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Dr. Marc Blatstein | About

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Marc Blatstein was born in Philadelphia, Pennsylvania, where he attended high school. He later went to George Washington University in Washington DC for his undergraduate degree, where he received a Bachelor of Arts in Psychology, all the while working a job on the side to help offset the high costs of a college education.

Marc later went to Ohio College of Podiatric Medicine, where he studied medical training and obtained his Doctor of Podiatric Medicine Degree. While studying there, he started the “Pink Panther Bartenders” along with his brother and two of his classmates to help with some of the costs of higher education. At one point, he was grateful to be asked to participate in a Gala for the Cleveland Opera, to which he agreed.

He then attended a surgical residency that covered Podiatric Medicine and Surgery, which was followed by a 31+ year career as a single practitioner. While in practice, Marc Blatstein incorporated a medically oriented shoe store, wound care, and physical therapy programs into his practice.

HOBBIES

Most of my joys have been spent on the water, while I have enjoyed power and sailing with my 1st mate, Bailey.

In the end, though, the peace of sailing is where I have spent most of my time.

 

 

EDUCATION | PRACTICE AND CONSULTING TIMELINE

George Washington Univ., BA in Psych. (’77),
Externship(s):
* Lutheran Hospital Baltimore MD. (’82),
* Atlanta Hospital & Medical Center, Atlanta GA (’82).
Ohio College of Podiatric Medicine, Doctor of Podiatric Medicine, DPM (’83),
Lawndale Community Hospital Surgical Residency in Podiatric Medicine & Surgery (’84)
1st Career: Podiatric Foot And Ankle Medicine and Surgery, License, 1985 – 2023
2nd Career: Physician Presentence Report Service, LLC., 2011

PRIVATE PRACTICE 1985 – 2023

POPULAR COMPONENTS OF MY PRACTICE

I. PLANTAR FASCITIS

According to Dr. Marc Blatstein, morning heel pain is the most common complaint he treats. Patients relate that it is pain upon standing first thing in the morning. While the pain initially is excruciating, with ambulating, the pain may subside, only to come back again with a vengeance after sitting and then immediately returning after standing up again.

The plantar fascia is a ligament attached at one end to the bottom of the heel (in a medial, central, and lateral band), then fanning out into the ball of the foot, thus acting as a shock absorber for the foot. As the foot impacts the ground, with each step, the plantar fascia stretches slightly. When these excessive pressures of pulling the plantar fascia on the heel occur over time, with an innocent step (like stepping on a marble or off a curb), they create small tears in the plantar fascia (the ligament on the bottom of the foot) resulting in a small amount of bleeding, pain & inflammation. Medical literature initially thought heel pain was due to a bone spur on the bottom of the heel bone (or calcaneus). We now know that the pain is due to excessive tension on the plantar fascia as it pulls on its attachment to the inside/medial aspect of the calcaneus (heel) bone.

In diagnosing heel pain, Dr. Marc Blatstein relates that over the years, patient care has demonstrated that not all bone spurs are painful, and everyone with heel pain (or plantar fascitis) does not necessarily have to have bone spurs. A complete history and physical exam play a large role in approaching this diagnosis, along with weight-bearing X-rays, which are useful in determining if a heel spur is present (fractured), or associated with other pathologies contributing to the diagnosis.

Initially, treatment by Dr. Marc Blatstein can start with a combination of one or all of the following: padding & taping of the foot in a supportive nature, taking oral anti-inflammatory medications, immobilization of the foot in a walking cast, physical therapy as well as implementing specific stretching exercises. Should additional treatment be necessary, cortisone injections and orthopedic functional foot orthotics may be prescribed. Should any or all of these treatments fail, and after a detailed review of X-rays and lab results with your physician, surgical intervention may be considered, and according to Dr. Marc Blatstein, it is very effective. Here, an Endoscopic Plantar Fasciotomy is one (of many) of the possible procedures that could be recommended. A plan is formed between you and your doctor for a successful outcome meant to add a full and enjoyable life to your years.

II. THE CIRCULATOR BOOT™

 

A major part of Dr. Blatstein’s practice is using The Circulator Boot™ as a method of treatment that helps with the core elements of lower extremity wound therapy: bacterial control, increased blood supply, moisture, and the removal of dead or damaged tissues to help the healing of healthy tissue. Along with other modes of treatment, surgical debridement of infected wounds, the use of antibiotic medications along with home care, and boot therapy in Marc Blatstein’s eyes may improve the blood supply and control the infection when standard methods of treatment are failing.

