Archive 07/09/2022

Post-COVID In Prison

PPRS - PPRSUS - Physician Presentence Report Service

Just consider, if COVID is on the rise now, [Post-COVID may follow] when we are all outside, then come fall 2022/2023 (when we are all inside in enclosed spaces (like prisons), it is anyone’s guess. The next more medically challenging question is, when and not if, will there be a treatment for the Post-COVID inmate/patient.

Should Post-COVID reflect your client’s current past medical history sometime over the past 30 months, the opportunity could be in place for either a downward departure or alternative sentencing. Why, because prisons are just not prepared to provide the required Post-COVID medical care. Additionally, corrections staff may just not be able to deal with sequelae of symptoms that they will encounter.

While hard to conceive, these efforts alone could also go a long way in relieving some of the life-altering fears your client and their families are going through. If you like what you are reading, send it to friends, ask them to subscribe using the button above, and consider engaging us.

The Post-acute sequelae of SARS CoV-2 infection (PASC), can include a wide range of ongoing health problems which can last weeks, months, or years. It is this author’s opinion that the sequelae and current treatments are constantly being adjusted in order to keep up with the ever-changing variants. This, unfortunately, compounds our efforts to gain the public trust in the science, while countering the pervasive misinformation.

It is still my belief that no jail, prison, or detention center (state or federal) has the: staff, in place training, time, supplies, or finances to provide this quality care. Why, because if our current hospital systems are still in the ‘research and study’ mode, this likely has not been part of their mission statement as it is still being studied. I’ll let the rest speak for itself.

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4/2022 | UC Davis Post-COVID Clinic | 2 years into the pandemic, pulmonologists are still trying to understand the syndrome, and this is just one hospital research system among many nationwide. Mark Avdalovic, is a pulmonologist, vice-chair for the Department of Medicine, and director of the Post-COVID-19 Clinic at UC Davis Medical Center. As one of the first health systems in the U.S. to create a clinic for Post-COVID patients, studies revealed that:

  • One-third of COVID-19 patients will have one or more symptoms three to six months after their diagnosis – or, as the US reaches 80 million infections, ~26 million Americans could potentially experience some degree of long-COVID. How many wind up in our prisons and jails? They probably do not even know due to our lack of comprehensive testing since its inception in 2019/2020.
  • Rehabilitation treatment is officially identified as post-acute sequelae of COVID-19 and is abbreviated as PASCBradley Sanville, also a pulmonary and critical care physician who specializes in exercise physiology, “Imaging of their lungs, lung function, and cardiopulmonary testing are often very normal. It’s still a mystery, but at this time, most of the available evidence is pointing away from it being a lung problem.” Sanville generally prescribes inhalers for those who are short of breath, but for those who can tolerate the exercise, he prescribes heart or lung rehab.
  • 4-2022 UC Davis Post-COVID-219-Clinic, Nontraditional approaches: the UC Davis Integrated Medicine team — which includes acupuncture, mind-body medicine such as meditation, and special diets — are used together for a forthcoming clinical trial.

more…

Pregnant Inmates

PPRS - PPRSUS - Physician Presentence Report Service

Whether federal or state, all pregnant inmates have the constitutional right to obtain appropriate medical care. To what extent prison policies address pregnancy-related services is one indicator of how that facility and state or federal agency treat pregnant women in its custody. We will cover federal prison policies today, and my next issue will cover several individual state policy examples, so stay tuned!

While the National Commission on Correctional Health Care (NCCHC) has been at the forefront leading to dramatic improvements in pregnancy inpatient care, they are by no means alone. As you will see, they are accompanied by the:

Introduction

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A significant percentage of women entering prison are of the age where they’re sexually active, are either at risk for pregnancy, or are already pregnant. A 2019 study reported that a total of 4% of women in federal custody were pregnant and 753 gave birth (Sufrin, 2019).

