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

MORE THAN WHISPERS – You’re Target #1, The FBI’s Coming

You’re Target #1, The FBI’s Coming

It’s MORE THAN WHISPERS 

You’re Going to  Prison, – There is no way to Dress this up – BUT

If the Rumors and whispers that the FBI is poking around are true…

I’d take that seriously

HELLO AND WELCOME, MY NAME IS MARC BLATSTEIN AND I AM THE PHYSICIAN WHO FOUNDED THE PHYSICIAN PRESENTENCE REPORT SERVICE

AFTER 30+ years IN PRACTICE

MY MORNING WAS interrupted by the feds at 6 am knock at my front door, and a 2nd at 8 am at my medical practice – interrupting my patients and staff, all for a problem that I created.

As I was Guilty, – I Plead to a Felony and was convicted of a federal White-Collar crime, and was sentenced to time in the BOP as a Justice-Impacted Person.

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 My Mission

TO PROVIDE YOU WITH THE RESOURCES

That You Will Need

SO, YOU’LL BE PREPARED- BECAUSE

 

IN PRISON – AS IN LIFE

PREPARATION = SURVIVAL

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

 

The Goal Is To Be Productive

FOLLOW YOUR REENTRY PLAN

and

Get Home As Soon As Possible

So let’s get to it!

 

If you’re hearing FBI whispers,

•        Start interviewing attorneys, ask questions, get references,

•        Sentencing Memorandum, ask to read samples written for previous clients, are they boilerplate?

•        Then, be honest with your attorney, and yourself – no surprises.

 

PSI Preparation is crucial – You Are your best and only Advocate

Ask yourself: 

•        Do you have confidence in your defense?

•        Do you need additional team partners who are specialized in,

  • Sentencing Mitigation, Allocution, Personal Narrative, and Reentry Release Planning Advocacy

•        All Before Your Presentence Interview

 

If Not, there are No Redo’s ⇒ this is Your Future ⇒ Speak up now

 

PREPARATION and SELF-ADVOCACY are your CORE VALUES

 

PREPARATION:

•        Attorney Interview, Working together – must be a Joint Defense

  • Decision #1: Trial or Plea

•        PRACTICE: Your Allocution (& Memorandum), for the Sentencing Hearing

  • Your Personal Narrative could take a month+ to write
  • The Memorandum is given by your Attorney

•        Your Presentence Interview (PSI)

  • Know Your Narrative → weave it into your conversation with your PO, for placement into your Presentence Report (PSR), which is now complete.

 

SELF-ADVOCACY:

•        Relies on the skills that made you successful, some being “Self-Motivated”

•        At your Attorneys request, your Personal Narrative was included in Your PSR

•        Reentry Planning

•        Sentence Mitigation Strategies are employed Before Sentencing, and During Incarceration


YOUR PREPARATION

Working Together With Your Attorney At Every Stage

 

1st) Be honest with your attorney, about everything –

•        Plea or Trial – Nobody wants surprises

 

2nd) Your PSI, needs to include everything about you.

•        In addition to all your Biographical Background information

•        Medical, Character References, Education, Legal, Etc.

•        Your attorney has connected with your PO before your Interview to;

  • get a “pulse” on how much they know, to
  • present their case/defense strategy
  • and learn the date the PO must have their final PSR completed

•        RDAP (if applicable), Include it now

•        If is not there, and you need it later to reduce your time, that may be a big lift.

•        Compassionate Release (medical issues, transplant, medications (physician testimony)

•        FSA Programs, your attorney will be able to review or know your PSF, and if any of the applicable programs apply;

•        Autism, Borderline Personality Disorder, Anger Management, etc.

•        Your Personal Narrative needs to be finished before your interview so;

•        That you know it, cold, and discuss it in 1st person with your P.O.

•        It should be able to be, copy-pasted, directly into the P.O., PSR

•        This Is  Your Story: In Written and/or Video Format3rd) Time must be allowed for the development of your Personal Narrative, with assistance

 

4th) The PSR is Now Complete and should Include all the Above, including your Personal Narrative – which Judges want to see.