The Circulator Boot™(Mayo Clinic.org), from Dr. Marc Blatstein’s years of experience, the end-diastolic timing of its leg compressions (this FDA-approved non-invasive technology) provides benefits in preventing leg amputation. Poor circulation and infection are the leading causes of 90,000 diabetic amputations that occur every year in the United States.

The Circulator Boot™, “A leg with poor arterial blood flow, may be likened to a dirty sponge that is half wet. Squeezing such a sponge disseminates the water throughout the sponge. Soaking and wringing the water repeatedly from the sponge may help clean it. In like fashion, the heart monitor of the Circulator Boot™ is timed to allow each arterial pulse wave to enter the leg as best it can (to partially wet the leg “sponge”). Boot compressions provide a driving force to disseminate blood around the leg and, at the same time, press venous blood and excess tissue water from the leg. Patients with a pulse rate of 80 beats per minute might receive 4800 compressions an hour. Patients with severe arterial leg disease might receive 100 such treatments or close to a half-million compressions! Breakdown of the clot, re-channelization of blocked vessels, and forming small new vessels may help restore blood flow.”

For those who may be facing amputation, this may be an option. Dr. Marc Blatstein recommends learning more about The Circulator Boot™ as a Method of Treatment via The Circulatory Boot Service at the Mayo Clinic.

III. TARSALTUNNEL SYNDROME

Similar to Carpal Tunnel, Tarsal Tunnel Syndrome is due to the compression of a nerve called the Posterior Tibial Nerve. Dr. Marc Blatstein, a Podiatric Surgeon, explained that Tarsal Tunnel Syndrome occurs over time as the nerve becomes inflamed, resulting in symptoms such as burning, electric shocks, and tingling, as well as a shooting type of pain. Other factors that Dr. Marc Blatstein has found factors contributing to Tarsal Tunnel Syndrome come from either an overly pronated foot, which puts a stretch on the nerve, pressure on the nerve from soft tissue masses such as ganglions, fibromas, or lipomas that physically compress the nerve, as well as other insults to the nerve.
The diagnosis is usually quickly made by physical exam and the patient’s complaint history. Observation may reveal a slight swelling just on the inside of the ankle joint. As part of the physical exam, Dr. Marc Blatstein finds that gently tapping the inside of the ankle joint in the acute phase will result in a tingling sensation that may shoot up the leg and/or into the foot. Nerve conduction studies are another tool that will reveal if there is damage to the nerve.

Treatment of the Tarsal Tunnel involves many different components, some of which are correcting the abnormal pronation of the foot [which is accomplished with prescription functional foot orthotics]. Along with this, oral anti-inflammatory medications, vitamin B supplements, &/or steroids may provide some benefit but are rarely curative. Should a soft tissue mass compress the nerve, surgical removal of the mass may be necessary. Surgical correction of Tarsal Tunnel Syndrome has a good chance of success; at the same time, the overpronation of the foot still needs to be followed with functional foot orthotics.

IV. THE PAINFUL HAMMERTOE

According to Dr. Marc Blatstein, hammertoes appear with the toes bent in a clawing fashion. Hammertoes may be flexible or rigid; flexible infers that you can manually straighten the toes, while it is not possible to straighten the rigid toe. Because most of us wear enclosed shoe gear, the pressure caused by the shoe gear we wear causes the toes to become painful. On top of this, pressure forms hard corn, while on the bottom of the foot, the toe pushes the metatarsal bone down, forming a callus under the metatarsal head. Treatment of hammertoes can be approached in many ways. Dr. Marc Blatstein starts by recommending a combination of appropriate shoe gear and a functional orthotic prescribed as a shoe insert to help the hammertoes from progressing or getting worse. In the very initial stages, while the toe is still flexible, it can be tapped into its corrected position, utilizing a functional orthotic. This conservative treatment also consists of hammertoe and buttress pads, all available over the counter, and open-toe shoes.

