The Federal Bureau of Prisons

Medical care regulatory state agencies were introduced to check health care amenities and practitioners. In addition, they were established to offer information concerning health care changes, guarantee health care security and foster legal compliance and proficient services. These medical care agencies assist to institute regulations and guidelines, which the medical care sector is required to advocate. The objective of this paper is to provide an improved understanding of a state regulatory agency that controls prison health care in the US; the Federal Bureau of Prisons or (BOP).

The Role of BOP

Its sole rationale is to offer more unbiased, cost-effective and considerate care to the federal inmates inside the US prisons. This agency is additionally responsible for offering medically required health care to prisoners according to federal along with the state laws. Among the greatly negative things that the agency is required to carry out are the judicially authorized federal executions, such as the lethal inoculation of prisoners awarded a death sentence in courts for crimes committed. BOP in addition preserves the lethal injection compartment of a prison at all times, ensuring the lethal shot is carried appropriately and humanely. The agency is made up of over 118 institutions, about 6 local office locations, the headquarter and 22 inhabited management office locations, formerly called community corrections offices (Allgov, 2014).

BOP’s Impact on Health Care

Ever since 2000 FY, the agency has adopted or developed over twenty initiatives deliberated to advance the supervision, management, and deliverance of health care to prisoners, and to decrease or contain increasing medical care expenses. The BOP has made significant progress among them being the Medical Designations Program. Here, BOP officials allocate every inmate a medical categorization or care level founded on the prisoner’s individual health circumstance. Care levels arrays starting at Care Level 1 to Care Level 4 (U.S. Department of Justice, 2008).

  • Care Level 1 comprise below 70 years old prisoners and who are commonly healthy but can have partial medical requirements that can be simply sustained by clinician examinations each 6 months. The sub-specialty test is rare in that it is not frequently required and is finished in below 3 months. Notably, this care position comprises of inmates with steady mental-health conditions needing chronic care meetings and personal psychology or medical services no greater than once each 6 months.
  • Care Level 2 prisoners are steady outpatients suffering from chronic illnesses needing at least quarterly physician evaluations. The prisoners independently execute daily living duties. The care level comprises inmates with psychological medical conditions that may be managed via chronic care treatments or personal psychology or medical services meetings in a monthly to quarterly basis.
  • Care Level 3 prisoners are weak outpatients bearing medical circumstances that necessitate daily to monthly medical contact. The prisoners may possess chronic or recurring psychological illnesses or continuing cognitive mutilations that need daily to monthly basis psychiatric medical services or psychology meetings to uphold outpatient position. These convicts may in addition require support in performing specific day-to-day duties, but do not need every day nursing care.
  • Care Level 4 prisoners contain acute medical or chronic cerebral health conditions leading to cruel impairments to bodily and cognitive performance. The prisoners here need services from the Federal Medical Centers or (FMC), and may need dissimilar extents of nursing care.

Over and above assigning every prisoner a care level founded on general health, as from 2004 the BOP as well allocated a health designation to every institution. The health designation matches with the prisoner’s medical classification that the establishment is adequately personated and is equipped to sustain. Designating institution health levels possess three benefits towards the BOP. Firstly, it permits the BOP to put forward guiding principles for the volume and categories of health staff to allot to every facility matching with the care rank populace at every facility. Secondly, it permits the BOP to assess each prisoner for suitability of assignment and to start movement of unsuitably housed prisoners through scheduled relocations rather than staying until the prisoner experiences a disaster needing direct air or land transport at an elevated cost. Thirdly, it lets the BOP to combine prisoners with related health conditions at amenities where suitable services and givers are present (SCHAENMAN, DAVIES, JORDAN, & CHAKRABORTY, 2013).

An illustration of BOP performing Its Duties

In the 2005 FY, BOP introduced staffing guiding principles for every care level. This necessitated staff transfers to institutions facing shortages this process lead to about 144 transfers of staff all through BOP. In the 2000 FY the agency bought videoconferencing equipment to enable the remote deliverance of medical care, for instance, currently a psychiatrist is able to offer psychiatric attention through video conferencing. In the year, 2006 BOP moved towards automation of prisoner health records. This has helped track the complete medical past of an individual, schedule prisoner clinic visits including other benefits. By 2008, all the facilities had automated their records. The agency additionally introduced a $2 fee prisoner medical visit to discourage unwarranted clinic visits (United States General Accounting Office, 2000).

