. Most federal prisons have “Emergency Dental Sick Call” several mornings a week, where inmates can have teeth x-rayed and, if categorized as emergencies, can be fixed within a week or two.

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The long and short of medical and dental care in the Federal Bureau of Prisons is that meaningful care is challenging to obtain, and rendered care is severely delayed. That said, prison medical staff generally do what they can to stop prisoners from dying.

While prisoners can count on medical staff to perform CPR and get them to a hospital if they are experiencing a heart attack, securing an MRI or a joint replacement could be a several-year process. For most prisoners, having bad cavities filled, teeth pulled, and receiving ibuprofen is usually the extent of available care. Likewise, necessary medications such as high blood pressure pills are typically prescribed. But this is all that they can expect from Health Services and Dental Services.

Here are some tips to help you to understand and navigate health care in federal prisons.

  • To access health care, you need to submit a triage form (i.e., a sick call form), usually found in inmate housing units. On this form you write the nature of your complaint and then place it in a box outside of the Health Services Unit for collection. Forms are usually collected every weekday morning.
  • Your appointment will be based on the severity of your complaint. Triage forms are sorted so that those with the most severe complaints are seen first. You should be scheduled for an appointment within two weeks of submitting the request. You’ll know about the appointment because it will be on the call-out sheet.
  • Every federal prison’s Health Services Unit does have doctors on staff, but mid-level practitioners (MLPs) are the first line of care. You will be assigned to one of these MLPs, who will assess your complaint and provide care. If your complaint is a serious or complex one, you will be scheduled to see a physician.
  • If you require an unusual treatment protocol, the request will be submitted to the Utilization Review Committee (URC), who will evaluate the request and either approve or deny it. MRIs and other non-x-ray diagnostic and non-blood-work tests, along with various therapies require URC review and approval.
  • You may be allowed to self-carry prescribed medication, depending on what type it is. Most federal prisons require you to show up to pill line for several weeks to show compliance prior to being assigned a bottle of medication. Pill lines are held during the morning, noon, and evening meals at a window leading off of Health Services.
  • If you require insulin shots, you will be called prior to breakfast and dinner to first test your blood sugar levels, then to self-administer an insulin shot if so required. Testing and insulin injections are handled at the window leading off of Health Services.
  • If you have been denied health care after requesting it, you are free to speak with the Health Services representative who stands at mainline during most noon meals. Likewise, you are free to file an administrative remedy contesting lack, delay, or denial of care.

Contact us for more information on medical and dental care in federal prisons.