With continued pain, correction of the deformity, while successful, depends on whether they are rigid or flexible. While the hammertoe is still flexible, a simple tendon release followed by taping it in the corrected position is usually effective. Then, a functional orthotic may be prescribed to help maintain this correction. With a rigid hammertoe, the surgical procedure consists of removing some skin and a small section of bone. Dr. Marc Blatstein told us that in cases of a severe hammertoe deformity, a pin may be used to hold the toe in its corrected position for several weeks & then it is removed. In all cases, following your surgeon’s after-surgery instructions is essential to get the best result.

V. INGROWN TOENAIL

Victoria Azaranka recently dropped out of a tennis match because of an ingrown toenail. Dr. Marc Blatstein tells us how to prevent ingrown toenails. Several people wait far too long to have the procedure, and they have more complications. 

Most people do not think an ingrown toenail will get in the way of their profession, but it did for one person. Victoria Azaranka, the world’s No. 1 tennis player, was sidelined due to an ingrown toenail in her right big toe. The toenail had become ingrown and made it so painful she had to sit out of a match against Serena Williams, a former world’s No. 1 women’s tennis player. The cause behind the ingrown toenail is a surprise, a bad pedicure.

PUBLICATIONS:

Nails Magazine, Contributor, through the 1990s

                                                                                                               

CREATIVE FOOTWORKS

Novelties, Business Supplies, and Gifts for those practicing Foot and Ankle Medicine and Surgery, 1986-1996.

 

        

             

                                                                     

 

 

 

 

SECOND CAREER

PHYSICIAN PRESENTENCE REPORT SERVICE, LLC. 2011

 

PUBLICATIONS:

 

 

Presentence Report

 

 

The Federal Lawyer, Co-authored, 2021

 

 

 

 

 

 

 

 

American Bar Association, Co-authored two Chapters in 2022

While In The BOP Your Client Needs A Medical Second Opinion – The Process

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If your client is lucky enough to get approval, they still may face months (or possibly years) to get to see and then be treated by that specialist. Having their condition noted in their PSR along with their treating physicians’ recommendations included may prove helpful here. Taking all of this into account, the BOP is under no obligation to follow the consulting physician’s treatment recommendations; Program Statement P6031.04 (Pg. 20-21).

 

Taken from my article below; The Federal Lawyer, Jan/Feb. 2021 (Pages 45-46), I review the process that the BOP uses to provide care. Briefly, they’re based either on their definition of medical need, treatment cost, staff availability to accompany the inmate to see the physician, or how close the inmate is to their release date.

 

  1. Life-Threatening Conditions

Treatment for life-threatening conditions is essential to sustain the life or function of a critical bodily system and requires immediate attention.

The BOP refers to these conditions as “Medically Necessary–Acute or Emergent” and includes the following conditions in this category: heart attacks, severe trauma such as head injury, hemorrhage, stroke, detached retina, sudden vision loss, and complications of pregnancy or labor.7

   2. Medically Necessary Conditions

The BOP defines this category to include conditions that are not immediately life-threatening but which without treatment now, the inmate could not be maintained without significant risk of:

• Serious deterioration leading to premature death.   

• Significant reduction in the possibility of repair later without present treatment. 

• Significant pain or discomfort that impairs the inmate’s participation in activities of daily living.

Examples of conditions the BOP includes here are chronic conditions such as:

  • High blood pressure, high cholesterol, heart disease,
  • Diabetes; severe mental health issues (e.g., bipolar disorder, schizophrenia);
  • Infectious disorders (e.g., HIV, tuberculosis); and cancer.

   3. Medically Necessary but Not Urgent

The BOP defines this category as “Medically Acceptable—Not Always Necessary.”10 The group includes conditions for which “treatment may improve the inmate’s quality of life.”11 Examples of treatments for conditions in this category, as listed in the BOP, Policy on Patient Care, include:

  • Joint replacements,
  • Reconstruction of the anterior cruciate ligament (ACL) in the knee, and treatment of:
  • Noncancerous skin conditions.

Such treatment procedures require review and approval by the institution’s Utilization Review Committee, which considers various factors, including:

  • Risks and benefits of the treatment,
  • Available resources (including the cost of security staffing and transportation),
  • The inmate patient’s medical history, and
  • How intervention (or lack thereof) will impact the inmate’s activities of daily living.

Should an outside specialist consult be needed for a non-emergent condition, a referral request is made to the prison’s Utilization Review Committee and clinical director. Other members involved in this decision-making process include:

  • The associate warden or warden,
  • Health service administrator or assistant,
  • The medical trip coordinator,
  • Any health care providers directly involved in the referral, and perhaps:
  • The director of nursing and
  • The chaplain or a social worker. 

