Category Dr. M Blatstein’s Blog

Compassionate Release

PPRS - PPRSUS - Physician Presentence Report Service

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…

Self-Surrender To Federal Prison

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…

Federal Sentencing: From PSR Preparation To Drafting The BOP Placement Request

In ALL cases, preparing for the Sentencing Hearing should start as soon as possible.
Why?
a) Depending on whether it’s a state or federal case, there may only be weeks (or months) after the guilty verdict.
b) Getting all medical records via the HIPPA release can take a long time as some physicians and hospitals have been busy, especially in the age of COVID-19. HIPAA-COMPLIANT AUTHORIZATION FOR THE RELEASE OF PATIENT INFORMATION PURSUANT TO 45 CFR 164.508.
c) Coordinating character references, expert witnesses, and documentation for their PSR all takes time.
d) Developing the PSR, along with recommendations for placement, takes time.

 

I- The Presentence Report is used by;
1st) Judges
To establish the length of the sentence, along with they have the option to make a placement request.

2nd) The BOP, For Use It For Facility Placement.

3rd) Probation: Use it during Supervised Release.

4th) It then becomes a permanent part of the defendant’s record.

5th) Lastly, for inmates, it’s referred to as the ‘Inmates Bible.’

 

II) Sentence Length Determined By The Court based on;

2021 (Released), Judiciary Sentencing INformation (JSIN) In real-time, the platform provides quick and easy online access to sentencing data for similarly situated defendants – An Updated USSC Sentencing Table.

USSC Sentencing Table (Point Based), [2018, CHAPTER 5: SENTENCING TABLE]
Offense Level (0-43+): *24+ categories.

Vs
Criminal History (0-13+)
Points for each prior sentence > 1 Year + 1 Month.
Points for each prior sentence > 60 days, not counted above.
Point for each prior sentence, <= 60 days not counted above, for up to a maximum of 4 points in this category.
Points for each revocation with a new charge or under federal supervision.
Point for each prior sentence resulting from a conviction of a crime of violence that did not receive any points as noted above because such sentence was treated as a single sentence, up to a total of 3 points for this subsection.

 

III) BOP Determines Placement Designation
1st) Healthcare: provided based on a CARE LEVEL I-IV Structure
Applies to Medical and Mental Healthcare CARE LEVELs.
Psychology and Life Skills National Programs have now been embedded into the First Step Act, with its limited availability and associated security requirements.
There are approximately 3,500 Medications in the BOP, which fall into 3 tiers. PPRS Prison Match™ has all of these drugs categorized by tier level should this apply to your client.
Is there a special diet request?
Allergies: all need to be documented in the PSR.

2nd) Non-Medical Placement is based on;
Bed Space Availability. 
Aspirational: placement within 500 driving miles of legal residence.
Population Management: some inmates, for specified reasons, need to be monitored or separated from others.

2a) Public Safety Factors (PSF) & Management Variables [P5100.08, CN-I, 9/4/2019, Tables: Chapter 5, pages 12-13]
Could a Public Safety Factor (PSF: Chapter 4, pages 5-13) warrant a reduced security level?
Accepting Responsibility (may get point reductions).
Voluntary Surrender (gets point reductions).
Drug / Alcohol Abuse may allow RDAP.
RDAP; Required usage is within 1 year prior to the date arrested (illegal or legal medications or drugs).
AGE: 55+ (0Pts), 36-54 (2pts), 25-35 (4pts), <25 (8pts), Unknown (8pts).
Education Level: High School (0pts), GED Progress (1pt), No degree (2pts).

Sentence Length
>10 years – Low
>20 yrs – Medium, (Females: High)
>30 yrs – High

Disruptive Group
Male inmates will be housed in a High-security level institution unless the PSF has been waived.

Greatest Severity Offense
Males will be housed in at least a Low-security level institution unless the PSF has been waived.

Threat to Government Official
Male or female will be housed in at least a Low.

Deportable Alien: (male inmate who is not a citizen will be housed in at least a Low).

History Violent Behavior
A female inmate whose current term of confinement or history involves two convictions or findings – Low.

Serious Escape
A female, serious escape with the last 10 yrs. designated to Carswell Adm. Unit unless the PSF has been waived.
A male inmate with or without the threat of violence or escapes housed in at least a Medium.

Juvenile Violence
A male or female who has any documented:
a) Violent behavior, past or present, which resulted in a conviction, delinquency adjudication, or finding of guilt.
b) Violence: aggressive behavior causing bodily harm, death, or behavior likely to cause serious bodily harm. 

Serious Phone Abuse
a) A male or female who utilizes the telephone to further criminal activities or Promote Illicit Organizations.
b) Conviction is Not Required, housed at least in a Low.
c) The PSF should be entered regarding any one of the following, if applicable.

Criminal acts conducted by telephone
-Leader/Organizer or primary motivator; or
a) communicate threats of bodily injury, death, assaults, or homicides.
b) conducts Fraudulent activity (actual or attempted) in an institution.
-Leader / Organizer who used the telephone to conduct fraudulent activity (actual or attempted)…
a) Smuggled narcotics or alcohol into a prison.
-Federal Law Enforcement notifies the BOP of concern and needs to monitor an inmate’s telephone calls…
a) The inmate has been found guilty of a 100 or 200-level offense code for telephone abuse.
b) A Bureau of Prisons official has reasonable suspicion and/or documented intelligence supporting telephone abuse.

Prison Disturbance
A male or female inmate who was involved in a serious incident of violence, Engaging / Encouraging a Riot:
a) Males will be housed in at least a HIGH-security level institution and
b) Females will be assigned to the Carswell Adm. Unit.

2b) Plus
a) Judicial Recommendations
b) Options For Work Cadre Participation (at secure facilities without satellite camps), where the inmate is allowed to work outside the perimeter of the institution.
c) PSF Waved: An inmate may receive up to three Public Safety Factors (PSFs) wavers.
d) Long Term Detainee transfers for positive or negative behavior may cause placement in a facility different from the scored security or custody level.

