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
Unit Team

AARP Foundation Finances 50+ (2022)

FSA - First step act

AARP Foundation Finances 50+ (2022)

Program Description

This program provides financial education and counseling for vulnerable households, particularly adults age 50+.

Older adults face unique challenges in financial planning and weak job prospects. This program will assist the older adult in financial goal setting that translates into positive financial behaviors.

Hours 1.5
Location(s) All BOP Locations
Needs Addressed Finance/Poverty

Schizophrenia in Federal Prison

Schizophrenia in Federal Prison


In federal prison, Schizophrenia is a mix of symptoms that varies from person to person and affects the mind. When severe, people have trouble staying in touch with reality. It’s hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately. There is no cure, and treatment requires a psychiatrist-guided team approach, which includes a psychologist, social worker, psychiatric nurse, and possibly a case manager to coordinate care.

Anxiety may present as a component, along with Posttraumatic stress disorder, as a symptom of a co-occurring disorder. While Schizophrenia is a serious brain illness, there is no test for it. Diagnosis requires eliminating what it’s not occurring, in order to identify the symptoms that are present.

There are three types of symptoms:

  1. Psychotic symptoms may distort thinking, including hallucinations, delusions (beliefs that are not true), and organizing thoughts.
  2. Negative symptoms: where you’re not able to show emotions – leaving you to present yourself as depressed and withdrawn.
  3. Cognitive symptoms: Trouble making decisions and paying attention.

There is no cure. Different medications may have to be tried to see which are effective because medications affect each person individually. Once you find the medication(s) that work, stay on them daily, keep your doctor’s appointments and follow their recommendations.


Changes in behavior;

Includes delusions and hallucinations – which may last a lifetime.

Delusions; False beliefs, not based on reality, such as another person is in love with you, or a major catastrophe is about to occur.

Hallucinations involve seeing or hearing things that don’t exist. They can be in any of the senses, hearing voices is the most common hallucination.

Disorganized thinking and speech may include putting together meaningless words that can’t be understood, sometimes known as word salad. Extremely disorganized or abnormal motor behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement. All of these behaviors can result in less than optimal interactions between other inmates or with correction staff. The result may be a trip to the hospital or the SHU (isolation), neither is acceptable, and both are preventable.

Negative symptoms can be expressed as, neglecting personal hygiene, appearing to lack emotion, (not; making eye contact, changing facial expressions, or speaking in a monotone), and losing interest in everyday activities, including socially withdrawing.

Treatment is accomplished under the psychiatrist-guided treatment team approach with a case manager coordinating care. The full-team approach may be available in clinics with expertise in schizophrenia treatment. These delusions and hallucinations — may last your lifetime.

First-generation older antipsychotics, introduced in the 1950s – As a class, these provided treatment for acute agitation, bipolar mania, and other psychiatric conditions.

On- Formulary Medications: Haloperidol (Haldol), Perphenazine (Trilafon), Loxapine, Trifluoperazine(Stelazine), and Fluphenazine

Not AvailableFlupentixol, Zuclopentixol, Sulpiride, Pimozide, Molindone, Prochlorperazine, Thioridazine, and Thiothixene

Second-generation or atypical antipsychotics,

Some associated side effects; “Schizophrenia in adults“Bipolar mania and hypomania in adults“,  “Unipolar major depression with psychotic features“,  “Delusional disorder”,   “Brief psychotic disorder”, and  “Treatment of postpartum psychosis”

On Formulary: Clozapine (Clozaril) “Clozapine remains the only antipsychotic that has been FDA-approved for treatment-resistant schizophrenia, “and it provides effective treatment even when patients do not respond to other second-generation antipsychotics. No existing first- or second-generation antipsychotic is as effective as clozapine monotherapy in treatment-resistant patients. Deanna Kelly, Pharm.D., of the Maryland Psychiatric Research Center (MPRC)” Other Medications: Olanzapine (Zyprexa), and Risperidone (Risperdal).