 

5th) Time is spent practicing for your sentencing hearing with your attorney regarding,

1.     If the Judge is aggregable, due to your allocution, and departs below the guidelines

2.     If RDAP is applicable now  is when your attorney can ask for it to be put into the order, and if the judge agrees, then

3.     Politely, also request for 1 specific BOP prison, based on that RDAP program – using this as an example (camp eligible < 10 years), to also be put into the order.

  • Further, should the BOP not be able to do so,
    1. The BOP could notify the court in writing
    2. Why they couldn’t make this placement?

SELF-ADVOCACY

Allocution – Your Personal Narrative

Listen To What Federal Judges Have To Say

THE FEDERAL LAWYER • September/October 2019, VIEWS FROM THE BENCH, Own the Mistake and Demonstrate Sincere Remorse

Judge Richard G. Kopf of the District of Nebraska,

Judge Jon D. Levy of the District of Maine in Portland,

Judge Patti Sarris of the District of Massachusetts

Judge Cynthia A. Bashant;

Judge Morrison C. England Jr;…one of the biggest mistakes defense lawyers can make is not having their client answer the question…

Judge Lawrence C. O’Neill,

Judge James K. Bredar—says he comes out on the bench with a sentence already in mind. “Allocution, however, changes this when I see the defendant has insight into the harm he has done.”

 

NACDL, The Champion • March 2011, Heartstrings or Heartburn:  A Federal Judge’s Musings On Defendants’ Right and Rite of Allocution,

Judge Mark Bennett; A Good Allocution Can Be Beneficial

 

What Federal Judges Want To Hear:

We’re interested in a defendant who has the capability of introspection and who has come to grips with the impact of his offense on others…

 

“No punishment will be enough. If I could go back and change everything, I would.”

 

I am persuaded that the defendant is sincere and demonstrates insight into the crime.

   

Allocution is very important, “I like to have a conversation with the defendant,”…

  

I want him to apologize to the victim and his or her family, particularly if they are in the courtroom.

   

“Allocution, however, changes this when I see the defendant has insight into the harm he has done,” when I see the defendant has insight into the harm he has done”

   

“I am 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.

  

“It’s very important that lawyers prepare a client for allocution, even if they have gone to trial, and do the job that they are retained to do.”

 

Start paying restitution, even $25/mo, and don’t show up at court in a $900/ month luxury car.


Consultations are on me.

Thank you! Marc
240.888.7778
Physician Presentence Report Service

No matter where you are in The Process, there are things we can do

* No Physician,  Attorney, or Consultant can promise any outcomes.

First Step Act – Revised 2022

FSA - First step act

Reduction in Recidivism

Requires the Attorney General to develop a risk and needs assessment system

  • The BOP assesses the recidivism risk and criminogenic needs of all federal prisoners
  • Place them in recidivism-reducing programs
  • Including productive activities to address their needs and reduce this risk.
  •  Under the act, the system provides guidance on the:
    • type,
    • amount, and
    • the intensity of recidivism reduction programming and
    • productive activities to which each prisoner is assigned, including
    • information on which programs prisoners should participate in based on their criminogenic needs.
    • on how to group, to the extent practicable,
      • prisoners with similar risk levels together in recidivism reduction programming and
      • housing assignments.
  • The Act also amends 18 U.S.C. § 4042(a), requiring the BOP to assist inmates in:
    • applying for federal and state benefits and
    • obtain identification, including a
      • social security card,
      • driver’s license or
      • other official photo identification, and
      • birth certificate.
  • The First Step Act also expands the Second Chance Act to deliver recidivism reduction programming.

Incentives for Success

  • The Act amended 18 U.S.C. § 3624(b), so that federal inmate can earn:
    • up to 54 days of good time credit for every year of their imposed sentence
    • rather than, for every year of their sentence served.
    • For example, if you’re sentenced to 10 years, and your maximum good time credit = 540 days.
    • These good-time credits go towards pre-release custody.
    • Ineligible for good-time credit are generally categorized as:
      • violent, or involve
      • terrorism,
      • espionage,
      • human trafficking,
      • sex and sexual exploitation; additionally
      • excluded offenses are a repeat felon in possession of a firearm, or
      • high-level drug offenses
      • For a complete list, see disqualifying offenses

Confinement

  • 18 U.S.C. § 3621(b) requires the BOP to house inmates in facilities within 500 driving miles of their primary residence.
  • The BOP variety of factors goes into placement, including:
    • bed space availability,
    • security designation,
    • programmatic needs,
    • mental and medical health needs,
    • any request made by the inmate related to faith-based needs,
    • recommendations of the sentencing court, and
    • other security concerns.
  • The FSA reauthorizes and modifies a pilot program that allows the BOP to place certain elderly and terminally ill prisoners in home confinement to serve the remainder of their sentences.