 

IV) Making The Placement Request
In recommending a facility placement, it’s helpful to provide a reason, for example:
To facilitate regular family visitation, or
To permit participation in a specific:
a) Medical CARE LEVEL
b) Mental Healthcare CARE LEVEL
c) Psychology has limited in availability and has associated security requirements.
d) Vocational Training Program
e) UNICOR job availability

 

V) Military: Is your client a Veteran?
If possible, connect your client with a facility that caters to veterans.
FCI Morgantown started a Veterans to Veterans Service Dog Training Program in 2016.
The Participants are federally imprisoned military veterans housed in a special wing responsible for training service guide dogs for veterans with mobility impairments, Post Traumatic Stress Disorder (PTSD), or other military service missions.

If you’d like to discuss this, I look forward to speaking with you.

Dr. Blatstein

Physician Presentence Report Service

info@PPRSUS.com, 240.888.7778

SENTENCING PREPARATION

Your Allocution. This is your chance to speak directly with the judge, an important moment in your hearing. Judges are “…looking for remorse and insight as to why he did what he did and what he is doing to make sure that it doesn’t happen again.” I hope you find this video helpful.

By now, the judge has already read your Presentence Report and hopefully your Personal Narrative, where you’ve explained how you arrived at this point in your life, standing before the court today. You have the opportunity to show the court that you take responsibility for the harm you’ve caused your victims, that you’re committed to making things right, and that you’re determined never to return to this courtroom. This is your moment to make a strong impression, humanizing yourself to your judge.


 

SENTENCING MEMORANDUM

Judge Scola notes that sentencing memoranda are the first opportunity for lawyers to make a positive impression on him. “I am very impressed with lawyers who show legal advocacy in their presentence memorandum ondisputed guideline issues. I appreciate lawyers who give me everything I need well in advance of the hearing.”

Your Sentencing Memorandum is written by your attorney and provided to the court approximately 7-10 days before the day of your sentencing hearing and can be provided in written or written and video format. As you have initially read several examples of your attorney’s writing style, you have both agreed on your memorandum’s final message.

Depending on the number of “Character” Reference Letters, the best (3 or less) have been attached, summarizing their common theme in the Memorandum, then noting that there are (for example) another 27 that you have provided to your Probation Officer. They have all been reviewed to ensure that none will come off as insulting to your judge. Also attached is your Personal Narrative, Release Plan, and possibly your Allocution, depending on how nervous you are or will be at the time. If needed, the Allocution can also be in Video format, and if financing is an issue, a smartphone can be used. What Federal Judges Want to Know at Sentencing.


 

Judges across the country have been interviewed, and here are their thoughts – ‘From the Bench.’

3 JUDICIAL VIEWS FROM THE BENCH

As you read the Judges’ views, you’ll see they prefer to hear from you directly, through your Narrative and Allocution, rather than your Attorney.

Judge Xinis

Judge Xinis has expressed a dislike for sentencing memos that appear to be copy-paste jobs. She believes that simply citing legal precedents without providing relevant information about the defendant does not serve the memo’s purpose. Instead, Judge Xinis prefers that lawyers explain why a variance is justified. She also wants lawyers to start with the offense and the defendant’s details upfront, as she is interested in the facts of the case.

Experienced lawyers provide me with information about the 3553(a) factors and explain why a deviation from the guidelines is warranted. If a case involves excessive punishment, they elaborate on the legislative history or the U.S. Sentencing Commission history behind the guidelines, if such exists. Additionally, they clarify how a guideline sentence could undermine the community’s respect for the law.

Judge Xinis is a dynamic and engaged judge known for her active involvement in the proceedings. She takes pride in asking a lot of questions and welcomes live character witnesses to the court. Judge Xinis is particularly interested in live testimony from mental health professionals and is known to engage them on specific points in their report. She believes that lawyers can significantly impact the sentence by presenting a strong argument in court.

She encourages lawyers to present a compelling argument on why a prison sentence should not be the default sentence and what sentence would be sufficient but not greater than necessary. Judge Xinis is committed to ensuring a fair and just trial, and her passion and dedication to her role is evident in every case she presides over.

 

Judge Scola Notes

Judge Scola notes that sentencing memoranda are the first opportunity for lawyers to make a positive impression on him.

What makes a positive impression on Judge Scola?

    • “…good legal advocacy in their memorandum, particularly as to disputed guideline issues,”
    • …lawyers who get him everything he needs. in advance of the hearing,
    • …suggesting that you have five or six good character letters, “put in the sentencing memorandum, quote from them, and attach them as Exhibit. A.
    • Put the rest in another exhibit.”

Pet peeves.

    • Lawyers who,
      • …do not submit memorandums or submit them on the eve of or submit poorly prepared ones.
      • …give him boilerplate citations
      • …ask for ridiculously low sentences.
      • …don’t prep the defendant or character witnesses before the hearing;
      • …don’t interrupt their clients who, during allocution, start digging a hole for themselves, and
      • …forget that the court is the audience and put on a useless show for their clients, family, and friends.

 

Judge Mehta

Most judges, including Judge Mehta, consider the failure to submit a sentencing memorandum as a missed opportunity for legal advocacy. This document is of utmost importance as it provides an opportunity to explain why the defendant committed the crime and demonstrate that they have undergone a positive transformation since the offense. It is also a chance to showcase the steps taken toward rehabilitation and assure the judge that the defendant is less likely to re-offend. For instance, individuals who have successfully overcome substance abuse addiction demonstrate to Judge Mehta that they possess genuine strength of character and are less likely to commit crimes again.