Medications Non-Formulary: Quetiapine (Seroquel)

Some of the more recent atypical antipsychotics:

Medications Not AvailableAsenapine (Saphris), Iloperidone (Fanapt), and Lurasidone (Latuda).


Symptoms of schizophreniform

Schizophreniform is a similar disorder that affects how you act, think, relate to others, express emotions, and perceive reality.

Unlike schizophrenia, it lasts one to six months.

A mental condition that can distort the way you:

  • Think.
  • Act.
  • Expresses emotions.
  • Perceive reality.
  • Relate to others.

Medication and Psychotherapy —to help the patient manage everyday problems related to the disorder.

Medications On Formulary: Click here for the article…

Brief psychotic disorder

Involves a sudden, short period of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick — usually less than a month.

The first line of treatment may include atypical antipsychotics.

Medications On Formulary: Click here for the article…

Medications Non-Formulary:   Click here for the article…

For those that have an increased risk of having depression, medications that address this symptom can be an important part of their treatment.

Delusion disorder

The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn’t, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month.

The exact cause is not yet known, but researchers are looking at genetic, biological, environmental, or psychological factors.

A cold, detached manner with the inability to express emotion

  • …has an over-inflated sense of worth, power, knowledge, or identity.
  • Jealous
  • …that someone is spying on them or planning to harm them.
  • …believes that he or she has a physical defect or medical problem.
  • …have two or more of the types of delusions listed above.

Symptoms that are ‘non-bizarre’:

  • An irritable, angry, or low mood
  • Hallucinations

Diagnosis: There are no laboratory tests to yield positive results, they are only good to rule out what it is not.


  • Psychotherapy is primary
  • Conventional antipsychotics

First-generation older antipsychotics, introduced in the 1950s – 

1st Generation, Medications On- Formulary for available medications: Click here for the article…

2nd Generation, Medications On- Formulary for available medications: Click here for the article…

Medications Non-Formulary medications require pre-authorization; click here for the article…

Other types of medications:

  1. Antidepressants might be used to treat depression, which often happens in people with delusional disorder
  2. Psychotherapy can also be helpful, along with medications, as a way to help people better manage and cope with the stresses related to their delusional beliefs and their impact on their lives.
  3. Sedatives and antidepressants might also be used to treat anxiety or mood symptoms if they happen with delusional disorder.
  4. Tranquilizers might be used if the person has a very high level of anxiety or problems sleeping.

Shared psychotic disorder (also called folie à deux)

Here one person in a relationship has a delusion and the other person in the relationship adopts that same delusion.

Diagnosing is difficult, possibly with an MRI.

Treatment: Psychotherapy aims to ease emotional distress, with medication to ease the symptoms of anxiety.

It cannot be prevented, and the key is to diagnose and treat them as soon as possible.

Substance-induced psychotic disorder

Substance-related disorders involve drugs that directly activate the brain’s reward system which typically causes feelings of pleasure.

The classes of drugs include

·       Alcohol

·       Caffeine

·       Cannabis and synthetic cannabinoids

·       Hallucinogens (eg, LSD, phencyclidine, psilocybin)

·       Inhalants (volatile hydrocarbons [eg, paint thinner, certain glues])

·       Opioids (eg, fentanylmorphineoxycodone)

·       Sedatives, hypnotics, and anxiolytics (eg, lorazepamsecobarbital)

·       Stimulants (eg, amphetaminescocaine)

·       Tobacco

·       Other (eg, anabolic steroids)


Clinical judgment, with a proper history, creates a safe environment during the withdrawal period. Due to the relative safety of most antidepressants in the setting of depressive symptomatology, and manic episode guidelines, second-generation antipsychotics, such as Quetiapine (Non-Formulary) or Olanzapine (On Formulary), may also be beneficial as they are faster-acting than mood stabilizers.

Psychotic disorder; due to other medical conditions;

Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumor.

Paraphrenia: symptoms similar to schizophrenia.