Correctional Reforms

  • Criminal justice-related provisions, including;
    • prohibition on the use of restraints on pregnant inmates in the custody of BOP and the U.S. Marshals Service.
    • requirement for the BOP to provide tampons and sanitary napkins for free
    • The FSA requires BOP to give training to correctional officers and other BOP employees:
      • on how to interact and de-escalate encounters with people who are diagnosed with mental illness or other cognitive deficits.
      • Also included is a prohibition against the use of solitary confinement for juvenile delinquents in federal custody.

Sentencing Reforms

  • Changes to Mandatory Minimums for Certain Drug Offenders for some drug traffickers with prior drug convictions
    • the threshold for prior convictions that count toward triggering higher mandatory minimums for repeat offenders,
      • is reduced from the 20-year to a 15-year mandatory minimum,
    • The life-in-prison mandatory minimum (where there are two or more prior qualifying convictions),
      • to a 25-year mandatory minimum.
  • Retroactivity of the Fair Sentencing Act (FSA)
    •  Those who received longer sentences for crack cocaine than if sentenced for possession of powder cocaine can submit a petition in federal court to have their sentences reduced.
  • Expanding the Safety Valve

FEMALE PATTERN RISK SCORING

MALE PATTERN RISK SCORING

Violent Offense Codes for PATTERN Risk Assessment *

Cut points used when calculating an inmate’s Risk of Recidivism

Ambridge Man Pleads Guilty to Possessing Fentanyl 12/2020

Possessing Fentanyl – DOJ

In early December 2020, Michael Gamble was paid a surprise visit by law enforcement. At the conclusion of their search, they found at least 90 G of Fentanyl along with a loaded handgun with an attached extended magazine. None of this looks good, and easily crosses an Offense Level of 34 (with its approximate base number of 28 or greater). Michael Gamble, age 37, pleaded guilty to one count before United States District Judge Christy Criswell Wiegand and is scheduled sentencing for Feb. 9, 2023.

The DOJ has a case, and while everyone deserves legal representation, in the federal system 98% plea as opposed to going to trial, but I get ahead of myself.

How over the years did a medication initially develop in 1959 by Dr. Paul Janssen as an intravenous surgical anesthetic, wind up on our streets? Recalling my days as a surgical resident in the mid-1980s, this was on no one’s radar, except anesthesia. Interest came initially from large animal veterinarians, which morphed into skin patches for humans in the early 2000s to treat chronic pain. This was followed with user-friendly delivery options; a lollipop, tablet, and nasal spray.

Carfentanyl, a fentanyl analog is approximately 10,000 times more potent than morphine, 100 times more than fentanyl, and 50 times more than heroin. It is to be used as a general anesthetic for very large animals.

Fentanyl (Carfentanyl) analogs, including fentanyl-laced heroin, come in many flavors, with street names such as white heroin, Perc-O-Pops, Chiclets, Apache, China Girl, White China, Dance Fever, Jackpot, Murder 8, TNT, Tango and Cash, Friend, Goodfella, and Redrum (murder spelled backward). The sheer variety and combinations make toxicology testing and accurate death reporting extremely challenging.

Having a cogent defense, that includes sentence mitigation through presentence interview preparation is key. Should you have a question, contact us.

Probation Officers | Federal | The PSR

Probation Officers Representing The Court:

They Conduct The Presentence Interview,

This is critical – as from it they prepare

Your Presentence Report (PSR),

Which acts as your “referral” to

The Federal Bureau of Prisons for everything

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For a No Obligation Free Consult Call Dr.Blatstein at: 240.888.7778, or through email at: info@PPRSUS.com. Dr. Blatstein answers and personally returns all of his calls.

Probation receives and evaluates pre-sentence investigation requests.