Live testimony is an essential aspect of a case, particularly when it comes from mental health experts. Judge Mehta finds it helpful because it allows him to question the witnesses directly. He also prefers character witnesses to speak in person rather than sending a letter. Notification to Judge Mehta’s chambers several days in advance is all that is required to request live testimony. Judges agree that when evaluating cases, both live testimony and data and statistics from similar cases, including those related to mental health, are crucial.

 

Chief Judge, Beryl Howell

It is highly advisable, particularly in complex cases, to submit sentencing memoranda and letters early on, according to Chief Judge Beryl Howell of the U.S. District Court for the District of Columbia in Washington. To ensure a thorough review, it is recommended that these documents be submitted several weeks before the sentencing date.

Judge Charles R. Breyer of the U.S. District Court for the Northern District of California in San Francisco, who is also the vice chair of the Sentencing Commission, expressed concern about lawyers who fail to realize that they can request a recess to speak with their clients if they begin to play the victim or blame others during allocation.


 

Sentencing the White Collar Offender: A View From the Bench, July 9, 2015, Alan Ellis

When preparing a sentencing memorandum, it is important to minimize the use of citations. Refraining from quoting or citing Booker, Kimbrough, Gall, or the 3553 factors is recommended. Rather, an effective alternative is to create a sentencing video. This approach can save time and compellingly showcase the defendant’s regret and personal connections through well-spoken character witnesses. It is also crucial to own up to the offense and express sincere remorse, emphasizing that the defendant is typically a responsible and productive member of society who made an uncharacteristic error.

Point out instances of disparity by showing what sentences other judges in the same district are imposing on similarly situated offenders in similar cases. Use data from the Sentencing Commission, including national data and statistics, i.e., Interactive Data Analyzer (IDA). Judges are more likely to follow the sentencing patterns of their peers in the same district, state, and circuit. Finally, consider starting a restitution program. Even a small amount is better than nothing.



Call 240.888.7778 for a personal one-on-one call

to discuss your current issue or that of a loved one.

-Marc Blatstein

BOP Prisons and Jails 2020 | Unprepared | COVID-19

BOP Prisons and Jails 2020 | Unprepared | COVID-19

COVID- 19 in Prisons and Jails are unprepared and may now be forced to recommend, in some cases alternative diversion sentences and/or home confinement.
I can only believe that the PSR could play a significant role in this process.

Six feet apart, unlikely

6' apart, unlikely

 Prisons and Jails (, like Cruise Ships, act as perfect breeding grounds

John Hopkins has a Live Interactive Dashboard

Provides Current Reported Cases of COVID-19. Use our interactive web-based map to track cases of the virus around the world

UpToDate/Coronavirus disease 2019 (COVID-19)

_____________________________

Recent Press Releases:

September 2020

Visitation beginning to restart.

June 3, 2020 (Marshall Project)

How Prisons in Each State Are Restricting Visits Due to Coronavirus

 

June 3, 2020 (Marshall Project)

Jails Are Coronavirus Hotbeds. How Many People Should Be Released To Slow The Spread?

May 15, 2020 (Marshall Project)

For Mentally Ill Defendants, Coronavirus Means Few Safe Options

While their mental health deteriorates, some are stuck in jail as hospitals are decreasing admissions to prevent the spread of infections

April 17, 2020                                                                                           

Inadequate access to medical care poses a severe threat to a population that is already more vulnerable to coronavirus: there are about 10,000 people over 60 in federal custody, and about a third have pre-existing conditions. Photograph: Jonny Weeks/The Guardian

In prisons and jails across the deep south, coronavirus threatens to overwhelm

chronically underfunded, understaffed and overpopulated facilities

Mar 21, 2020;

Forbes; Can US Prisons React Fast Enough To COVID-19? By Walter Pavlo

 

March 22, 2020; 

Assistant U.S. Attorney Tanya Hajjar –  – wrote that no inmates at the Metropolitan Detention Center (MDC) in Brooklyn, NY or any other federal facility had tested positive for the coronavirus. What she failed to mention is that the BOP was not doing any testing of prisoners. ByJ.J. O’Hara

 

3-23-2020;

At least 38 people in New York City jails have contracted the virus. Associated Press

First federal prisoner, in Brooklyn, tests positive for COVID-19. Associated Press

3-20-2020

Florida beaches covered with 1000’s on spring break, 2020.
All of this while COVID-19 is spreading across our country and the world. As a growing number of state governors urged all of us to Shelter in Place, in Florida, their beaches were covered with 1000’s on spring break.
You ask why and I have no idea. But these revelers are now on their way home to spread the virus throughout their families, friends and fellow workers’ personal space. Yet another vector.
The spread of COVID-19 from these beaches will ultimately whether direct or indirectly impact our society and prison system.

The Marshall Project, 3-19-2020

‘Those 55 and older are a growing share of the people in prisons. They’re also the most at risk as coronavirus spreads.’ By WEIHUA LI and NICOLE LEWIS

Couple this with the unprecedented delay of the federal government to act in any manner to assist state governors since January 2020, COVID-19 has exploded across the country exponentially! These same prisons and jails are already overcrowded, resulting in a healthcare disaster ready to get out of control.

Marshall Project: Jails are perfect incubators for COVID-19.” By Cary Aspinwall, Keri Blakinger, Abbie VanSickle and Christie Thompson

3-19-2020

ICE Now could be another vector waiting to explode, impacting immigrants and ICE officers alike. While ICE claims to “have a plan”, the horse has already left the barn.

_____________________________

#covid19 #Covid19Prison #covidBOP

White-Collar FBI Target: How Do I Get Out of Prison — The Fastest?

White-Collar FBI Target: How Do I Get Out of Prison — The Fastest?

Hello and welcome

My name is Marc Blatstein, and I’m the Physician who founded the Physician Presentence Report Service (PPRS)

My focus in creating The Physician Presentence Report Service is to prepare you for what is to come.

 

Learn From My Mistakes – So You Don’t Make Yours.