BOP’s Regulatory authority in relation to medical care

The BOP was introduced on 14th May 1930 and endorsed of by then President Hoover. It is a United States Justice Department subdivision and is accountable for the federal prison healthcare supervision. The agency as a part of Justice Department is legally and constitutionally obligated to carry out health care services in all the United States prisons. Part of the agency’s duty to provide convicts in a safe and humanitarian manner, it is therefore required to convey medically essential health care to its convicts in following the established standards of care.

Accreditation, Certification, and Authorization

To provide prisoner medical care, the agency’s institutions hire the following practitioners.

• Licensed independent practitioners- these health providers are sanctioned by an up-to-date and legitimate state license to autonomously carry out medicine, podiatry, dentistry or optometry.

• Non-independent practitioners; these are physician assistants, dental hygienists, nurse practitioners, dental assistants along with unlicensed health care graduates.

• Others comprise clinical nurses along with crisis medical technicians (U.S. Department of Justice, 2008).

The agency’s P6027.01 Program Statement offers direction for establishing the agency’s Credential Substantiation, Practice Agreement Program and Privileges. In this initiative, the agency:

  1. Awards licensed independent practitioners’ medical privileges founded on the practitioner’s credentials, knowledge, expertise, and practice;
  2. Introduces practice agreements amongst its licensed autonomous practitioners and its non-autonomous practitioners, for instance mid-level practitioners;
  3. Introduces protocols that ought be followed by practitioners, like clinical nurses and crisis medical technicians;
  4. Undertakes peer reviews for every provider who operates under medical privileges or work agreements.

BOP’s Protocols, Privileges and Practice Agreements

The agency grants clinical rights to its internal and contracted workers. Medical privileges are the particular duties that a medical care giver is permitted to offer to BOP prisoners. The authorities below are assigned to award BOP’s specific medical privileges.

  • The agency’s Medical Director gives privileges to physicians selected as Clinical Directors, counting physicians chosen as Interim Clinical Director whilst the permanent rank is unfilled. The Medical Director additionally awards privileges towards Chief Dental Officers and Clinical Specialty Consultants. The Chief Psychiatrist is given the privilege of giving authority to Chief of Psychiatry by Medical Director.
  • The establishment’s Clinical Director gives privileges to the remaining licensed autonomous practitioners who convey medical care in the organization, such as contractors, consultants, along with the ones concerned with tele-health.
  • The establishment’s Chief Dental Officer provides privileges for all branches Chief Dental Officers.

BOP policy indicates that medical privileges may be provided for a duration of not greater than 2 years, additionally newly hired physicians may be given privileges for a duration of not exceeding 1 year. Self-regulating practitioners are forbidden from practicing in BOP till they are been given privileges by a sanctioned BOP officer. The particular institutions set up practice agreements amongst licensed self-regulating practitioners and non-autonomous practitioners. Practicing agreements hand over specific medical or dental operations to non-autonomous practitioners through a licensed autonomous practitioner’s administration and are applicable for periods not exceeding 2 years. Non-autonomous practitioners comprise of graduate physician assistants, unlicensed medical graduates and nurse practitioners who have to be openly monitored by a licensed autonomous practitioner. The agency’s policy forbids non-autonomous practitioners from offering medical care in BOP till a practice accord has been introduced. The agency’s is other medical care providers, for instance clinical nurses and crisis medical technicians have to operate under protocols permitted by licensed autonomous operator. A protocol refers to a plan for performing medical-based functions for example patients cure regimen (U.S. Department of Justice, 2008).

Despite the BOP’s positive performance there still shortcomings within the agency. These shortcomings range from unauthorized personnel attending to prisoners, some inmates receiving inadequate medical care to mismanagement of resources directed towards improving the convicts’ health. The challenge remains to be solved with rising numbers of law suits regarding inadequate medical attention towards the convicts, therefore the Department of Justice still has a lot yet to attain towards ensuring a good and cost-efficient prison health care system.


Allgov. (2014). AllGov – Departments. Retrieved August 15, from

Schaenman, P., Davies, E., Jordan, R., & Chakraborty, R. (2013). Opportunities for cost savings in corrections without sacrificing service quality: inmate health care. Retrieved august 15, from

U.S. Department of Justice. (2008). The Federal Bureau Of Prison’s efforts to manage inmate healthcare. Retrieved August 15, from

United States General Accounting Office. (2000). Containing health care costs for an increasing inmate population. Retrieved august 15, from

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