The clinical director has the final say over all Utilization Review Committee decisions. If approved, the inmate-patient will be placed on a schedule or waitlisted until the specialist has an opening during the contract’s limited monthly hours, which may be several months or years later.

Notably, the clinical director is under no obligation to follow medical recommendations made by the outside physician consultant specialist. If the recommendations are not followed, the clinical director will document his/her justification in the inmate’s health record.16 Justification may be based on the category of care sought.

  1. Medically Appropriate

Some treatments, even though recommended by a health care provider and deemed appropriate by the clinical director, still require approval by the Utilization Review Committee, which is not likely to be granted. These treatments are considered by the BOP to have “limited medical value” and include cosmetic procedures and removal of noncancerous skin lesions.17 It is worth noting that some skin lesions may be misdiagnosed, so the denial of treatment for these appropriate medical procedures is a concern for inmates with such health needs. 

  1. Extraordinary Treatments

The BOP considers a medical treatment extraordinary if it “affect[s] the life of another individual, such as organ transplantation.”18 Thus, organ transplants and experimental/investigational treatments require the approval of the Utilization Review Committee, which is not likely to be granted.

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

Federal Sentencing and Placement – The Process

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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 1st and 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 is explained in this video.

      • 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

Federal Prison Placement Preparation

By inDr. M Blatstein's Blog Tag , ,
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

Video PPRSUS. 14 explains how medical care is provided in federal prisons. The caveat can be read in recent reports in the news:

The BOP CARE LEVELS I-IV Structure

  • 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, a primary diagnosis of Borderline Personality Disorder, and 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 12, Is considered for sexually dangerous persons with the possibility of criminal recidivism. MAY NOT BE AVAILABLE.

VIII) Female Integrated Treatment: A female with substance abuse (RDAP Eligibility Possible), trauma-related disorders, and other mental illnesses. (FIT) Program

Medication availability falls into 3 tiers; this video helps explain whether your medication will be available by comparing your medication against those on the BOP list available online.

  1. On the BOP Formulary (available).
  2. Non-Formulary; these require a lengthy preauthorization process – so likely Not-Available.
    • As these are just not available. Similar medications are substituted, but 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 with a new charge or 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

Compassionate Release

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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,

No alt text provided for this image

…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

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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!

No alt text provided for this image

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…

No alt text provided for this image

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

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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

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

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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

First Step Act – Revised 2022

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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

Thomas Court Denies Women The Right To Choose…

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Justice Thomas on Dobbs

Credit: REUTERS/Jonathan Ernst

The Thomas Court – Denying Women The ‘Freedom To Choose’ Their Medical Reproductive Healthcare

Justice Thomas’s Message, Next: contraception, same-sex marriage…

Inside the Court’s ruling, Justice Thomas wrote that

  • “in future cases, we should reconsider all of this Court’s substantive due process precedents.”
  • “Because any substantive due process decision is ‘demonstrably erroneous,’ we have a duty to ‘correct the error’ established in those precedents.”  Just food for thought…

The More Restrictive States

Louisiana.

Louisiana is an example of extreme regulations, which defines “a viable in vitro fertilized human ovum” as a “juridical person which shall not be intentionally destroyed,” along with at least five states, that have introduced bills establishing fetal personhood. Now,

  • the ’embryo’ may be considered an individual, and if a couple is undergoing IVF, your criminal liability implications have suddenly exploded.
  • Why, because all of the embryos will have to be used.

IVF – Fertility Treatments

IVF and in some cases, even genetic screening, is seeing extreme statements from extreme states;

Will patients have to use all the embryos they develop,

  • a) which forces an individual or couple to expand their family before they can afford to do so, or
  • b) forgo the opportunity to have children, or
  • c) suggests that the couple limit the number of embryos to one or two, and hope that they are chromosomally balanced and will result in a live birth, but if not…
  • d) putting them through IVF stimulation over and over again, associated with the financial, emotional, psychological, and physical implications.