Unfortunately, I’ve been in practice for 30+ years, which was interrupted by an early 6 a.m. knock at my front door and a 2nd at 8 a.m. at my podiatric medical practice – all for a problem I created.

As a result, I pleaded guilty to a Felony, was convicted of a federal White-Collar crime, and was sentenced to time in the BOP.

After my release and several years of hard work, my license was fully restored in 2010.

Around that time

·        I chose to use my skills in medicine

·        with my understanding of the BOP

·        to assist those of you,

·        who like me,

·        find themselves facing our Criminal Justice System.

While I found myself totally UNPREPARED

I Made It A Point

TO PROVIDE YOU WITH THE RESOURCES SO YOU WILL BE PREPARED –

BECAUSE

IN PRISON, AS IN LIFE PREPARATION = SURVIVAL

WHILE YOUR STAY IN  PRISON WILL BE TEMPORARY (and a bit terrifying)

The Goal Is To Be Productive and  Keep It as Short as Possible

So, let’s get to it!

 

Today, we’re going to Cover:

“You find yourself at the end of an FBI White-Collar Investigation

 And now you want to know: How Do I Get Out of Prison — The Fastest?

I)                 GOOD TIME CREDIT 15%

  • time reduction from the date the sentence was imposed.
  • Don’t get in trouble – No Infractions.

 

II)               First Step Act (FSA): LAW 12 MONTHS

The program allows up to 365 days of earned time credits (ETC) will apply to early release if you:

  • The court ordered your supervised release
  • You have a Low or Minimum PATTERN (SPARC-13) score
  • You have kept your PATTERN risk level for at least two consecutive assessments conducted by your Unit Team
  •  You have no detainers or unresolved charges, including immigration status
  • You have accepted All required programs and are in earning status.
  • RDAP

You’re allowed up to 1 Year OFF for RDAP

PLUS

UP TO ANOTHER 1 YEAR OFF AFTER THE SUCCESSFUL COMPLETION OF APPROXIMATELY 2 YEARS OF FSA PROGRAMS –  BUT DON’T STOP THERE…

 

III)             Congress Second Chance Reauthorization Act (SCRA). 12 MONTHS in an RRC Law  

  • If your sentence is > 60 mo (5 yrs) = last 6 mo on home confinement
  • If your sentence is < 60 mo (5 yrs) = last 10% on home confinement

1. The regulation mandates that 

  • “Inmates may be designated to community confinement as a condition of pre-release custody and Programming during their final months not to exceed twelve months.” 28 C.F.R. § 570.21(a).

2. This regulation also provides for 

  • home detention as a condition of pre-release custody during their final months of imprisonment,
  • not to exceed the shorter of ten percent of the inmate’s term of imprisonment or
  • six months.”

3. BOP staff is required to review inmates for RRC placement 17-19 months before their projected release date, and inmates are to be individually considered using the five factors listed in §3621(b).

4. Elderly Home Detention through the First Step Act: Rare to Get Program availability at all BOP facilities.

  • The qualifying age of 60+ years, and You can serve that last part at Home, but
  • You must have served two-thirds of the sentence must be served to be eligible.
  • The offender must be serving a term of imprisonment other than life imprisonment based on a conviction for an offense or offenses that
    • the offender must not have been convicted in the past of any Federal or State crime of violence, sex offense, or other offense enumerated in the statute.
  • the offender must not have escaped or attempted to escape from a BOP institution;
  • the BOP must determine that the release of the offender to home detention will result in a substantial net reduction of costs to the federal government, and
  • the BOP must determine that the offender poses no substantial risk of engaging in criminal conduct or of endangering any person if released to home detention.

IV)            P5050.49, CN-1 (2019), Compassionate Release/Reduction in Sentence: Procedures for Implementation of 18 U.S.C. § 3582(c)(1)(A) and 4205(g)

The new Compassionate Release Program has added more criteria to make qualifying inmates easier. These include medical circumstances for the inmate, non-medical circumstances for elderly inmates, situations where the family member caregiver of an inmate’s child has died or become incapacitated, and situations where an inmate’s spouse or registered partner has become incapacitated. One of the most significant changes is for elderly inmates with medical conditions. If an inmate is 65 years or older and suffers from chronic or serious medical conditions related to aging, they may qualify for release. In addition, a 65-year-old inmate with deteriorating mental or physical health that significantly affects their ability to function in a correctional facility may also qualify, particularly if conventional treatment offers no substantial improvement.

I hope you have found this helpful, and am grateful that you have taken the time to listen.
My Contact info
PPRSUS.com
240.888.7778

Treatment and Rehabilitation in Federal Prison: The Critical Role of the Presentence Report

Availability of Treatment and Rehabilitation in Federal Prison

The Federal Lawyer Jan./Feb. 2021                    Availability of Treatment and Rehabilitation in Federal Prison

 

 

The Critical Role of the Presentence Report
MARC BLATSTEIN, D.P.M.; FAY F. SPENCE, J.D.; E.J. HURST II, J.D.; AND MAUREEN BAIRD

Prisoners have a constitutional right to adequate medical care, but what that means and how to get needed treatment are often not well understood by attorneys representing criminal defendants.
This article attempts to address that knowledge deficit by explaining the medical, mental health, and substance abuse programs and policies in the federal Bureau of Prisons (BOP), as well as some of the educational, vocational, and other available programs intended to rehabilitate inmates and prepare them for return to society. Equally important, the article explains the critical role of the presentence report (PSR) in determining whether and how needed treatment and programs will be available to a defendant. Documentation is paramount, and the diligent attorney must be proactive in gathering and supplying the appropriate documentation to the probation officer preparing the PSR and to the court, along with a sentencing memorandum advocating for the defendant’s desired sentencing outcome and institutional placement, supported by the sentencing factors set forth in 18 U.S.C. § 3553(a).

https://www.pprsus.com/wp-content/uploads/2022/09/Dr.-Blatstein_The-Federal-Lawyer-The-Critical-Role-Of-The-PSR_Jan-Feb2021.pdf

TO SUCCEED – 10 LIFE LESSONS

Admiral McRaven’s Story: Write Your Story – Your NARRATIVE   



William H. McRaven, rising through the ranks to become commander of the Pentagon’s Joint Special Operations Command, was credited for organizing and overseeing the execution of Operation Neptune’s Spear, the special ops raid on Osama bin Laden on May 2, 2011. Admiral McRaven’s experiences and challenges hold true in those challenging times of warfare as a member of SEAL Team Six or to those of us facing Federal Indictments and Prison (temporarily).