Their Process:

  • 1st they interview you, and then
    • Identify and pursue leads to obtain evidence.
    • Gather and document evidence by interviewing involved parties, obtaining statements, reviewing and analyzing records and files, etc.
    • Gather criminal history, police reports, victim impact statements, criminal complaints, and information and review them prior to the interview with the offender.
    • Conduct offender criminal history checks, warrant inquiries, and driver’s license abstract checks.
    • Compile and maintain history and case records.
    • Inform offenders of their rights, responsibilities, and purposes of the pre-sentence investigation process.
    • Interview offenders are required by the courts to have a pre-sentence investigation completed.
    • Utilize PSI interview guide and the Criminogenic Domains of Criminal History, Education/Employment, Financial, Family/Marital, Accommodation, Leisure/Recreation, Companions, Alcohol/Drug, Emotional/Personal, and Attitude/Orientation.
    • Complete various extensive assessment tools to gauge offender risk and needs.
    • Collect PSI fees.
    • Coordinate investigations with other law enforcement agencies, regulatory agencies, and other relevant entities.
    • Confirm information gathered during the interview.
    • Communicate with the appropriate Department of Corrections and Rehabilitation staff, other state agencies, related organizations, other entities, volunteers, and the public to provide information, referral services, technical advice, and consultation regarding PSI.
    • Communicate with Courts, attorneys, law enforcement, and other agencies involved in a court-ordered pre-sentence investigation.
    • Document interview and investigation.
  • Identify and Inform crime victims of their rights.
    • Assist the victim advocates in coordinating victim requests for offender information; victim issues such as recovery from injury, financial losses, or victim mediation; preparation of victim impact statements and reports; communicate offender progress and victim assistance to various local, state, and federal officials, and to treatment staff.

Prepare The Presentence Report and

Recommend administrative, legal, and/or sentencing action.

  • Present evidence to prosecutors, legal staff, or courts.
  • Prepare and present testimony as required for legal proceedings or administrative hearings.
  • Report offender compliance with the presentence investigation to courts.
  • Summarize information gathered during the investigation and interview into the pre-sentence format.

Make sentencing recommendations

  • based on sentencing guidelines and a thorough analysis of:
  • Ensure the report is distributed according to Applicable Code standards.
  • Monitor programs for compliance with state and federal laws compliance.
  • Gather, compile, and maintain statistics for required and requested reports.
  • Investigate and confirm the information on offender release plans or interstate compact investigations.
  • Maintain working knowledge of the Department of Correction and Rehabilitation (DOCR) programs and community-based programs that are available for offenders.

Note: The duties of probation officers listed above are not intended to be all-inclusive.

Federal Sentencing and Placement – The Process

98% of federal defendants plea

Federal Sentencing

1st: Federal Defendants indicted, >93% likely will receive a federal sentence to a BOP facility

 

2nd: The defendant’s first appearance in court
  • ~93+%, can result in either a plea or verdict of guilty to a federal sentence
  • Between the Defendant’s 1stand, 2nd court appearance; a resume or CV of the defendant’s background is developed: called the Presentence Report (PSR).
  • The PSR is where the Defense Team Can make a Placement Request, while documenting the defendant’s medical, criminal, work & education histories, etc.
3rd: The defendant’s second court appearance is for the Sentencing Hearing
  • The details of sentencing are not taught in most law schools
  • Judges determine the length of time the defendant is imprisoned
  • Judges can also make a placement request to the BOP
4th: The BOP determines placement
  • Some of the factors that affect placement (BOP Policy Statement P5100.08 (Chapter 4 Pages 5-13 and Chapter 5 Pages 12-13):
    • Judges recommendations
    • Public Safety Factor (PSF) Variables
      • Accepting Responsibility
      • Age
      • Criminal History
      • Education Level
      • Legal Release Residence
    • Management Variables; Pre-determined Security levels
      • Disruptive Group-confirmed member
      • Greatest Offense Severity #
      • Greatest Severity Offense
      • Prison Disturbance
      • Serious escape
      • Serious Telephone Abuse
      • Sex Offender
      • The threat to Government Officials
    • Medical CARE LEVELS I-IV Structure
    • Mental Healthcare CARE LEVELS I-IV Structure
    • Psychology Treatment Programs
    • Medication Availability

      • On Formulary, or available
      • Non-Formulary requires a lengthy preapproval process
      • Or Just Not Available, where a similar substitute may be implemented

For Groups: My PowerPoint Presentation

Mental Healthcare In The BOP – Is This Your Client?