It starts late in life in the elderly,

  • Generally has a much better prognosis than other psychotic disorders.
  • Antipsychotic medication can be helpful,
  • Paraphrenia sometimes co-occurs with depression and anxiety

I) BOP Placement Based On Security Level Alone – Without Multiple Medication Needs

The Challenge Program – an EBBR FSA Evidence-based Recidivism Reduction Program for male inmates in Penitentiary (High Security) facilities. Treats those with substance abuse and/or mental illness disorders (psychotic, mood, anxiety, or personality).

II) BOP Placement- With Multiple Medication Needs v Prior Hospitalizations

Here, it depends;

  • the number of types of psychiatric hospitalizations, not related to substance abuse, and
  • the number of multiple diagnoses treated with antipsychotic and/or different psychotropic medications

Influences Mental Healthcare (MH) CARE LEVEL I-IV facility placement.

Sex Offender Programs – Federal Prison

FSA - First step act



SEX OFFENDER PROGRAM RESIDENTIAL (SOTP-R) is a voluntary program (P5324.10) for Sex Offenders, and those with a history of multiple sexual offenses, re-offense, extensive non-sexual criminal histories, and/or a high level of sexual deviancy or hypersexuality. Inmates ordinarily participate in the program during the remaining 36 to 48 months of their sentence. The duration of the program is 12-18 months. Placement in the SOTP-R is reserved for inmates with more extensive sex offense histories, and cohousing participants permit the implementation of a modified therapeutic community, separate from the general population.

Having only 2 SOTP-R facilities nationwide – before they enter the program, initial placement into a free-standing Federal Prison Camp (FPC), or satellite minimum camp (adjacent to a higher secure facility), if practical, should be part of the court’s calculation.

This is because should an inmate consider acting violently towards your client – most would likely refrain as a single incident would have them transferred behind the wall, to a higher security facility, which they would not want.

Ultimately it just may come down to you knowing your client and the facility recommendation options available during the period before SOTP-R placement. Keep in mind that no matter what the BOP says, this could be a real-life event, therefore having this discussion with your client may prove crucial.


SEX OFFENDER PROGRAM NON-RESIDENTIAL (SOTP-NR), is also a voluntary program (P5324.10) for low to moderate first-time sex offenders with a single history of Internet Sex Crime, intended to identify offenders who are likely to re-offend. Inmates ordinarily participate in the program during the remaining 36-48 months of their sentence. SOTP-NR participants reside in the general population.

Having only 9 facilities nationwide – before they enter the SOTP-NR program, if practical, other than an FPC, or satellite minimum camp, should an inmate act violently towards your client – again, they would most likely refrain, as a single incident would have them transferred behind the wall, to a higher security facility. Otherwise, any other placement could result in a life-threatening sentence.

Consideration may again come down to knowing your client and understanding the facility options available for the period before their SOTP-NR placement.


BUTNER’S COMMITMENT AND TREATMENT PROGRAM FOR SEXUALLY DANGEROUS PERSONS (2022-2023), “This FCI remains a flagship facility and is frequently chosen to pilot new programs such as the Sex Offender Commitment and Treatment Program,” (Page 6).

  • FCI Butner is responsible for the psychological treatment and implementation of behavior management plans, with the coordination of the multidisciplinary treatment teams. Treatment is holistic and multidimensional with the ultimate goal of reducing sexual dangerousness and criminal recidivism potential.
  • FCC Butner has an internship integrated practitioner-scholar model which seeks “the productive interaction of theory and practice in a primarily practice-based approach to inquiry”. The internship component of the Psychology Service strives to meet the training needs of doctoral candidates in applied psychology through supervised experience, didactic programs, and focused scholarship.
  • As there is only 1 location, which appears ‘court ordered’, there should be no other issues regarding inmate threats.

Fore more…


PPRS - PPRSUS - Physician Presentence Report Service


It is important for the court to consider your client’s, (sex offender) safety, by requesting the court grant initial placement into a Sex Offender Management Program (SOMP), while waiting for your client’s voluntary admittance into a SOTP Program.

