The PSR – A Medical, Medication, and Security Level Referral

I) The Presentence Report (PSR) is the court’s intake sentencing and placement/medical referral document.

  • The judge uses to determine the length of a sentence.
  • The Bureau of Prisons (BOP) uses it for prison placement.
  • Don’t overstate or hide medical and/or mental healthcare issues from the Probation Officer, or for inclusion into the PSR: because if it is not included within the PSR – it will definitely not be provided.

The Presentence Report PSR) determines a defendant’s placement process, taking into account the defendant’s medical and mental healthcare needs (e.g.; Bipolar Disorder), as evaluated by the BOP Medical CARE LEVEL I-IV structure.

II) Prescriptions should be included in the PSR, but their availability is either:

  • on formulary (available for use), or
  • non-formulary, these could be brought to the court’s attention at the sentencing hearing as these medications require a lengthy formal request process.
  • or just not available, in which case they may be able to provide a similar medication.


Currently, there is no attempt to address recidivism. This could be accomplished by recommending placement to a facility that would match with the defendant’s interest in either higher education (college) or learning a specific occupation or trade. All of this in an effort to interrupt the ‘revolving door’ re-incarceration paradigm.


An opportunity to reduce the Recidivism Paradigm.

Reentry is a sub-specialty that discusses how inmates are prepared to be released back into their communities. Why not start preparing for reentry before sentencing by supporting those defendants who want to change and create a positive future for themselves and their families? Matching them with a facility that supports an interest they may have in either higher education or in learning an occupational or trade; will, in the long run, reduce recidivism by better preparing these individuals for successfully reentering their communities.

The remaining, albeit significant challenge, is a political one; that being the removal of the word ‘felony’ (in certain cases) from a defendant’s record. This is because the word ‘felony’ which appears on most job applications prohibits the offender from reentering the job pool before they ever get the opportunity to appear for an interview.


The Presentence Report (PSR)