FSA - First step act

Serious Mental Illness In The BOP 

The BOP provides Medical and Mental Healthcare (MH), through their 4 CARE LEVELS.

The BOP’s Psychology Data System (Page 2) Is Filled Out For All MH Levels.

The Designation and Sentence Computation Center places inmates into Care Levels 1 and 2

CARE LEVEL 1 MH

  • No Significant Need.
  • No history of serious functional impairment due to mental illness
  • No need for regular mental health visits
  • No hospitalization in the last 5 years
  • Defendant on their own has sought help
  • Controlled with 2 psychotropic meds (Not MH I if taking antipsychotic)
  1. Psychotropic medications:
    • anti-anxiety agents
    • mood stabilizers
    • stimulants
  2. Antipsychotic medicines, 
    • delusions (false, fixed beliefs) or
    • hallucinations (hearing or seeing things that are not really there).
    • schizophrenia, bipolar disorder, or
    • very severe depression (also known as “psychotic depression”).
  • Clinical visits q 6 mo

CARE LEVEL 2 MH

  • He/she has a mental illness requiring:
  • Routine Ongoing Outpatient visits
    • Medication controlled,
    • Medical visits q 1-6 months
    • Group Therapy, interventions every other week
  • Crisis Oriented, BRIEF MH Care, g., placement on suicide watch
  • Psychiatric Hospitalizations within the last 5 yrs
  • On Antipsychotic or 2 psychotropic meds

CARE LEVEL III & IV designation is made by the BOP’s Office of Medical Designations and Transportation

 CARE LEVEL 3 MH

  • Not In-patient
  • Enhanced Outpatient (Requires outpatient contacts with a prescribing doc > than monthly [at least weekly]); or
  • Housed in A Residential Treatment Program.
  • 2+ Psychiatric Hospitalizations within the last 3 yrs
  • 3+ anti-psychotic meds [Or > 5 meds for multiple Dx]

If you have a client with an MH CARE LEVEL of III, and a Medical CARE LEVEL of II,
The MH placement takes precedence.

Care Level 4 MH

  • Inpatient
    • gravely disabled and
    • cannot function in the general population, as in CARE3-MH
    • medical care 24/7/365
  • Tx plan reviewed every 90 days

Federal Prison Placement Preparation

The Presentence Report

1st. Prepare For Your Presentence Interview

Properly prepared, will allow the probation Office to draft an accurate

Presentence Report – which will control your future

Incorporate these federal prison placement data points:

Medical and Mental Healthcare needs to be implemented through

  • Psychological Treatment Programs while available, have limited access and several may be security level specific.

The First Step Act Includes;

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 diagnostic 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

Medication availability falls into 3 tiers:

  1. On the BOP Formulary (available).
  2. Non-Formulary; these require a lengthy preauthorization process.
  3. Last: these are just not available. While similar medications are substituted, how is their efficacy verified?

Security Requirements

  1. Offense Level vs Criminal History Calculation
  2. Criminal History Calculation
    • +3 points for each prior sentence > 1 Year + 1 Month.
    • +2 points for each prior sentence > 60 days, not counted above.
    • +1 point for each prior sentence, <= 60 days not counted above; for up to a maximum of 4 points in this category.
    • +2 points for each revocation that has a new charge or occurs under federal supervision.
    • + 1 point for each prior sentence resulting from a conviction of a crime of violence that did not receive any points as noted above because the sentence was treated as a single sentence, up to a total of 3 points for this subsection.

The BOP and Prison Security Level Placement

The Presentence Report – A Medical, Medication, and Security Requirement Referral

PPRSUS.com

As found in my LinkedIn 2/29/2020 post

Presentence Interview Preparation – Gets Your “Message On The Record”

Getting The Presentence Interview (PSI) Right

Gets Your “Message On The Record”

The Presentence Interview, and its preparation, long before the interview takes place is likely the pivotal time when the defense team can make a difference in their client’s future. Properly prepared for the presentence interview can at best provide a pathway for the defense to get “their” message on the record.