Most women entering prisons are mothers, as well as the primary caregivers to young children, (Glaze & Maruschak, 2010). It would be helpful if facilities (federal and state) made a conscious effort in recognizing the resulting psychological difficulties that result when forced separation occurs following childbirth. While it’s a lot to ask, creating areas for new mothers to pump breast milk for their infants, then having a place to store it, goes a long way in allowing them to establish their relationship with their new child, at a minimum.

NCCHC Has Set National Standards for Pregnancy-Related Health Care in Correctional Settings

ACOG: specialists in Obstetrics and Gynecology, “The use of restraints on pregnant incarcerated women and not only compromise health care but are rarely necessary.”

Department of Justice Office of the Inspector General, Review of the Federal Bureau of Prisons Management of Its Female Inmate Population, Evaluations and Inspections Division 18-05 (Washington, DC: September 2018).

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An interview with an Assistant Federal Public Defender (Page 82 bottom)

1-    They found the lack of information and communication about the MINT program for pregnant women facing prison time, problematic.

2-    Specifically, as pregnant women await sentencing, they do not have a sense of what to expect, or decisions they need to make in terms of medical care or custody of their infant.

3-    BOP was not forthcoming with any substantive information about how to initiate the approval process for MINT participation while the defender’s pregnant client awaited sentencing, despite their and the judge’s efforts to contact BOP and MINT programs.

The views expressed by the defender are their own and do not represent the views of the Administrative Office of the U.S. Courts or the federal judiciary.

For more…

Pregnant In Federal Prison

PPRS - PPRSUS - Physician Presentence Report Service

A significant percentage of women entering prison are of the age where they’re sexually active, are either at risk for pregnancy, or are already pregnant.

Federal – While onsite nurseries are not available, they do have limited offsite programs

  1. MINT: Mothers and Infants Together (MINT) Program (GAO, Page 79)
  2. RPP: Residential Parenting Program (RPP) (GAO, Page 82).
  3. A reason to be very proactive:

Department of Justice Office of the Inspector General, Review of the Federal Bureau of Prisons Management of Its Female Inmate Population, Evaluations and Inspections Division 18-05 (Washington, DC: September 2018).

 

I) Fort Worth, Texas (Mothers and Infants Nurturing Together (MINT) Program, Tx.);

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CONTACT: The “Little House”, houses the MINT women and their babies.

Volunteers of America Texas, 2710 Avenue J., Fort Worth, Texas 76105, 817) 535-0853

BOP (PS 5200.02, CN-1):

  • If RRC placement is medically appropriate and documents this on the Medical/ Psychological Pre-Release Evaluation (BP-A0351), which is forwarded to Unit Management.
  • Direct court commitments have a secondary designation noted on the Inmate Load and Security Designation form (BP-A0337).

From the GAO-21-147, Pregnant Women in DOJ Custody, Page 79

  • They also have a Residential Reentry Center for men.
  • They work to reduce recidivism and the stigma for children born to incarcerated parents, by enhancing the bond between the mother and infant, while teaching the women how to care for their infants and be better citizens.
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  • Women have a weekly check-in with a nurse and are taken outside of the facility for prenatal care.
  • The program holds up to six women at one time.
  • They usually have approximately two or three participants at any given time,
  • And approximately 10 participants annually.
  • The women typically stay 3 months postpartum and BOP officials noted that women may request an additional 6-month extension (PS 5200.02, CN-1, page 16).
  • When interviewed by GAO staff, the women stated that they received regular medical care, including any special care that was needed, and any special accommodations that they requested.
  • The mother is then returned to an institution to complete her sentence, if necessary.

II) The Greenbrier ‘MINT’ Program, WV.