For states that take abortion bans to the extreme, and specify that,

Life begins at fertilization,

  • a) each excess embryo would have the same rights as an embryo,
  • b) all the embryos would then have to be implanted (by law), and
  • c) which could lead to financial hardships for an unprepared family to have multiple children all at once, high-risk pregnancy, multiple babies, risking the life of the mother and/or the children,
  • d) or regarding the fear of prosecution, the couple would decide not to have any children or
  • e) they would elect to move to another state.
  • Added to all this; are threats of violence that extremists have targeted at our behavior and beliefs, while representatives have kept quiet, and made this acceptable behavior.

Pregnancy Loss or Miscarriage.

Pregnancy Loss (NIH) | Miscarriage (Cleveland Clinic).

  • Some miscarriages require immediate medical interventions to prevent life-threatening infections or tubal rupture. Every year between 10% and 20% of known pregnancies end in miscarriages, mostly because the fetus is not developing normally, according to the Mayo Clinic.
  • Post Dobb’s, providers may now fear that the ‘state’ may view their treatment – as if they are providing abortion services, even if they have the necessary training and clinical skills, albeit the services may be similar.
  • If there is a malpractice (or negligence) claim where the provider was handicapped by the laws of their state, how then will this be reflected in their malpractice and liability carriers’ representation(s) going forward?

But it is in those most restrictive states, that women of color (and not those of means) could see even higher maternal mortality rates, increased child poverty, and face a greater risk of prosecution for seeking illegal abortions.

Religion

Religious freedom in America should mean that we all have a right to our religious beliefs. But it should not give us the right to use religion and beliefs to discriminate against others who do not share them—especially when doing so risks lives.

Attorneys – You Can Hear The Dam Breaking

Bloomberg Law – “There is so much confusion”

‘Aiding and Abetting’

Abortion bans before six weeks in some states can depend on enforcement through lawsuits filed by private citizens. Possible targets: abortion providers and anyone who aids and abets an abortion – after an assumed heartbeat is detected – which is a “flutter (or the beginning of our pacemaker),” and not a heartbeat.

Hospitals, Healthcare Systems, Telehealth providers, Pharmacists, Nurses, and Providers are all looking for answers (and to date, getting few). I am sure that most of you are getting calls (if not, you will), as confusion reigns, from Coast to Coast.

Regulations

The Emergency Medical Treatment and Labor Act obligates all Medicare-participating hospitals with emergency departments to furnish all medical conditions that pose serious jeopardy to health, bodily severe impairment, or serious organ damage. This duty extends to emergency care for pregnancy or pregnancy loss.

Medical Societies Speak Out

The American Psychiatric Association

By dismantling nearly 50 years of legal precedent, the Court has jeopardized millions of American women’s physical and mental health and undermined the physician-patient relationship’s privacy.

This move will disproportionately impact our most vulnerable populations, such as communities of color, people living in rural areas, and those with low incomes who may have to travel long distances to receive abortions.

Today’s ruling will put many pregnant women and their families into life-threatening and/or traumatic situations.

American Society and Association, of Clinical Oncology

Unfortunately, with the implementation of Dobbs, doctors have been handicapped in this critical patient-doctor decision-making process. Still, ASCO will work to help our members navigate this new situation and preserve their patients’ access to the highest quality care by providing evidence-based clinical guidance, including fertility preservation, and by advocating for access to all the components of high-quality care.

The American College of Obstetricians and Gynecologists (ACOG)

“We are treating this as a disaster response,” Verma said. “We are in an emergency, and this is a disaster.” Its impact on situations will include miscarriage and in vitro fertilization. The practice of medicine will be reshaped, the group said, or even contradicted by “by-laws not founded in science or based on evidence.” She wondered, “Are surgeons going to be afraid to intervene when a pregnant patient ruptures their appendix because they might inadvertently end the pregnancy?”

The American Academy of Pediatrics (AAP)

Today’s ruling means that in many places in the United States, this evidence-based care will be difficult or impossible to access, threatening the health and safety of our patients and jeopardizing the patient-physician relationship.

New England Journal of Medicine

The Supreme Court’s fig-leaf justification behind these restrictions was that induced abortion was a dangerous procedure that required tighter regulation to protect the health of persons seeking that care. Facts belie this disingenuous rhetoric.1,2. In view of these predictable consequences, the editors of the New England Journal of Medicine strongly condemn the U.S. Supreme Court’s decision

AAMC (Association of American Medical Colleges)

These laws and policies that restrict or otherwise interfere with the patient-physician relationship put patients at risk by limiting access to quality, evidence-based care.