His 10 Inspirational Lessons to Live by, from Mandela to a young girl in Pakistan, Malala, should leave you with hope. I Hope You Take 15 Minutes and watch this YouTube; it may Change Your View on Life – “NEVER GIVE UP.”

#10. NEVER GIVE UP

  1. START THE DAY WITH A TASK COMPLETED – MAKE YOUR BED, [PLEASE DON’T LAUGH]
    • Don’t depend on The Correction Staff For Support now that you’re aware and Have Your Plan – Work Your Plan…
  2. FIND SOMEONE TO HELP YOU THROUGH LIFE
    • You’ll need a Federal Criminal Defense Attorney with Experience in Federal Criminal Court.
    • You may also need someone Familiar With Federal Prison and the work needed to get you through – with a Possible Early Release Date.
    • REMEMBER – NO GUARANTEES
  3. RESPECT EVERYONE
    • Then, become friends with those with shared interests – Don’t Get Disciplined and No Cell Phones.
  4. LIFE IS NOT ALWAYS FAIR
    • Disappointments are how the BOP operates – How You React is Up To You, Stay Humble.
  5. DON’T BE AFRAID TO FAIL
    • That’s part of Life and Moving Forward – Please don’t constantly Complain to your Case Manager – Everyone else is Complaining – Keep Your Head Down and Do the Work.
    • If needed: Start The Administrative Remedy Process.
  6. SOMETIMES, HIT LIFE HEADFIRST 
    • This Is What We Have All Been Doing Since Being Indicted – Own It and Keep Moving Forward
  7. FACE DOWN THE BULLIES
    • If it’s an inmate – walk away; if It’s BOP staff – Apologize
  8. STEP UP WHEN TIMES ARE THE TOUGHEST
    • The only person’s emotions you can control – Are Yours.
  9. HOPE – LIFT UP THE DOWNTRODDEN: Washington, Lincoln, King, Mandela, and even a young Pakistan Malala
    • Prison Is Temporary IF THEY OVERCAME OBSTACLES – So Can You
  10. NEVER GIVE UP
    • Don’t Give Up On Working Towards Your Goal, Your REENTRY Plan. Even if your Case Manager throws it in the trash, it eventually will be read as you document your journey.
    • It could be used in a BLOG or Website.
    • The Halfway House Reentry Manage, Supervised Release Probation Officer, and possibly your Judge may eventually read it.

LIFE LESSONS, WHETHER IN PRISON OR A SEAL

Your Personal Narrative | PSI Investigation Report

Your Personal Narrative

and

The Presentence Interview Investigation Report

When addressing the Judge, initiating a written exercise is advisable. The Personal Narrative presents a great opportunity to share pertinent details about yourself and the incident in question.

YOUR SENTENCING HEARING – YOUR 1st and ONLY CHANCE TO SPEAK WITH YOUR JUDGE 

 What Can You Do To Stand Out?

M.. Santos interviews Federal Judge Mark Bennett on the importance of writing Your Personal NARRATIVE and including it in Your Presentence Report.

Creating a compelling narrative requires multiple revisions. To ensure the best possible outcome, it’s worth asking trusted friends or family to review beforehand. While your biography should contain pertinent information, we’ll collaborate to select the most pertinent details. We must communicate with those closest to you to gain a more intimate understanding of your personality, character, and circumstances. Remember, this is Your Life – we should approach it with the utmost seriousness.

The categories below are meant to encourage deep reflection but may be challenging. It is advisable to take time to consider them carefully and seek advice from trusted individuals, including a legal representative. You must provide authentic and heartfelt responses for several reasons. Firstly, it will hold no worth if you do not believe in what you are saying. Secondly, if a Judge suspects that someone else wrote your responses, it may cause further complications for you. Lastly, Probation will review your answers and offer recommendations to the Judge, therefore, they must trust your responses are sincere.

 Topic Categories:

In the United States Code, specifically in Title 18, Section 3553, there are provisions that state the various factors that judges must take into consideration when determining the proper sentence for a given offense. Among the most pertinent considerations are the Nature and Circumstances of the offense itself, as well as the offender’s Personal History and Individual Characteristics. These factors help to ensure that sentencing decisions are fair and just and that the punishment fits the crime. Here, through your NARRATIVE, this is your opportunity to provide your Story, Autobiography, or NARRATIVE of your life and what brought you to this day. Accepting responsibility, Triggering Events, and Having Remorse for the Victims you Created,

It is essential to start by conveying heartfelt condolences to the victims of the crime and acknowledging the immense agony and distress they have undergone. It is imperative to understand the seriousness of the crime and refrain from belittling its severity in any manner. This provides an opening to delve deeper into the subject.

Take some time to reflect on the events that led to this moment. What circumstances led you to commit this act? If applicable, you may draw on pertinent experiences from your childhood. Seeking the advice of an expert or legal professional may be helpful.

It is advisable to try and identify any triggers that may have contributed to your actions. Develop a plan to eliminate them from your life. It is pertinent to refine your initial drafts over time and to ensure that your personal narrative is authentic and truthful.

What have you learned from this experience? Did it bring up memories from your past? Share these insights with the judge. If you have victimized others, describe your plan to make amends, even if it is a small effort. Finally, outline your plan for preventing re-offending and ensuring that you will never appear in their courtroom again.

