|Before any initial designation decision is made, DSCC staff assess a provisional CARE LEVEL from I – IV for each inmate. BOP institutions also have a care level assignment which reflects the medical resources available at that facility.
The Designation and Sentencing Computation Center (DSCC) designates those inmates with Medical (and Mental Healthcare), Care Levels 1 and 2.
For those inmates with Medical (and Mental Healthcare), Care Levels 3 and 4, 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.
Medical Health Care Level II (the majority of BOP facilities)
- Inmates are stable outpatients who require at least quarterly clinician evaluations.
- Can be managed in chronic care clinics, including for mental health issues.
- Examples: medication-controlled diabetes, epilepsy, emphysema.
For those inmates with Medical (and Mental Healthcare) Care Levels 3 and 4, the designation decision will be made by The Office of Medical Determinations and Transportation (OMDT).
Medical Health Care Level III
- Inmates are fragile outpatients who require frequent clinical contacts to prevent hospitalization.
- May require some assistance with activities of daily living, but do not need daily nursing care.
- Examples: cancer in remission less than 1 year, advanced HIV disease, severe mental illness in remission on medication, severe congestive heart failure, end-stage liver disease.
- Designation is done by BOP’s Office of Medical Determinations and Transportation (OMDT).
Medical Health Care Level IV
- Functioning is severely impaired.
- 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, high-risk pregnancy.
- Designation is done by BOP’s OMDT.
- Requesting a CARE LEVEL IV placement should be carefully considered as the inmates there are of all security levels that includes both violent and non-violent offenders.
- There are seven Federal Medical Centers
- FMC Butner (North Carolina); the cancer center for the BOP, provides inpatient mental healthcare and houses all security levels.
- FMC Carswell (Texas); 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); 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.