Following their interview and investigation, the Probation Officer will draft the official Presentence Report (PSR). Together with preparation, your message stands a better chance of being part of the PSR, and is included “on the record”.

Not being placed into a SOMP, and should an incident occur, could at best result in your client spending the remainder of their sentence in isolation for their protection. Then over time, this may yield a host of mental health phobias, leading to more severe ailments.

The benefit of being proactive as you help your client during their transition into the prison environment safely; cannot be overstated. This is especially significant if the PSR includes the documentation of a mental illness with diagnosis, including the treating physician’s records and testimony.



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Among inmates and convicts, sex offenders are at the bottom of the prison hierarchy and generally, are greeted with hostility.

The BOP, where needed, assigns sex offenders to higher security facilities, which may not be perfect. But this can be especially evident when they’re placed in general population.

Next, when the new sex offender first arrives and meets their new bunkmate, it is not unusual for them to be asked, what did you do?

No matter how they answer, eventually, their roommate or bunkmate Will Find Out! After that, at best, the sex offender is avoided – at worse, they could be robbed, beaten, or even killed. Then he/she may have to spend the rest of their entire sentence in solitary confinement?

Therefore, in your memorandum, safety may dictate placement in either a facility with a Sex Offender Management Program (SOMP) or at minimum, a camp.

For more…

Post-COVID Virus Causes Lingering or Ongoing Symptoms

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The complicated care required for Post-COVID Long-Haulers is likely beyond the mission of most (if not all) prisons, jails, and detention centers.

According to researchers, this is still an active area of investigation. As we are approaching spring/fall 2022/2023, the Post-COVID Pandemic may be becoming an Endemic. Still, with that in mind, treating Post-COVID Long-Haulers and the amount and variety of staff, equipment, finances, and time needed, may just not be available to those incarcerated.

COVID is a true roller coaster of symptoms and severities, with each new day offering many unknowns.”

 “The difficulty is sorting out long-term consequences,” says Joseph Brennan, a cardiologist at the Yale School of Medicine.

While some patients may fully recover, he and other experts worry others will suffer long-term damage, including lung scarring, heart damage, and neurological and mental health effects.

Long after the fire of a Covid-19 infection, mental and neurological effects can still smolder[1]. ‘Long-Haulers’ after the initial COVID-19 hospitalization: fall into 3 categories (Dr. Sanghavi)

1st) The COVID virus causes lingering or ongoing symptoms, meaning that “ symptoms do not recover completely and are ongoing because of direct cell damage from the virus,”

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2nd) involves chronic ICU hospitalization for weeks. This causes:

  • muscle weakness,
  • cognitive brain dysfunction,
  • psychosocial stress-causing post-traumatic stress disorder (from chronic hospitalization).

3rd) symptoms appearing after recovery. “Interplay with the immune system of a person, and then the impact that both those things have on the body.”

“We are still trying to understand exactly how this interplay between the immune system and inflammatory markers work, but there’s no doubt that that is a group of symptoms because of ramped up immunity or ramped up inflammatory system,” Dr. Sanghavi added.

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Peripheral nerve issues, such as Guillain-Barré Syndrome, can lead to paralysis and respiratory failure.

Post-COVID Stress Disorder is another emerging consequence of the global pandemic.

Although most cases of COVID-19 appear to be mild with a recovery time of a few weeks, health experts are seeing more patients who suffer symptoms for months or get better, and then relapse down the road.

Isolation Is Not the Answer, Precautions for Adults with COVID-19[ii]

For more…


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Post – COVID a physician’s journey in the summer of 2020 working on both general medical and COVID-positive wards. But by November of that year, the U.K. was in its second wave and second lockdown, with COVID deaths and hospital admissions rising.

