Archive 07/19/2022

Female Integrated Treatment (FIT) Program

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The Female Integrated Treatment (FIT) Program

  • An evidence-based approach designed to ensure that each participant has an individually tailored treatment plan and
  • receives a full range of services to address their needs.
  • The program will combine 3 psychology treatment programs, including
  • The Residential Drug Abuse Program is for those who are eligible.

Women are twice as likely as men to experience PTSD, according to the World Health Organization.

  • A woman’s chances of experiencing trauma are higher —
  • 10% of women will experience PTSD versus 4% of men.
  • “It’s tough to say there are sure symptoms of PTSD since no two people will have the same experience,” Pereau says.

DSM-V Revisions to Signs and Symptoms of PTSD

  • In the most recent publication of the DSM, the DSM-V, PTSD symptoms are grouped into five different clusters.
  • One or more symptoms are required from each of these clusters in order for a patient to receive a full diagnosis.

Those clusters include:

Stressor– (one required)

  1. The person was exposed to injury or severe illness that was life-threatening, which includes actual or threatened injury or violence. This may include at least one of the following:
    • Direct exposure to the trauma
    • Witnessing a trauma
    • Exposure to trauma by being a first responder, such as a police, firefighter, medic, or crisis counselor
    • Learning that someone close to you experienced the trauma

Intrusion Symptoms(one required) –

  1. The person who was exposed to trauma then re-experiences the trauma in one or more ways, including:
    • Flashbacks
    • Nightmares
    • Distressing and intense memories
    • Distress or physical reactions after being exposed to reminders, known as “triggers”

Unpleasant Changes to Mood or Thoughts(two required) –

    • Blaming self or others for the trauma
    • Decreased interest in things that were once enjoyable
    • Negative feelings about self and the world
    • Inability to remember the trauma clearly
    • Difficulty feeling positive
    • Feelings of isolation
    • Negative affect, and difficulty feeling positive

Avoidance(one required) –

  1. This occurs when a person tries to avoid all reminders of the trauma, including:
    • Avoiding external reminders of what happened
    • Avoiding trauma-related thoughts or emotions, sometimes through the use of drugs or alcohol

Changes in Reactivity(two required) –

  1. This occurs when a person becomes more easily startled and reacts to frightful experiences more fully, including symptoms of:
    • Aggression or irritability
    • Hypervigilance and hyper-awareness
    • Difficulty concentrating
    • Difficulty sleeping
    • Heightened startle response
    • Engaging in destructive or risky behavior
    • Difficulty sleeping or staying asleep

All of these symptoms must have persisted for at least one month, and they must be causing distress or functional impairment of some kind.

These symptoms must not be related to any substance use, illness, or medications.

Also seen:

Schizophrenia in Federal Prison

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Schizophrenia in Federal Prison

 

In federal prison, Schizophrenia is a mix of symptoms that varies from person to person and affects the mind. When severe, people have trouble staying in touch with reality. It’s hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately. There is no cure, and treatment requires a psychiatrist-guided team approach, which includes a psychologist, social worker, psychiatric nurse, and possibly a case manager to coordinate care.

Anxiety may present as a component, along with Posttraumatic stress disorder, as a symptom of a co-occurring disorder. While Schizophrenia is a serious brain illness, there is no test for it. Diagnosis requires eliminating what it’s not occurring, in order to identify the symptoms that are present.

There are three types of symptoms:

  1. Psychotic symptoms may distort thinking, including hallucinations, delusions (beliefs that are not true), and organizing thoughts.
  2. Negative symptoms: where you’re not able to show emotions – leaving you to present yourself as depressed and withdrawn.
  3. Cognitive symptoms: Trouble making decisions and paying attention.

There is no cure. Different medications may have to be tried to see which are effective because medications affect each person individually. Once you find the medication(s) that work, stay on them daily, keep your doctor’s appointments and follow their recommendations.

Schizophrenia

Changes in behavior;

Includes delusions and hallucinations – which may last a lifetime.

Delusions; False beliefs, not based on reality, such as another person is in love with you, or a major catastrophe is about to occur.