CONTACT: Operates under The Baltimore Residential Reentry Office, Baltimore Maryland, Appalachian Mountains in Pocahontas County, Hillsboro, WV. Facility Director: Starlena Robertson, Case Manager’s Susan Lane or Mary Eggert, (304) 653-4882 or (304) 653-4570, mint3vz@frontiernet.net

BOP (PS 5200.02, CN-1):

  • If RRC placement is medically appropriate and documents this on the Medical/ Psychological Pre-Release Evaluation (BP-A0351), which is forwarded to Unit Management.
  • Direct court commitments have a secondary designation noted on the Inmate Load and Security Designation form (BP-A0337).
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  • Here they promote maternal bonding and parenting skills in a home-like environment.
  • There is no medical care provided onsite.
  • Mental health providers offer onsite services twice weekly and women are taken outside of the facility for prenatal care.
  • The program has ten staff and can hold up to 20 women at one time.
  • The program has approximately 10 participants at any given time and approximately 20 annually.
  • The women typically stay 3 months postpartum and BOP officials noted that women may request an additional 6-month extension (PS 5200.02, CN-1, page 16).
  • Interviewed by GAO staff, the women stated that they received regular medical care, including any special care that was needed, and any special accommodations that they requested.
  • One woman stated that she appreciated the welcome basket she received upon arriving at the Hillsboro MINT program of donated items such as toiletries for the woman, as well as infant clothing and accessories.
  • The mother is then returned to an institution to complete her sentence, if necessary.

III) Residential Parenting Program (RPP), Washington State Department of Corrections

CONTACT: Sonja Alley, Correctional Unit Supervisor, Washington Corrections Center for Women, Washington State Department of Corrections (253) 858-4200 X 8274, sonja.alley@doc.wa.gov

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BOP (PS 5200.02, CN-1):

  • Unit Team completes the BP-A0210, Institutional Referral for CCC Placement, and submits it to the Seattle Residential Reentry Manager.
  • Furloughs are only accepted Tuesdays through Thursdays at RPP. Release residence can be to any state.
  • The Designation and Sentence Computation Center (DSCC) may also refer initial designations to the Seattle Residential Reentry Manager, with a copy to the Female Offender Branch Administrator.

For more click here

Guilty and Facing Prison, Now What? Critical 1st steps that will determine your future…

Critical 1st steps that will determine your future are in the PSR.

To support your attorney’s efforts, please contact me, Dr. M. Blatstein: at DrMB@PPRSUS.com, or call 240.888.7778 (leaving a brief message).

While I cover preparing for BOP placement, medical issues could apply to both state and federal agencies.

  1. Having attorney representation is critical, and if expenses are an issue there are Federal Public Defenders.
  2. Before the sentencing hearing, if your attorney identifies medical (or mental healthcare) issues, now is when a professional consult is recommended.
  3. If you have a history with any medical specialty or drug clinic etc.; getting your records is especially important.
  4. Religious Diet – Accommodation Form (BP A700.53).
  5. First Time Offenders (NACDL)– Alternatives to Incarceration
  6. Do any of these mental health issues apply to the defendant? Federal prison placement includes Medical and Mental Healthcare needs to be implemented through the BOP CARE LEVELS I-IV along with their Structured Psychological Treatment Programs.
    • I) Brave Program A first-timer young male offender 32 years of age or younger, facing a sentence of 60 months or more
    • II) Challenge Program A male inmate facing a high-security penitentiary with a current diagnosis of either: Mood, Anxiety, Schizophrenia, Delusion, and/or Substance-induced Psychotic Disorders
    • III) Mental Health Step Down A male or female who lacks the skills to function in a general population prison setting and is willing to work with Psychiatry Services.
    • IV) Resolve: A male or female with a current diagnosis of a mental illness related to physical, mental, and/or intimate domestic violence or traumatic PTSD
    • V) Skills A significant functional impairment due to intellectual disabilities, neurological and/or remarkable social skills deficits such as Autism Spectrum Disorder, Obsessive Compulsive Disorder, Epilepsy, Alzheimer’s, Parkinson’s or Traumatic Brain Injuries (TBIs) to mention just a few.
    •  VI) Stages  A male inmate with a serious mental illness and a primary diagnosis of Borderline Personality Disorder, along with a history of unfavorable institutional adjustment.
    • VIIa) Sex Offender Non-Residential Single Sex Crime or first-time Internet Sex Offense
    • VIIb) Sex Offender Residential Multiple sex crimes.
    • VIIc) Butner’s Commitment and Treatment Program for Sexually Dangerous Persons, Page 12Is considered for sexually dangerous persons with the possibility of criminal recidivism
    • VIII) Female Integrated Treatment Is a female with substance abuse (RDAP Eligibility Possible), trauma-related disorders, and other mental illnesses. (FIT) Program
  7.  COVID-19:

Unfortunately, prisons and jails are perfect Petri dishes for contagions to spread into their communities via the corrections staff and inmates. Masks along with 6’ of separation are unlikely and problematic to implement.