It is advisable to inform the Judge of your willingness to take financial responsibility and make amends. Bring some money with you (such as $100 or $1000) and tell the court that you would like to submit it if you can. You may say something like, “I understand that this may not be a significant amount, but I would like to offer $ 000.00 to the court.” 

Moreover, it would be helpful to let the court know that you have a job offer (only if you do and have that Character Letter with you) for when you return home and are willing to participate in the Financial Responsibility Program. If the Judge orders a payment of $25/Qt, you may find it challenging to comply. However, doing your best to honor the plan is advisable, even if you have little to no financial support while in prison. 

Not participating in the Financial Responsibility Program (FRP) while in prison may affect your ability to participate in other programs and could be held against you. Therefore, it is strongly advisable to participate in the FRP and any other programs that may be available to you.

Overall, it is essential to take financial responsibility seriously, as it can have a significant impact on your future. Additionally, it is advisable to approach the situation respectfully and properly, as this may positively impact how the court views your case.

Cases that judges find most challenging. If you fall into either of these two categories, the plan we have covered still applies, but with a caveat.
1. Predatory child sex offenders who have harmed children; if you fall into this category – You will be strictly monitored once released.

2. White-collar criminals who have harmed vulnerable people. If you fall into this category – once off supervised release, you are smart enough to know that you do not want to return.

 

 The Presentence Interview Investigation Report

can be aided by

Your Personal Narrative and Allocution

While I previously mentioned that it could be started in written format, it could also be submitted with the Sentencing Memorandum and made available in,

  • Video MP4 format and placed in a flash drive or CD so that the judge could easily see it the week before (optimal timing) sentencing.
  • You could work this with your attorney using either PowerPoint or a smartphone.

YOUR PRESENTENCE INTERVIEW (PSI) – INVESTIGATION REPORT

 


LIFE LESSONSAdmiral McRaven


PREPARATION FOR THE PRESENTENCE INTERVIEW.

§9:30.7 Inside Baseball: Interview With Former Federal Probation Officer Tess Lopez, by Alan Ellis.

 

Counsel and Clients need to hold each other accountable and be respectful and listening to each other. While counsel is reaching out to Probation, the defendant is responsible for providing copies of ‘all’ of their Biographical Background and Personal Identification information that Probation has requested from your attorney.

At the same time, it is critical to draft a well-thought-out NARRATIVE and Release Plan and include content relevant to their PATTERN SCORE and Risk Assessment Survey. After multiple revisions, these are woven together, and then with the copies of all of the documents that are accurate and comprehensive, are organized and prepared and then given to the Probation Officer ~2 weeks before the interview so that it can be eventually included in their PSR, under Seal.

This allows time at the interview for the Probation Officer to get to know the client and ask any questions they may have. This ‘discussion’, with counsel present and the fact that the defendant was prepared and the officer’s time was respected, is usually appreciated as Probation Officers’ time is a rare commodity. Being comprehensive and accurate, as outlined below, allows the court to consider sentences outside the guideline range or “variances” because you are the only resource for the – the government will Not Volunteer this information.

I. Counsel’s goal is to learn the final “dictation date,” or the date by which the P.O. must complete their first draft of the official Presentence Report (PSR).

  • Right away, counsel and client know their timeline to have everything completed. If the client has a company with legal issues that need to be resolved or personal issues, all of this requires time in addition to preparing for their Interview.
  • Therefore, requesting, at a bare minimum 3 months to prepare for the interview would be great. This would also have been done at the guilty hearing, and hopefully, the judge agreed before setting the date for sentencing.
  • Counsel learns who the PO will be and contacts them before they have spoken with the Prosecutor. Next, building a fundamental introductory relationship is important to understand what the officer already knows – which hopefully is not a lot!
    • This offers counsel the opportunity to explain your position, as the PO was not at trial and has not yet formed an opinion.
    • They may still have an open mind if they have not spoken with the prosecutor.
      • If the PO had already spoken with the Prosecutor before they ever met/interviewed you – they may have already been influenced, just not in your favor.
    • Your attorney aims to make their case and position with a personal meeting.
    • Meanwhile, you have begun writing your personal narrative, which will undergo multiple rewrites until it is distilled into its final version, where you accept responsibility.
      • This is your story, a Unique and Honest version of the events that resulted in your arrest. Once complete, your Personal Narrative is to be included in your Presentence Report.
      • Next, start writing your Release Plan, followed by an Allocution or your conversation with the judge at sentencing.
      • Then, be ready should the Judge wish to speak with you at the Sentencing Hearing and honestly answer his/her questions from the heart.
  • Prison Placement: Counsel will start framing reasons “why” this prison placement request is being made (e.g., supported with reasons why, for example, programs: medical, FSA programming, etc.).
  • Counsel will outline each factor for the PO to consider under 18 U.S. Code § 3553
    • Part E (departure, assistance in the investigation or prosecution of another person, section 994 of title 28,)
      • These factors include aspects of the offense or the offender’s background that the guidelines do not adequately consider. Some examples of E factors include:
        1. The defendant’s role in the offense
        2. The defendant’s criminal history
        3. The presence of substantial assistance provided by the defendant to law enforcement
        4. The defendant’s mental or physical condition
        5. The defendant’s acceptance of responsibility for the offense
        6. Any other relevant factor that justifies a departure from the guidelines and
    • Part F (sentence below the guideline range under 18 U.S.C. §3553(a)) of the PSR makes strong arguments to support these requests.
      • These factors are also considered under 18 U.S.C. § 3553(a) and include:
        1. The nature and circumstances of the offense
        2. The history and characteristics of the defendant
        3. The sentence must reflect the offense’s seriousness, promote respect for the law, and provide just punishment.
        4. The need to afford adequate deterrence to criminal conduct.
        5. The need to protect the public from further crimes of the defendant.
        6. The need to provide the defendant with needed educational or vocational training, medical care, or other correctional treatment.
      • Defendant does Not Have:
        • 1) more than 4 criminal history points, 2) a prior 3-point offense, or 3) a prior 2-point violent offense
        • did not use violent threats
        • did not result in death or injury
        • was not an organizer, leader, manager, or supervisor
        • defendant has truthfully provided the Government with all information and evidence
    • If the PO is receptive to a variance, it may be key to convincing the court to consider a sentence below the guideline range.
    • If your client receives a prison sentence, the Presentence Report (PSR) followed by The Statement of Reasone (SOR) are the documents used by the BOP to determine your client’s future.
      • This information (or lack thereof) will dictate whether the client is sent to a dormitory-style Camp or the Penitentiary Maximum-Security Prison.
  • Meeting with the probation officer is to discuss their position on these issues.
    • This is particularly important in a complex case involving numerous counts, various ways to calculate the guidelines, and which guideline is appropriate.
    • Personal contact with the probation officer builds rapport and offers an opportunity to explain your position.
    • Sometimes as they are so busy with no extra time, and for a complex case, the PO would welcome the opportunity for defense counsel to explain their version of the case.
    • Remember, the PO wasn’t present at the trial; therefore, this personal meeting also assures the lawyer that the PO understands the case and their personal position. At the same meeting, they can get a feel as to how receptive the PO is.
  • When working with Probation Officers, a little extra effort goes a long way as they are very busy, doing their best, and never have enough time. They may appreciate your efforts in easing that portion of their workload.
    • Consider presenting your entire view of the case clearly in a letter to the PO as soon as possible.
    • It is helpful to have the Probation Officer and Assistant U.S. Attorney (AUSA) buy into your client’s behavior and role in the offense before requesting relief from the Guidelines, and again, everything to be completed and handed in before the interview and dictation date.