Hallucinations involve seeing or hearing things that don’t exist. They can be in any of the senses, hearing voices is the most common hallucination.

Disorganized thinking and speech may include putting together meaningless words that can’t be understood, sometimes known as word salad. Extremely disorganized or abnormal motor behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement. All of these behaviors can result in less than optimal interactions between other inmates or with correction staff. The result may be a trip to the hospital or the SHU (isolation), neither is acceptable, and both are preventable.

Negative symptoms can be expressed as, neglecting personal hygiene, appearing to lack emotion, (not; making eye contact, changing facial expressions, or speaking in a monotone), and losing interest in everyday activities, including socially withdrawing.

Treatment is accomplished under the psychiatrist-guided treatment team approach with a case manager coordinating care. The full-team approach may be available in clinics with expertise in schizophrenia treatment. These delusions and hallucinations — may last your lifetime.

First-generation older antipsychotics, introduced in the 1950s – As a class, these provided treatment for acute agitation, bipolar mania, and other psychiatric conditions.

On- Formulary Medications: Haloperidol (Haldol), Perphenazine (Trilafon), Loxapine, Trifluoperazine(Stelazine), and Fluphenazine

Not AvailableFlupentixol, Zuclopentixol, Sulpiride, Pimozide, Molindone, Prochlorperazine, Thioridazine, and Thiothixene

Second-generation or atypical antipsychotics,

Some associated side effects; “Schizophrenia in adults“Bipolar mania and hypomania in adults“,  “Unipolar major depression with psychotic features“,  “Delusional disorder”,   “Brief psychotic disorder”, and  “Treatment of postpartum psychosis”

On Formulary: Clozapine (Clozaril) “Clozapine remains the only antipsychotic that has been FDA-approved for treatment-resistant schizophrenia, “and it provides effective treatment even when patients do not respond to other second-generation antipsychotics. No existing first- or second-generation antipsychotic is as effective as clozapine monotherapy in treatment-resistant patients. Deanna Kelly, Pharm.D., of the Maryland Psychiatric Research Center (MPRC)” Other Medications: Olanzapine (Zyprexa), and Risperidone (Risperdal).

Medications Non-Formulary: Quetiapine (Seroquel)

Some of the more recent atypical antipsychotics:

Medications Not AvailableAsenapine (Saphris), Iloperidone (Fanapt), and Lurasidone (Latuda).

Schizophreniform

Symptoms of schizophreniform

Schizophreniform is a similar disorder that affects how you act, think, relate to others, express emotions, and perceive reality.

Unlike schizophrenia, it lasts one to six months.

A mental condition that can distort the way you:

  • Think.
  • Act.
  • Expresses emotions.
  • Perceive reality.
  • Relate to others.

Medication and Psychotherapy —to help the patient manage everyday problems related to the disorder.

Medications On Formulary: Click here for the article…

Brief psychotic disorder

Involves a sudden, short period of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick — usually less than a month.

The first line of treatment may include atypical antipsychotics.

Medications On Formulary: Click here for the article…

Medications Non-Formulary:   Click here for the article…

For those that have an increased risk of having depression, medications that address this symptom can be an important part of their treatment.

Delusion disorder

The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn’t, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month.

The exact cause is not yet known, but researchers are looking at genetic, biological, environmental, or psychological factors.

A cold, detached manner with the inability to express emotion

  • …has an over-inflated sense of worth, power, knowledge, or identity.
  • Jealous
  • …that someone is spying on them or planning to harm them.
  • …believes that he or she has a physical defect or medical problem.
  • …have two or more of the types of delusions listed above.

Symptoms that are ‘non-bizarre’:

  • An irritable, angry, or low mood
  • Hallucinations

Diagnosis: There are no laboratory tests to yield positive results, they are only good to rule out what it is not.