Access 2022

FSA - First step act

Productive Activities (PA)
Access 2022

Program Description

This program is designed for incarcerated women who are survivors of domestic violence.

It assists women in identifying suitable career options to be economically independent upon reentry. An interactive computer component (which can be printed and used in class) is used
to explore career options. Participants also complete testing to determine what career field is best for them.

Hours 10
Location(s) All-female sites
Needs Addressed Cognitions, Mental Health, Trauma
Program Delivery Special Population Program Coordinator

Facing The BOP With: Intellectual Disabilities, Neurological Impairments, Social Deficiencies Or Autism

FSA - First step act
CorrectionalOfficer.org © 2020 – Screen Shot[i]

 

The Skills Program[i] There are only 2 locations nationwide.

Do you have clients facing incarceration in the BOP, and who are being treated for intellectual disabilities, neurological impairments, social deficiencies, or autism? If yes; which of the BOP’s ‘2’ available prison facilities are best suited for their placement? That’s right, there are only 2 locations.

I ask this is because the concept of prison officials engaging individuals with autism (for example), has its own brand of procedural issues. For those with a documented history, this could be critical for the safety of all parties; the inmate, correction officers, and the facility general population.

Increasingly, media outlets are reporting instances whereby police officers are confronting subjects on the streets and encountering behaviors of some as “resisting verbal commands” and “obstructing justice,” among others. Eventually, the presence of autism or a different disability is discovered after these police/civilian engagements. Thus, a BOP facility who at a minimum, provides this type of care at a couple of facilities, should be made part of the BOP placement request through the PSR.

Inmates with significant functional impairment due to intellectual disabilities, neurological deficits, and/or remarkable social skills deficits are considered for the program. Participants must be appropriate for housing in a low or medium security institution. Inmates must volunteer for the program.[i] While this program is conducted over 12-18 months, inmates may continue with the program at additional times.

Autism spectrum disorder

Autism spectrum disorder (ASD[ii]) occurs in all ages, racial, ethnic, and socioeconomic groups, according to the Centers for Disease Control (CDC)[iii]. Autism is generally characterized by social and communication difficulties and repetitive behaviors. Signs of autism[iv] occur in three main areas:

  • Social interactions
  • Verbal and nonverbal communication
  • Repetitive or ritualistic behaviors
  • Characteristics 
    • having difficulty with everyday conversations
    • sharing emotions or interests less often than peers
    • having difficulty responding to or understanding social cues
    • having difficulty understanding other people’s facial expressions or emotions
    • having delayed speech or language skills
    • having trouble developing or understanding relationships
    • doing repetitive actions, such as hand-flapping or rocking
    • becoming intensely interested in certain topics
    • speaking in atypical ways, such as in a singsong voice
    • having a significant need for predictable structure and order
    • becoming overwhelmed or angry in new situations
    • having a sensitivity to certain stimulants, such as being overwhelmed by loud noises or bright lights experiencing intellectual delays

A particular focus on autism-affected inmates, classified by BOP under the umbrella category as “Intellectual Disabilities, Autism Spectrum Disorders” and “Major Neurocognitive Disorders,” seeks to treat affected inmates with a multidisciplinary modality, albeit only available at two BOP locations nationwide. The Federal Bureau of Prisons amended and published (May 2014)[v] its agenda to handle/treat mentally unstable inmates while incarcerated.