“Like being on a treadmill I could not get off”

Being given only basic personal protective equipment (PPE), Dr. Fearnley and her newly graduated doctors were sent onto medical and COVID wards. While on a COVID ward, and after not feeling well, a PCR Test returned positive for COVID, and what comes next follows the phases she went through:

  • “The acute phase lasted 2 weeks – comparable to a case of mild-to-moderate flu.”
  • “As a fit and healthy 35-year-old with no comorbidities, she naively expected to recover quickly,”
  • “By week 3, she still had a lingering fever,”
  • By week 4, Dr. Fearnley wanted to return to work, but being lightheaded and jelly-legged, just made it home.

Thus began the start of her long Post-COVID Long-Hauler (as it was later defined) Journey.

Getting slightly graphic, these attacks “were associated with an unquenchable thirst, with or without an urgent need to open to my bowels, vomiting, or increased shortness of breath. These came in daily cycles lasting up to 14 hours at a time. I would frequently shake through the entire night”.

For more…

COVID In Prison

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Omicron, B.1.1.529- Fears Of Catching COVID In Prison

When I first started writing on Omicron, B.1.1.529 (a variant of COVID-19), it was back in January 2022,

At the time we have watched it become a ‘variant of concern. along with fears of catching COVID in prison more of a reality. While not as prevalent and lethal as Delta, it’s a more contagious spreader, and testing is best done with an oral swab which has to be done in a certain and exact way.

The Centers for Disease Control and Prevention (CDC) listed the possible symptoms of Omicron as:

  • cough,
  • fatigue,
  • diarrhea
  • headache,
  • sore throat,
  • fever or chills,
  • nausea or vomiting
  • shortness of breath,
  • difficulty breathing,
  • muscle or body aches
  • new loss of taste or smell,
  • congestion or runny nose

“However, the CDC noted that this list is not exhaustive, and people might experience different symptoms or combinations of symptoms.”

Unfortunately, this presents a challenge not only to all of us, but to all prisons (state and federal), jails, and detention centers. As history has shown us, these facilities likely may be unable to meet this medical need due to:

  1. the current ‘politicization of COVID-19’ and vaccinations,
  2. the physical nature of how inmates are housed,
  3. the continued refusal of some correction staff to get vaccinated, and masked
  4. the limited availability of medications and masks.
  5. I am adding to the list those with Post-COVID19 which I will cover later, but which no prison or jail has the staff, supplies, or finances to provide the support required to meet their needs.

Definition: The novel coronavirus, or SARS-CoV-2, is the deadly virus that led to COVID-19. Oversimplifying, a virus replicates its RNA by making copies of itself, but while coping, if a mistake in replication is made, these ‘mistakes’ result in creating the mutation.

How we get exposed(, is through these respiratory fluids that carry COVID, which occurs in three principal ways. Though not mutually exclusive, these are ‘physical particles, some of which we cannot see, but most of which can be blocked with physical masks; either N-95 masks, (double layer) surgical masks, or multi-layer cloth physical masks, by blocking the majority of these aerosolized viral fluids before they enter our respiratory system.

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1st- Inhalation – Air Bourne Transmission (Top Photo) this 20-minute uTube, “a Must-View and Listen” – on How To Protect Yourself

While not perfect, a little knowledge is helpfulby Mike Hansen MD, Board Certified in Internal Medicine, Critical Care Medicine, and Pulmonary Disease.

Just the act of breathing in the air allows these small, fine, physical droplets including the aerosolized particles that contain these viruses, into our system. Here, the risk of transmission is greatest:

  • within three to six feet from the infected source. Don’t be fooled though, as these
  • exhaled aerosolized particles can travel, likely well past the
    • 9-12 feet (and up to 27 feet) in an enclosed space.

 2nd- The viral particles, as noted, can be physically exhaled as aerosolized droplets.

  • As we breathe in these physical particles, they too can be blocked, for the most part
  • by appropriate physical masks. But again, the risk of transmission is greatest:
    • the closer we are to the infected person, which is where
    • the concentration of these exhaled droplets and particles is greatest.