Treatment:

  • Psychotherapy is primary
  • Conventional antipsychotics

First-generation older antipsychotics, introduced in the 1950s – 

1st Generation, Medications On- Formulary for available medications: Click here for the article…

2nd Generation, Medications On- Formulary for available medications: Click here for the article…

Medications Non-Formulary medications require pre-authorization; click here for the article…

Other types of medications:

  1. Antidepressants might be used to treat depression, which often happens in people with delusional disorder
  2. Psychotherapy can also be helpful, along with medications, as a way to help people better manage and cope with the stresses related to their delusional beliefs and their impact on their lives.
  3. Sedatives and antidepressants might also be used to treat anxiety or mood symptoms if they happen with delusional disorder.
  4. Tranquilizers might be used if the person has a very high level of anxiety or problems sleeping.

Shared psychotic disorder (also called folie à deux)

Here one person in a relationship has a delusion and the other person in the relationship adopts that same delusion.

Diagnosing is difficult, possibly with an MRI.

Treatment: Psychotherapy aims to ease emotional distress, with medication to ease the symptoms of anxiety.

It cannot be prevented, and the key is to diagnose and treat them as soon as possible.

Substance-induced psychotic disorder

Substance-related disorders involve drugs that directly activate the brain’s reward system which typically causes feelings of pleasure.

The classes of drugs include

·       Alcohol

·       Caffeine

·       Cannabis and synthetic cannabinoids

·       Hallucinogens (eg, LSD, phencyclidine, psilocybin)

·       Inhalants (volatile hydrocarbons [eg, paint thinner, certain glues])

·       Opioids (eg, fentanylmorphineoxycodone)

·       Sedatives, hypnotics, and anxiolytics (eg, lorazepamsecobarbital)

·       Stimulants (eg, amphetaminescocaine)

·       Tobacco

·       Other (eg, anabolic steroids)

Treatment/Management

Clinical judgment, with a proper history, creates a safe environment during the withdrawal period. Due to the relative safety of most antidepressants in the setting of depressive symptomatology, and manic episode guidelines, second-generation antipsychotics, such as Quetiapine (Non-Formulary) or Olanzapine (On Formulary), may also be beneficial as they are faster-acting than mood stabilizers.

Psychotic disorder; due to other medical conditions;

Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumor.

Paraphrenia: symptoms similar to schizophrenia.

It starts late in life in the elderly,

  • Generally has a much better prognosis than other psychotic disorders.
  • Antipsychotic medication can be helpful,
  • Paraphrenia sometimes co-occurs with depression and anxiety

I) BOP Placement Based On Security Level Alone – Without Multiple Medication Needs

The Challenge Program – an EBBR FSA Evidence-based Recidivism Reduction Program for male inmates in Penitentiary (High Security) facilities. Treats those with substance abuse and/or mental illness disorders (psychotic, mood, anxiety, or personality).

II) BOP Placement- With Multiple Medication Needs v Prior Hospitalizations

Here, it depends;

  • the number of types of psychiatric hospitalizations, not related to substance abuse, and
  • the number of multiple diagnoses treated with antipsychotic and/or different psychotropic medications

Influences Mental Healthcare (MH) CARE LEVEL I-IV facility placement.

Sex Offender Programs – Federal Prison

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FEDERAL PRISON SEX OFFENDER:

BOP PROGRAMMING WITH 2 LOCATIONS NATIONWIDE

SEX OFFENDER PROGRAM RESIDENTIAL (SOTP-R) is a voluntary program (P5324.10) for Sex Offenders, and those with a history of multiple sexual offenses, re-offense, extensive non-sexual criminal histories, and/or a high level of sexual deviancy or hypersexuality. Inmates ordinarily participate in the program during the remaining 36 to 48 months of their sentence. The duration of the program is 12-18 months. Placement in the SOTP-R is reserved for inmates with more extensive sex offense histories, and cohousing participants permit the implementation of a modified therapeutic community, separate from the general population.

Having only 2 SOTP-R facilities nationwide – before they enter the program, initial placement into a free-standing Federal Prison Camp (FPC), or satellite minimum camp (adjacent to a higher secure facility), if practical, should be part of the court’s calculation.

This is because should an inmate consider acting violently towards your client – most would likely refrain as a single incident would have them transferred behind the wall, to a higher security facility, which they would not want.

Ultimately it just may come down to you knowing your client and the facility recommendation options available during the period before SOTP-R placement. Keep in mind that no matter what the BOP says, this could be a real-life event, therefore having this discussion with your client may prove crucial.