II. Learn as much as they can about the judge’s likes and dislikes. If they find this hard, ask a Federal Defender.

  • Counsel will want to learn whether the judge reads sentencing memos and character letters and how long those letters should be.
  • If applicable, issues like overcrowding and staff shortages could affect your client’s access to their Programming Needs or other required BOP Services- is the Judge sensitive to this?

 III. Mental Illness: Did this contribute to the crime, or has your client suffered significant abuse or trauma? Either way, have them evaluated, and if you are unsure of a local expert, ask the prosecutor for recommendations.

  • If there is a current treating therapist, it is best for all if they appear as witnesses; most judges would rather hear from a treating physician than a doctor for hire. This is not to put down experts, as they provide expert testimony that can only come from a select few.
    • If, on their own, treatment was started before the indictment, Guilty Hearing, PSI, or Sentencing, all the better. (AA, NA, GA, Psych. Counseling); this needs to be included in the PSR, Sentencing Memorandum…
  • Mental Health example in this White Collar case. This client is an
    • Exceptionally bright, high-functioning, and very successful individual.
    • He/She is very skilled, highly motivated, and works 18-20-hour days for money-promotions-privileges.
    • The psychological evaluation:
      • The client is an obsessive-compulsive perfectionist.
      • Suffers from depression and anxiety.
      • The overwhelming desire to be successful, personally and financially, may cause an ordinarily law-abiding person to “cross the line” into inappropriate or illegal behavior.
        • Familiar?
      • Later diagnosed with bipolar disorder
    • Latest statistics by the U.S. Sentencing Commission
      • 6 percent of inmates received downward departures for diminished capacity (U.S.S.G. §5K2.13).
      • If half of the inmates have symptoms of mental health problems,
        • yet only 2.6 percent are receiving departuresare the judges simply insensitive?
      • Or does the problem lie at the feet of the defense counsel, who is not taking the time to conduct a thorough investigation into the client’s social and psychological history?

 IV. Character Letters: only pick out a few to discuss in the memorandum, but add at the end that “there were another 50 that all said similar things, and the PO has those.”

  • If an employer is willing to write a character letter that says they are willing to rehire you due to your skills and character once you are released – that is a Great letter for The NARRATIVE and Release Plan. 

 V. The Sentencing Memorandum is best submitted approximately seven days before the sentencing hearing,

  • Corroborate the issue with the appropriate supporting documents, albeit a doctor’s letter/ report/ medical/treatment records, etc. Remember to document, document, document.
  • All of this is preferably done under seal via the Probation Office so that the information is appended to the PSR when given to the BOP.
  • In The Sentencing Memorandum, give the Judge 1 or 2 cases with the highlighted pertinent points; if there is a video or pictures, include those.

 VI. 18 U.S.C. §3553(a)(2)(D) requires a sentencing court to consider The Nature and Circumstances of the offense and The History and Characteristics of the Defendant. In the client’s NARRATIVE, most of this should be covered.

  • To determine which 18 U.S.C. §3553(a) factors apply, while someone with experience should:
    • 1st) Conduct in-depth (multi-hour) interviews with the defendant, should an evaluation be needed (even in White-Collar); now is the time, and
    • 2nd) plus having the time (multi-hours) to speak with family members, close friends, and business associates or trusted employees to understand the person better.
    • As most Officers do not have ‘any’ time, at times, this is left to counsel to do themselves. This provides the opportunity to discuss hiring someone to do this part of the background work, or it may just not get done.
  • Evaluation of the care needed for a client’s medical condition – may support a cost-related (home confinement) argument.
    • This is most apparent in cases of defendants diagnosed with a terminal illness or a diagnosis that falls outside the scope of what the BOP can provide (Long-Haulersor Post-COVID).
  • The cost of incarceration should also be factored into whether a sentence is “greater than necessary.”
    • Last are those, where appropriate, emphasizing to the court what the client would be doing if not incarcerated (i.e., working, supporting a family, paying taxes, and/or restitution).