 3rd- Rubbing your nose and eyes with viral residue on your hands just spreads the infection.

Therefore, ensuring an adequate supply of:

  • soap and hand sanitizer are available to allow frequent washing and hand sanitizing
  • is the responsibility of each facility, no matter whether state, county, or federal.
  • Viral residue in indoor settings may originate from either:
    • exhaled respiratory fluids, or
    • from touching inanimate surfaces contaminated with the virus. Therefore;
      • cleaning all surfaces is critical as well as
      • understanding that when you cough or sneeze, please
        • cover your mouth and nose with
        • the sleeve of your shirt or arm, and
        • not your bare hand if you can help it.

The basic protection we can all do:

  1. Social distancing indoors where practical, and
    • outside where ≥6 feet cannot be maintained.
  2. All types of masks are reviewed by the (Mayo Clinic.Org), and this is a very good resource. Multilayer physical cloth masks are cheap, and most importantly, should be made available by each facility to be used in indoor spaces. Photo Credit: ACLU
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  • Having two or more layers of washable, breathable fabric
  • Completely cover your nose and mouth
  • Fit snugly against the sides of your face while not having any gaps
  • Have a nose wire (or equivalent) to prevent air from leaking out of the top of the mask
  • Follow the recommendations of science, take the appropriate medications approved by the FDA, and get vaccinated, and this goes for staff and inmates alike!

I understand that for some this may be a non-starter, but please understand that just because:

  • we can’t see these physical droplets, or
  • don’t know anyone personally who has passed due to COVID; that doesn’t mean that
  • neither has happened; like the story of the tree that fell in the forest,
  • it still fell even though we didn’t see, or hear it.

While you may have No Symptoms, you

  • still could be a carrier,
  • pass the virus on to an older loved one who is
  • later hospitalized, and then
  • may fatally succumb to the infection.
  • That is not a burden that anyone would want to carry.

Your client’s looking for COVID sentencing relief, but were they vaccinated?

If your client’s going to prison and has not been vaccinated, it is important to learn why. If their reasoning is because it imposes on their freedom, or they just do not want to, I cannot believe that this reason is going to endear any sympathy for any alternative sentencing, from any court in the land.

Obviously, this does not take into account those with cancer, immunocompromised diseases, etc., as these are private conversations between your client and their physician. Should this be the case, I feel confident that the court would likely take this into consideration when considering your request.

If your client’s been vaccinated, has been wearing a mask, and falls into any of the following groups, now you have a good argument, especially with Omicron, B.1.1.529, and Delta ever-present across our country. The positive is that now in 2022, antivirals could be the ‘holy grail’ as far as controlling this pandemic, although their availability in a prison setting is anyone’s guess.

For more…

Federal Prison Camps

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There are differences;


Minimum Satellite Camps are adjacent to higher secure facilities.

Minimum Federal Prison Camps (FPC) are not, hence usually may have No” Solitary Confinement or Razorwire.

This may result in overall less tension among staff and inmates alike and is possibly due to the absence of the adjacent higher secure facility. Above are the BOP Federal Prison Camps, only.


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After the sentencing  designation is made:

With your client and their family, review relevant information such as nearby hotels and prison visiting (list and hours), mail (including email), commissary, telephone, items that are allowed in prison, and how to get money to your client (including when they self-surrender and then monthly via Western Union, Money Gram, or other services), will go a long way to helping take the edge off this life-altering event.

  • If there are medications involved, are they on Formulary (easily available), Non-Formulary (available, but require a lengthy pre-authorization process), or just Not Available? If either of the latter two applies, then what medical/legal options have been presented to the court? Hopefully, all of these issues have already been resolved, long before the PSI was finalized.



§ Basic wedding band, Bible.

§ Prescriptions; I recommend that prescriptions be attached to everything you bring with you, including, medications and medical devices, prosthetics, etc. Together with your attorney, make sure that copies of these prescriptions are included in your PSR, which was developed from your PSI.