BOP PROGRAMMING WITH 9 LOCATIONS NATIONWIDE

SEX OFFENDER PROGRAM NON-RESIDENTIAL (SOTP-NR), is also a voluntary program (P5324.10) for low to moderate first-time sex offenders with a single history of Internet Sex Crime, intended to identify offenders who are likely to re-offend. Inmates ordinarily participate in the program during the remaining 36-48 months of their sentence. SOTP-NR participants reside in the general population.

Having only 9 facilities nationwide – before they enter the SOTP-NR program, if practical, other than an FPC, or satellite minimum camp, should an inmate act violently towards your client – again, they would most likely refrain, as a single incident would have them transferred behind the wall, to a higher security facility. Otherwise, any other placement could result in a life-threatening sentence.

Consideration may again come down to knowing your client and understanding the facility options available for the period before their SOTP-NR placement.

BOP, 1 LOCATION NATIONWIDE

BUTNER’S COMMITMENT AND TREATMENT PROGRAM FOR SEXUALLY DANGEROUS PERSONS (2022-2023), “This FCI remains a flagship facility and is frequently chosen to pilot new programs such as the Sex Offender Commitment and Treatment Program,” (Page 6).

  • FCI Butner is responsible for the psychological treatment and implementation of behavior management plans, with the coordination of the multidisciplinary treatment teams. Treatment is holistic and multidimensional with the ultimate goal of reducing sexual dangerousness and criminal recidivism potential.
  • FCC Butner has an internship integrated practitioner-scholar model which seeks “the productive interaction of theory and practice in a primarily practice-based approach to inquiry”. The internship component of the Psychology Service strives to meet the training needs of doctoral candidates in applied psychology through supervised experience, didactic programs, and focused scholarship.
  • As there is only 1 location, which appears ‘court ordered’, there should be no other issues regarding inmate threats.

Fore more…

SEX OFFENDER SAFETY IN PRISON- PART OF YOUR SENTENCING CALCULATION

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SEX OFFENDER SAFETY – PART OF YOUR SENTENCING CALCULATION

It is important for the court to consider your client’s, (sex offender) safety, by requesting the court grant initial placement into a Sex Offender Management Program (SOMP), while waiting for your client’s voluntary admittance into a SOTP Program.

Following their interview and investigation, the Probation Officer will draft the official Presentence Report (PSR). Together with preparation, your message stands a better chance of being part of the PSR, and is included “on the record”.

Not being placed into a SOMP, and should an incident occur, could at best result in your client spending the remainder of their sentence in isolation for their protection. Then over time, this may yield a host of mental health phobias, leading to more severe ailments.

The benefit of being proactive as you help your client during their transition into the prison environment safely; cannot be overstated. This is especially significant if the PSR includes the documentation of a mental illness with diagnosis, including the treating physician’s records and testimony.

 

ENSURING THE PHYSICAL SAFETY OF YOUR CLIENT

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Among inmates and convicts, sex offenders are at the bottom of the prison hierarchy and generally, are greeted with hostility.

The BOP, where needed, assigns sex offenders to higher security facilities, which may not be perfect. But this can be especially evident when they’re placed in general population.

Next, when the new sex offender first arrives and meets their new bunkmate, it is not unusual for them to be asked, what did you do?

No matter how they answer, eventually, their roommate or bunkmate Will Find Out! After that, at best, the sex offender is avoided – at worse, they could be robbed, beaten, or even killed. Then he/she may have to spend the rest of their entire sentence in solitary confinement?

Therefore, in your memorandum, safety may dictate placement in either a facility with a Sex Offender Management Program (SOMP) or at minimum, a camp.

For more…

Post-COVID Virus Causes Lingering or Ongoing Symptoms

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The complicated care required for Post-COVID Long-Haulers is likely beyond the mission of most (if not all) prisons, jails, and detention centers.

According to researchers, this is still an active area of investigation. As we are approaching spring/fall 2022/2023, the Post-COVID Pandemic may be becoming an Endemic. Still, with that in mind, treating Post-COVID Long-Haulers and the amount and variety of staff, equipment, finances, and time needed, may just not be available to those incarcerated.