Abstract

Imprisonment is a frightening experience for your client and their family. Counsel and the defendant’s family together can assuage some of these fears by addressing healthcare and the specialty programs available in Federal Prison before the defendant is in the custody of the Federal Bureau of Prisons (“BOP”) through being properly prepared for their presentence interview,

The Presentence Interview

The Presentence Interview:

  • is done by the Probation Officer (the court’s representative).
  • Following their investigation where they verify your background history,
  • the Probation Officer will take what she/he learned from the presentence interview and draft the official Presentence Report (PSR) along with,
  • making sentencing and placement recommendations to the judge.

 

The Presentence Report (PSR) Importance

The Presentence Report (PSR) also plays a critical role in the Sentencing Guidelines and statutory sentencing considerations, meaning,

  • The judge at sentencing will use it to determine how long you will be incarcerated,
  • The BOP will use it to 1st: place or designate you to a specific facility while matching you according to any needs you may have based on: 
    • security level,
    • prison placement,
    • programming,
    • pre-release, and even
    • medical care.
    • The inmate’s federal prison life depends on that PSR.
  • Should you qualify for Supervised Release,
    • Probation will then get a copy before meeting you in order to get an idea as to whom they are going to supervise over the next several years. 
  • Last, The Presentence Report (PSR) is considered:
    • gospel fact about the defendant.
    • This is because it is often considered the “Inmates Bible”.
    • So you see: It Truly Is The Gift That Keeps On Giving...

One cannot overstate the importance of The Presentence Interview to be properly prepared for – as it impacts The Presentence Report (PSR).

Asking to change the PSR later asks a court to,

  • change positions that it has already adopted as accurate.
  • Even if this can be done – a big if –
  • the amendment process can take years and
  • many billable hours to complete.

Should there be a medical or mental healthcare issue,

  • the PSR drafting process is the time to get it right.
  • An inaccurate PSR can mean a lack of consideration at sentencing and
  • inappropriate or absent care after imprisonment.

For example, if kidney dialysis is necessary,

Everything is important, from osteoarthritis and degenerative joint diseases to food allergies and medically necessary diets.

Activities of Daily Living (ADL)

  • Everything needs to be documented, including:
  • how any maladies would limit “activities of daily living” (“ADL”).
    • Patient-inmates are considered ‘independent’ if they can accomplish their Activities of Daily Living (ADL) – things like dressing, bathing, and eating – on their own.

Medications

Medications must also be identified to estimate which prescription drugs the BOP will make available. It is critical to identify whether given medications are available,

  1. On- Formulary, or
  2. Non-Formulary medication.
    • Understand that the BOP will discourage the use of non-formulary medications
    • They require that they need special approval.
    • More likely, BOP physicians will just switch the inmate’s treatment medications to those that have similar equivalents.
    • Do you know which medications are either available and on-formulary or non-formulary?
    • These issues should be addressed with the court before incarceration because,
      • after incarceration, the court has no real oversight.
      • Letters from the client’s personal physicians should provide documentation about their prescription selection, and
        • reasons why “similar” medicines are not appropriate for individual inmates.
  3. Last, What do you do if you learn that your client’s medication are not available?
    • There are options, but you need:
      • Time
      • The cooperation of the current treating physician

Medical Care

  1. Today the BOP uses a complicated method to convert a person’s medical diagnoses and treatments into a CARE LEVEL Classification. 
    • Classifications range from CARE LEVEL I for the healthiest inmate-patient, to
    • CARE LEVEL IV for gravely ailing inmate-patients who need ‘in-patient’ care. 
  1. Each facility then is identified by both a Security Level and this
  2. CARE LEVEL structure and inmates are then placed accordingly.

Photo Credit: https://pixabay.com

Healthy Steps for Older Adults 2022

FSA - First step act

FSA, Productive Activities (PA)
Healthy Steps for Older Adults 2022

Program Description Healthy Steps for Older Adults is an evidence-based falls prevention program designed to raise participants’ knowledge and awareness of steps to take to reduce falls and improve health and well-being. The goal of the program is to prevent falls, promote health, and ensure that
older adults remain as independent as possible for as long as possible.
Hours 3
Location(s) All institutions
Needs Addressed Medical/Recreation/Leisure/Fitness
Program Delivery Contractors
Health Services
Recreation
Unit Team
Volunteers