Medical Healthcare CARE LEVEL (I-IV) Placement

Is Determined By The Information In Your Presentence Report

PPRSUS 2021/2022 PowerPoint – Healthcare in The BOP

BOP COVID-19 Modified Operational Level Indicators are raised or lowered after 48 hours of respective sustained increases or decreases in the following indicators:

2 BOP Facilities are at Level 1
Level 2 {Yellow}, Medical isolation rate 2% to < 7%, or Facility vaccination rate 50% to < 65%, or The Community transmission rate is 50-99 per 100,000 over the last 7 days

Level 3, Medical isolation rate ≥ 7%, or Facility vaccination rate < 50%, or Community transmission rate ≥ 100 per 100,000 over the last 7 days.

CPR Can Save A Life


“As a cardiologist, I have been frustrated learning of athletes dying on the playing field unnecessarily and resuscitating people brought into our ER with no brain viability – because people do not know what to do and it’s so simple. We have to change this.”


dr. holly anderson signature

Attending Cardiologist at NewYork-Presbyterian Hospital
Director of Education and Outreach for The Ronald O. Perelman Heart Institute

For a personal, one-on-one call with me to discuss your current issue, or that of a loved one,  give me a call (240.888.7778). If I cannot answer, please leave me your name, number, and a brief message, as I make every effort to return all of my calls – that same day. Marc

We are not Attorneys, you need legal representation.

Medical Health Mental Health

Before any initial designation decision is made, DSCC staff assess a provisional BOP CARE LEVEL from I–IV for each inmate. BOP institutions also have a care level assignment that reflects the medical care resources available at that facility.

The Designation and Sentencing Computation Center (DSCC) designates those inmates with Medical (and Mental Healthcare), CARE LEVEL I and II.

For those inmates with Medical (and Mental Healthcare), Care Levels III and IV, the designation decision will be made by The Office of Medical Determinations and Transportation (OMDT).



Medical Health CARE LEVEL I

  • Inmates are generally healthy but may have limited medical needs that can be easily managed by clinician evaluations every 6 mos.
  • Inmates are less than 70 years of age.
  • Examples: mild asthma or diet-controlled diabetes not requiring medications.
  • Community Hospital Medical centers may be located over one hour away.

Medical Health CARE LEVEL II (the majority of BOP facilities)

  • Inmates are stable outpatients who require at least quarterly clinician evaluations.
  • It can be managed in chronic care clinics, including mental health issues.
  • Examples: medication-controlled diabetes, epilepsy, and emphysema.
  • Hospital Medical centers may be located within one hour of the facility.

Medical Health CARE LEVEL III

  • Inmates are fragile outpatients who require frequent clinical contact to prevent hospitalization.
  • May require some assistance with activities of daily living (BOP Program Statement 5200.05, page 2), but do not need daily nursing care.
  • Examples: cancer in remission of less than 1 year, advanced HIV disease, severe mental illness in remission on medication, severe congestive heart failure, and end-stage liver disease.
  • The designation is done by BOP’s Office of Medical Determinations and Transportation (OMDT).

Medical Health CARE LEVEL IV

  • Functioning is severely impaired.
  • Cannot perform Activities of Daily Living (ADL), such as caring for oneself, performing manual tasks, eating, sleeping, walking, standing, sitting, reaching, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, bathing, and cleaning oneself.
  • Requires 24-hour skilled nursing care or nursing assistance.
  • Examples: cancer on active treatment, dialysis, quadriplegia, stroke or head injury patients, major surgical patients, acute psychiatric illness requiring inpatient treatment, and high-risk pregnancy.
  • The designation is done by BOP’s OMDT.
  • There are seven Federal Medical Centers
    • FMC Butner (North Carolina); the cancer center for the BOP, provides inpatient medical/surgery and mental healthcare and sex offender treatment programs, along with housing all security levels.
    • FMC Carswell (Texas); is the only facility just for women.
    • FMC Devens (Massachusetts); provides dialysis, one of several facilities that provide a residential sex offender program, along with inpatient mental healthcare.
    • FMC Forth Worth (Texas)
    • FMC Lexington (Kentucky); for lower security.
    • FMC Rochester (Minnesota); is contracted with the Mayo Clinic providing all levels of complex medical care along with inpatient mental healthcare.
    • FMC, Springfield (Missouri); higher security, dialysis, and inpatient mental healthcare.

BOP Psychology Programs

Medication availability (~ 3500 different drugs), falls into 3 tiers;

  • Available- On Formulary (Which are they?)
  • Non-Formulary; Requires a lengthy Preauthorization Process. Which are they? How do you ensure their availability for your client upon their admission starting on day 1?
  • Just not available; what similar (equivalent) substitutions need to be requested? (What do you do here?)

If You Suspect You’re The Target of a Federal Investigation | Before The Presentence Interview (PSI) | After The PSI – But Before The Sentencing Hearing | or After Sentencing or You’re Already Incarcerated – There Are Still Things – At All Levels, We Can Do