COVID is a true roller coaster of symptoms and severities, with each new day offering many unknowns.”

 “The difficulty is sorting out long-term consequences,” says Joseph Brennan, a cardiologist at the Yale School of Medicine.

While some patients may fully recover, he and other experts worry others will suffer long-term damage, including lung scarring, heart damage, and neurological and mental health effects.

Long after the fire of a Covid-19 infection, mental and neurological effects can still smolder[1]. ‘Long-Haulers’ after the initial COVID-19 hospitalization: fall into 3 categories (Dr. Sanghavi)

1st) The COVID virus causes lingering or ongoing symptoms, meaning that “ symptoms do not recover completely and are ongoing because of direct cell damage from the virus,”

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2nd) involves chronic ICU hospitalization for weeks. This causes:

  • muscle weakness,
  • cognitive brain dysfunction,
  • psychosocial stress-causing post-traumatic stress disorder (from chronic hospitalization).

3rd) symptoms appearing after recovery. “Interplay with the immune system of a person, and then the impact that both those things have on the body.”

“We are still trying to understand exactly how this interplay between the immune system and inflammatory markers work, but there’s no doubt that that is a group of symptoms because of ramped up immunity or ramped up inflammatory system,” Dr. Sanghavi added.

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Peripheral nerve issues, such as Guillain-Barré Syndrome, can lead to paralysis and respiratory failure.

Post-COVID Stress Disorder is another emerging consequence of the global pandemic.

Although most cases of COVID-19 appear to be mild with a recovery time of a few weeks, health experts are seeing more patients who suffer symptoms for months or get better, and then relapse down the road.

Isolation Is Not the Answer, Precautions for Adults with COVID-19[ii]

For more…

POST – COVID A PHYSICIAN’S JOURNEY

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POST – COVID, A PHYSICIAN’S JOURNEY

Post – COVID a physician’s journey in the summer of 2020 working on both general medical and COVID-positive wards. But by November of that year, the U.K. was in its second wave and second lockdown, with COVID deaths and hospital admissions rising.

“Like being on a treadmill I could not get off”

Being given only basic personal protective equipment (PPE), Dr. Fearnley and her newly graduated doctors were sent onto medical and COVID wards. While on a COVID ward, and after not feeling well, a PCR Test returned positive for COVID, and what comes next follows the phases she went through:

  • “The acute phase lasted 2 weeks – comparable to a case of mild-to-moderate flu.”
  • “As a fit and healthy 35-year-old with no comorbidities, she naively expected to recover quickly,”
  • “By week 3, she still had a lingering fever,”
  • By week 4, Dr. Fearnley wanted to return to work, but being lightheaded and jelly-legged, just made it home.

Thus began the start of her long Post-COVID Long-Hauler (as it was later defined) Journey.

Getting slightly graphic, these attacks “were associated with an unquenchable thirst, with or without an urgent need to open to my bowels, vomiting, or increased shortness of breath. These came in daily cycles lasting up to 14 hours at a time. I would frequently shake through the entire night”.

For more…

Compassionate Release

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Compassionate Release

The Federal Docket, Updated 9/27/2021

Published by the criminal defense lawyers at Pate, Johnson & Church. Here, they provide the following 12 successful case examples of Compassionate Release,

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…listed by category below.

  1. Medical Condition
  2. COVID-19 Positive/Recovered
  3. COVID-19 Vaccinated
  4. No Medical Condition
  5. No Confirmed Cases
  6. Mental Health
  7. Short Time Served
  8. Family Circumstances
  9. Excessive Sentence
  10. Circuit Opinions
  11. 1B1.13 Policy Statement
  12. Request to Warden

 

The COVID Prison Project appears at first glance to be a great resource as it tracks current data and policy while monitoring COVID-19 and the number of

COVID Cases, Deaths, and Vaccines that are given, as recently as 7/8/2022. It appears that the site updates at regular intervals.