Below is a sample from the BOP online Formulary that is available for your attorney’s use.

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  • BOP Medication Formulary is based on a 3 Tier Structure. If you are able, I recommend bringing a month’s supply, at best you can use them, at worst they just throw them out. If you arrive on a holiday or weekend, they may be allowed.

Medical Devices:(CPAP, etc.). Prosthetics / Orthotics, Diabetic shoes (P6031.01, Patient Care, (Page 58): may need extra deep, extra wide toe box )/ Wheelchairs, etc.

Glasses that are not made with metal.

AUTHORIZATION ‘FORM’ TO RECEIVE PACKAGES, is provided by the facility, but you can print the form here.

§ Forms of ID: birth certificate, passport, driver’s license, and social security card.

§ Cash; Then Per Month- $320, ($370 in November and December), Money Gram or Western Union for monthly deposits.

§ Legal papers.

§ List of personal names (including phone numbers and addresses).

Noteworthy: 20-minute video that shows you basic steps on how to protect yourself from COVID; whether or not you are in prison, by Mike Hansen MD

  • Mike Hansen MD, a Board-Certified Internist, Intensivist, and Pulmonologist who specializes in Internal Medicine, Critical Care Medicine, and Pulmonary Disease.
  • He explains what has been at best; a politically challenged topic these past several years – in a way that all of us can understand.
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Also available through an article I previously published titled: How Do You Address Your Client’s Fears Of Catching COVID?

My background and experiences have provided me with a unique understanding of the federal Security Classification structure, Medical and Mental Healthcare – CARE LEVELS, along with an understanding of the BOP’s Medication Formulary (availability through their 3 Tier System).

Career Transition: My skills and experiences, together with 31+ years in medicine (my license is current and active), along with my lifelong compassion for others, have made me uniquely qualified to develop a Comprehensive PSR while providing the ‘best and appropriate’ placement outcome recommendations, along with counsel, to the court.

For more…

Long-COVID In Prison

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Kara Gormont, former Chief of Staff for the Defense Health Agency. A year and a half after developing Long-COVID in November 2020, she learned, that the military at the time had no process to deal with it.

“I truly felt very abandoned by the healthcare system that I had at that time given 28 years of my life to,” read (or listen) to her story, American Homefront Project | By Andrew Hirschfeld, Published April 27, 2022.

Current Treatment Challenges – CDC, 2022: Living with a Long-COVID condition can be hard, especially when there are no immediate answers or solutions. Their website then links to the 2021 page linked below…

Treatment Though Medical Management – CDC, 2021: for Long-COVID In Prison conditions is developed through a comprehensive plan based on:

  • Medical and psychiatric conditions, personal and social situations,
  • Through already established symptom management approaches (e.g., breathing exercises to improve symptoms of dyspnea).
  • Different therapies might include physical and occupational therapy, speech and language therapy, vocational therapy, as well as neurologic rehabilitation for cognitive symptoms.
  • A gradual physical rehabilitation plan for some patients (e.g., persons with post-exertional malaise);
  • Consultation with physiatry for cautious initiation of exercise and recommendations about pacing may be useful.

While not mentioned above, reported in REUTERS, April 18, 2022, The case for testing Pfizer’s Paxlovid for treating long COVID. The article makes several points; 1st, while there have been positive patient results, 2nd, there should be more scientifically regulated studies before conclusions can be made. You be the judge, but either way, it is hard to see this antiviral making its way into any prison pharmacy.

  • To date, there are no established treatments for Long-COVID In Prison. Why is this important, because the symptoms identified with post-acute sequelae of COVID-19 adversely affect the inmates’ ability to care for themselves or function normally, during a normal work day.
  • A remaining question still exists, are 100% of corrections staff fully vaccinated and boosted? Why, because as imperfect as the vaccines are, they do prevent hospitalizations and death. Unvaccinated (and if appropriate unmasked) staff can be active spreaders of the virus.