Intellectual disabilities are classified by severity, [i]

  • Mild to Moderate
    • Mild
      • slower in all areas of conceptual development and social and daily living skills
      • can learn practical life skills, which allows them to function in ordinary life with minimal levels of support.
    • Moderate
      • care of themselves,
      • travel to familiar places in their community, and
      • learn basic skills related to safety and health.
      • Their self-care requires moderate support.
    • Severe
      • has the ability to understand speech but otherwise has limited communication skills ()[ii].
    • Profound (MH CARE LEVEL III [iii])
      • cannot live independently, and
      • they require close supervision and
      • help with self-care activities.
      • limited ability to communicate and often have physical limitations.

Social Deficiency[iv]; reasons why a person may have a social skills deficit.

    • inability to acquire new skills,
    • because of a competency deficit,
    • they may struggle to perform because of limited practice or inadequate feedback, or
    • external factors
      • anxiety or
      • chaotic surroundings.

Basic Communication

  • inability to listen,
  • follow directions and/or
  • refrain from speaking.

Empathy and Rapport

Interpersonal Skills

  • Those who have a social skill deficit may struggle with asking accurate and concise questions.
    • appear disinterested and even
    • anti-social,
    • they may struggle to understand proper manners in different social contexts and settings.

Problem Solving: involves asking for help, apologizing to others, deciding what to do, and accepting consequences;

  • morbidly shy or
  • clinically introverted.

Accountability, fear of being criticized in public;

  • struggle with accepting blame for problems or
  • dealing with constructive feedback.

Other neurological impairments[vi] (e.g. traumatic brain injury, Spina Bifida, Prader-Willi syndrome, Alcohol-Related Neurodevelopmental Disorders or FASD)

As a Police Officer, Cheri Maples, stated earlier, “…wisdom is being able to discern when gentle compassion is called for and when fierce compassion is called for.” That, my friends, rather sums it up.[ix]

Criminal Justice Advocacy – Screen Shot[i]

 ‘The responsibility for a client’s mental and physical health should be safeguarded to protect them from themselves and others, providing a safe environment for the duration of their incarceration.’

This is the responsibility of the legal defense team, court, and BOP.

The Skills Program[ii] is available at these two facilities:
FCI Coleman, FL-Medium

FCI Danbury, CT-Low

 

[i] https://www.arcnj.org/programs/criminal-justice-advocacy-program/

[ii] https://dev-pprsus.pantheonsite.io/bop-psychology-treatment-the-federal-presentence-report-sentencing-and-prison-placement-preparation/skills-program/

[i] https://www.ncbi.nlm.nih.gov/books/NBK332877/#:~:text=Historically%2C%20intellectual%20disability%20(previously%20termed,100%20in%20the%20population)%E2%80%94and

[ii] https://www.ncbi.nlm.nih.gov/books/NBK332877/#

[iii] https://dev-pprsus.pantheonsite.io/programs/bop-mental-healthcare/

[iv] https://www.masters-in-special-education.com/lists/5-types-of-social-skills-deficit/

[v] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1350917/

[vi] https://www.ninds.nih.gov/Disorders/Support-Resources

[vii] https://www.cerebralpalsyguide.com/cerebral-palsy/

[viii] https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy

[ix] https://www.correctionalofficer.org/overseeing-inmates-with-autism

[i] https://dev-pprsus.pantheonsite.io/bop-psychology-treatment-the-federal-presentence-report-sentencing-and-prison-placement-preparation/skills-program/

[ii] https://www.additudemag.com/autism-spectrum-disorder-in-adults/

[iii] https://www.additudemag.com/autism-spectrum-disorder-in-adults/#footnote1

[iv] https://www.additudemag.com/signs-of-autism-in-adults/

[v] https://www.bop.gov/policy/progstat/5310_16.pdf

[i] https://www.correctionalofficer.org/overseeing-inmates-with-autism

[i] https://dev-pprsus.pantheonsite.io/bop-psychology-treatment-the-federal-presentence-report-sentencing-and-prison-placement-preparation/skills-program/