For more…

COVID In Prison

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Omicron, B.1.1.529- Fears Of Catching COVID In Prison

When I first started writing on Omicron, B.1.1.529 (a variant of COVID-19), it was back in January 2022,

At the time we have watched it become a ‘variant of concern. along with fears of catching COVID in prison more of a reality. While not as prevalent and lethal as Delta, it’s a more contagious spreader, and testing is best done with an oral swab which has to be done in a certain and exact way.

The Centers for Disease Control and Prevention (CDC) listed the possible symptoms of Omicron as:

  • cough,
  • fatigue,
  • diarrhea
  • headache,
  • sore throat,
  • fever or chills,
  • nausea or vomiting
  • shortness of breath,
  • difficulty breathing,
  • muscle or body aches
  • new loss of taste or smell,
  • congestion or runny nose

“However, the CDC noted that this list is not exhaustive, and people might experience different symptoms or combinations of symptoms.”

Unfortunately, this presents a challenge not only to all of us, but to all prisons (state and federal), jails, and detention centers. As history has shown us, these facilities likely may be unable to meet this medical need due to:

  1. the current ‘politicization of COVID-19’ and vaccinations,
  2. the physical nature of how inmates are housed,
  3. the continued refusal of some correction staff to get vaccinated, and masked
  4. the limited availability of medications and masks.
  5. I am adding to the list those with Post-COVID19 which I will cover later, but which no prison or jail has the staff, supplies, or finances to provide the support required to meet their needs.

Definition: The novel coronavirus, or SARS-CoV-2, is the deadly virus that led to COVID-19. Oversimplifying, a virus replicates its RNA by making copies of itself, but while coping, if a mistake in replication is made, these ‘mistakes’ result in creating the mutation.

How we get exposed(CDC.gov), is through these respiratory fluids that carry COVID, which occurs in three principal ways. Though not mutually exclusive, these are ‘physical particles, some of which we cannot see, but most of which can be blocked with physical masks; either N-95 masks, (double layer) surgical masks, or multi-layer cloth physical masks, by blocking the majority of these aerosolized viral fluids before they enter our respiratory system.

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1st- Inhalation – Air Bourne Transmission (Top Photo) this 20-minute uTube, “a Must-View and Listen” – on How To Protect Yourself

While not perfect, a little knowledge is helpfulby Mike Hansen MD, Board Certified in Internal Medicine, Critical Care Medicine, and Pulmonary Disease.

Just the act of breathing in the air allows these small, fine, physical droplets including the aerosolized particles that contain these viruses, into our system. Here, the risk of transmission is greatest:

  • within three to six feet from the infected source. Don’t be fooled though, as these
  • exhaled aerosolized particles can travel, likely well past the
    • 9-12 feet (and up to 27 feet) in an enclosed space.

 2nd- The viral particles, as noted, can be physically exhaled as aerosolized droplets.

  • As we breathe in these physical particles, they too can be blocked, for the most part
  • by appropriate physical masks. But again, the risk of transmission is greatest:
    • the closer we are to the infected person, which is where
    • the concentration of these exhaled droplets and particles is greatest.

 3rd- Rubbing your nose and eyes with viral residue on your hands just spreads the infection.

Therefore, ensuring an adequate supply of:

  • soap and hand sanitizer are available to allow frequent washing and hand sanitizing
  • is the responsibility of each facility, no matter whether state, county, or federal.
  • Viral residue in indoor settings may originate from either:
    • exhaled respiratory fluids, or
    • from touching inanimate surfaces contaminated with the virus. Therefore;
      • cleaning all surfaces is critical as well as
      • understanding that when you cough or sneeze, please
        • cover your mouth and nose with
        • the sleeve of your shirt or arm, and
        • not your bare hand if you can help it.

The basic protection we can all do:

  1. Social distancing indoors where practical, and
    • outside where ≥6 feet cannot be maintained.
  2. All types of masks are reviewed by the (Mayo Clinic.Org), and this is a very good resource. Multilayer physical cloth masks are cheap, and most importantly, should be made available by each facility to be used in indoor spaces. Photo Credit: ACLU
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  • Having two or more layers of washable, breathable fabric
  • Completely cover your nose and mouth
  • Fit snugly against the sides of your face while not having any gaps
  • Have a nose wire (or equivalent) to prevent air from leaking out of the top of the mask
  • Follow the recommendations of science, take the appropriate medications approved by the FDA, and get vaccinated, and this goes for staff and inmates alike!