The Presentence Report Determines Your Future – So Preparation For Your Interview is Vital

  • Judges use the PSR to determine the length of a sentence.
  • The Bureau of Prisons (BOP) uses the same PSR for prison placement.
  • The PSR is again used by Probation during Supervised Release.
  • Lastly, this same PSR becomes a permanent part of your record and the Inmates Bible – It truly is the gift that keeps on giving.

Call Dr.Blatstein at 240.888.7778 or by email for a No Obligation Free Consult; I return all of my calls personally.

Medications 💊 For Indigent Inmate/Patient | AVAILABLE AT THE COMMISSARY, (OTC)

OVER-THE-COUNTER (OTC) MEDICATION AVAILABLE THROUGH THE COMMISSARY

Ammonium lactate lotion/cream

  1. Requests to improve the appearance of the skin will be disapproved.
  2. Indigent Patient AND treatment is medically necessary. Orders are limited to 30 days in duration when approved on the basis of indigent status alone. If renewed, the indigent status will be reassessed.

 

Analgesics Topical – capsaicin cream, diclofenac 1% (Voltaren®), salicylate/menthol (Bengay®)

  1. A failed 30-day trial of oral NSAIDs or NSAIDs is contraindicated AND
  2. Documented improvement in functional status (required for renewals) OR
  3. Indigent Patient AND treatment is medically necessary. Orders are limited to 30 days in duration when approved on the basis of indigent status alone. If renewed, the indigent status will be reassessed.
  4. Diclofenac gel 3% will not be approved without sufficient justification as to why 1% cannot be used.

Artificial tears – solution and ointment (various OTC formulations)

1. Initiated by an optometrist or ophthalmologist with ongoing evaluation and

2. Failure of commissary alternatives or Indigent Patients AND treatment is medically necessary. Orders are limited to 30 days.

 

Benzoyl peroxide washes/soaps

  1. Chronic cystic scarring acne and/or causing secondary bacterial infections OR
  2. Indigent Patient – treatment is medically necessary. Orders are limited to 30 days in duration when approved on the basis of indigent status alone. If renewed, indigent status will be reassessed.

Bismuth Subsalicylate (Pepto Bismol®)

  1. Indigent Patient: treatment is medically necessary AND has failed OTC Indigent program alternatives. Orders are limited to 30 days in duration.

Calcium carbonate (Tums®)

  1. Indigent Patient: treatment is medically necessary AND has failed OTC Indigent program alternatives. Orders are limited to 30 days in duration.

Carbamide peroxide 6.5% ear drops (Debrox®)

  1. Indigent Patient – treatment is medically necessary. Orders are limited to 10 days in duration when approved on the basis of indigent status alone. If renewed, indigent status will be reassessed.

Coal Tar shampoo/gel/solution

  1. Documented failure of OTC commissary selenium or coal tar shampoo OR
  2. Indigent Patient, treatment medically necessary AND has failed OTC Indigent Program alternatives (ex: Selenium 1% Shampoo). Orders are limited to 30 days in duration when approved on the basis of indigent status alone. If renewed, indigent status will be reassessed
  3. For Psoriasis, lesions interfere with function.
  4. For Psoriasis: Psoriasis affects >10% of BSA (refer patients to the commissary for mild psoriasis) OR crucial body areas (hands, feet, fact, etc.)
    • Selenium shampoo/lotion
    • Documented failure of OTC commissary selenium or coal tar shampoo OR
    • The patient is indigent, treatment medically necessary, AND has failed OTC Indigent Program alternatives (ex: Selenium Shampoo 1%Shampoo). Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.

Hemorrhoidal cream/ointment- (Preparation H®, Anusol ®, others), dibucaine ointment

  1. Pending hemorrhoid surgery or 30 days (or less) post-hemorrhoid surgery OR
  2. For indigent Patients, treatment is medically necessary. Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.

Loperamide (Immodium®)

  1. For Indigent Patients, treatment is medically necessary. OTC has failed Indigent program alternatives. Orders are limited to 30 days in duration.

Magnesium/aluminum/simethicone-containing products (Maalox®/Mylanta®/Gaviscon®, Milk of Magnesia®, etc.)

  1. For Indigent Patients, treatment is medically necessary. OTC has failed Indigent program alternatives. Orders are limited to 30 days in duration.

Moisturizers topical (all formulations except Vitamin A&D)

  1. Failed a 30-day trial of two commissary moisturizers OR
  2. Indigent Patients, and treatment are medically necessary. Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.

Naphazoline-pheniramine Ophthalmic drops (Visine-A®, Opcon A®)

  1. Initiated by an optometrist or ophthalmologist with ongoing evaluation and
  2. Failure of commissary alternatives or
  3. Indigent Patients, and treatment are medically necessary. Orders are limited to 3 days.

Simethicone tablets/capsules (Gas-X®)

  1. Indigent Patients, and treatment are medically necessary. Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.

Sunscreens (various formulations)

  1. Prescribed an essential medication causing documented photosensitivity OR
  2. For indigent Patients, treatment is medically necessary. Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.
  3. Requests due to the unavailability of protective clothing will be disapproved.
  4. Approvals will be for SPF 30 products only.

Vitamin A&D Ointment

  1. Diabetes with Neuropathy OR
  2. Circulatory disorder evidenced by the absence of pedal pulses and/or extremity hair loss due to poor circulation or abnormal monofilament exam demonstrating loss of sensation OR
  3. Indigent Patients, and treatments are medically necessary. Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.

Witch hazel & glycerin pads topical (Tucks® Pads)

  1. Pending hemorrhoid surgery or 30 days (or less) post-hemorrhoid surgery OR
  2. Indigent Patients, AND treatment are medically necessary. Orders are limited to 30 days in duration when approved based on indigent status alone. If renewed, the indigent status will be reassessed.

The administration of that dose must be recorded on a Medication Administration Record (MAR’s) by the employee.

Risk Evaluation and Mitigation Strategies (REMS)