I understand that for some this may be a non-starter, but please understand that just because:

  • we can’t see these physical droplets, or
  • don’t know anyone personally who has passed due to COVID; that doesn’t mean that
  • neither has happened; like the story of the tree that fell in the forest,
  • it still fell even though we didn’t see, or hear it.

While you may have No Symptoms, you

  • still could be a carrier,
  • pass the virus on to an older loved one who is
  • later hospitalized, and then
  • may fatally succumb to the infection.
  • That is not a burden that anyone would want to carry.

Your client’s looking for COVID sentencing relief, but were they vaccinated?

If your client’s going to prison and has not been vaccinated, it is important to learn why. If their reasoning is because it imposes on their freedom, or they just do not want to, I cannot believe that this reason is going to endear any sympathy for any alternative sentencing, from any court in the land.

Obviously, this does not take into account those with cancer, immunocompromised diseases, etc., as these are private conversations between your client and their physician. Should this be the case, I feel confident that the court would likely take this into consideration when considering your request.

If your client’s been vaccinated, has been wearing a mask, and falls into any of the following groups, now you have a good argument, especially with Omicron, B.1.1.529, and Delta ever-present across our country. The positive is that now in 2022, antivirals could be the ‘holy grail’ as far as controlling this pandemic, although their availability in a prison setting is anyone’s guess.

For more…

Federal Prison Camps

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“MINIMUM” FEDERAL PRISON CAMPS (FPC) vs “MINIMUM” SATELLITE CAMPS

There are differences;

 

Minimum Satellite Camps are adjacent to higher secure facilities.

Minimum Federal Prison Camps (FPC) are not, hence usually may have No” Solitary Confinement or Razorwire.

This may result in overall less tension among staff and inmates alike and is possibly due to the absence of the adjacent higher secure facility. Above are the BOP Federal Prison Camps, only.

 

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After the sentencing  designation is made:

With your client and their family, review relevant information such as nearby hotels and prison visiting (list and hours), mail (including email), commissary, telephone, items that are allowed in prison, and how to get money to your client (including when they self-surrender and then monthly via Western Union, Money Gram, or other services), will go a long way to helping take the edge off this life-altering event.

  • If there are medications involved, are they on Formulary (easily available), Non-Formulary (available, but require a lengthy pre-authorization process), or just Not Available? If either of the latter two applies, then what medical/legal options have been presented to the court? Hopefully, all of these issues have already been resolved, long before the PSI was finalized.

 

SELF SURRENDERING – WHAT YOU CAN BRING WITH YOU

§ Basic wedding band, Bible.

§ Prescriptions; I recommend that prescriptions be attached to everything you bring with you, including, medications and medical devices, prosthetics, etc. Together with your attorney, make sure that copies of these prescriptions are included in your PSR, which was developed from your PSI.

Below is a sample from the BOP online Formulary that is available for your attorney’s use.

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  • BOP Medication Formulary is based on a 3 Tier Structure. If you are able, I recommend bringing a month’s supply, at best you can use them, at worst they just throw them out. If you arrive on a holiday or weekend, they may be allowed.

Medical Devices:(CPAP, etc.). Prosthetics / Orthotics, Diabetic shoes (P6031.01, Patient Care, (Page 58): may need extra deep, extra wide toe box )/ Wheelchairs, etc.

Glasses that are not made with metal.

AUTHORIZATION ‘FORM’ TO RECEIVE PACKAGES, is provided by the facility, but you can print the form here.

§ Forms of ID: birth certificate, passport, driver’s license, and social security card.

§ Cash; Then Per Month- $320, ($370 in November and December), Money Gram or Western Union for monthly deposits.

§ Legal papers.

§ List of personal names (including phone numbers and addresses).

Noteworthy: 20-minute video that shows you basic steps on how to protect yourself from COVID; whether or not you are in prison, by Mike Hansen MD

  • Mike Hansen MD, a Board-Certified Internist, Intensivist, and Pulmonologist who specializes in Internal Medicine, Critical Care Medicine, and Pulmonary Disease.
  • He explains what has been at best; a politically challenged topic these past several years – in a way that all of us can understand.
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Also available through an article I previously published titled: How Do You Address Your Client’s Fears Of Catching COVID?

My background and experiences have provided me with a unique understanding of the federal Security Classification structure, Medical and Mental Healthcare – CARE LEVELS, along with an understanding of the BOP’s Medication Formulary (availability through their 3 Tier System).

Career Transition: My skills and experiences, together with 31+ years in medicine (my license is current and active), along with my lifelong compassion for others, have made me uniquely qualified to develop a Comprehensive PSR while providing the ‘best and appropriate’ placement outcome recommendations, along with counsel, to the court.

For more…

Self-Surrender To Federal Prison

PPRS - PPRSUS - Physician Presentence Report Service

Self-Surrender To Federal Prison

You’ve been allowed to self-surrender to a minimum federal prison camp – but find yourself in isolation (or solitary confinement), because your paperwork has not arrived. This does happen, and can be avoided!

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For the purpose of this article, we are going to examine the process that follows after the court agrees to let your client self-surrender.

Up until this point, there has been the back and forth between defense counsel, the U.S. attorney, and lastly the court. The defendant’s number one job has been to get their affairs in order and then to show up on the specified day, at their BOP Institution.

The process of getting the court’s order delivered to the specified BOP Institution on time is, for the most part, considered something that automatically happens as the next step in the process. But it is this author’s opinion that at times, the council should reflect on President Ronald Reagan’s famous quote; Trust – But Verify

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Because, in this case, here we have Trust, without the Verification. I offer the following so that more care and empathy for your client can be taken, as you guide them completely through this process.

These steps I believe will help to ensure a smoother, self-surrendering process;

  1. Verify with all parties that: the receiving facility is in receipt of all the required judge’s orders for your client’s arrival – before they get there, 18 U.S.C. § 3621(c).
  2. If your client is ultimately designated to a ‘satellite’ camp, let them know ahead of time that they have to present themselves to the adjacent, ‘higher secure facility – and not to the satellite camp.
  3. Also let them know that at the higher secure facility, they are likely to see prisoners in handcuffs and shackles, guards with long guns, guard towers, etc., so they are not caught off guard.
    • This is because each client will deal with the emotional aspects of “prison” in their own way, especially if it’s their first time.
  4. There they will be screened and given a change of clothes. The clothes that they came with along with peripherals, will then be boxed and returned to their ‘legal residence’.
  5. Their birth certificate, passport, driver’s license, and social security card all will be kept, to be returned at the end of their incarceration.

Whatever legal papers you have accumulated, just like medical records, these copies can be kept with you as your own personal records. Your PSR, I believe is not allowed to be brought in with your other personal items.

What happens if you depend solely on the process, and do not verify that the court’s orders have preceded your client’s arrival?

Your client was allowed to self-surrender, and the rest was an ‘assumed formality’…

  • Upon your client’s arrival, the prison’s guards at receiving had not received any of the court’s orders regarding their sentenced incarceration – which does happen, no matter how infrequently.
  • Policy-wise, once they have your client’s birth certificate, passport, driver’s license, and/or social security card, this may only allow the facility to hold your client (meaning that they will not turn your client away), but likely will not allow them to formally admit them into the institution.
  • This ‘hold’ option further may also involve moving your client into an ‘isolation’ cell until the court order arrives, which according to staff, “may take up to a month”.
  • A core value in this author’s opinion is verifying that the institution has received all of his/her required court-ordered intake documents, before your client’s arrival.

Attorneys’ Reputation and Future Referrals: No one really wants to go to prison. Therefore, while this defendant (and their family), may or may not turn out to be a great referral resource, bad reviews on the other hand can come from anywhere and travel at lightning speed – case in point.

  • For those of you who already do this, your clients are grateful – even if they don’t know, or show it.

For more…