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

Dr. Marc Blatstein | About

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.

EDUCATION | 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)
– Podiatric Licensure, 1985 – present

HOBBIES

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

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

 

 

PUBLICATION:

Nails Magazine, Contributor, through the 1990s

 

 

 

CREATIVE FOOTWORKS

Novelties, Business Supplies, and Gifts for those practicing Foot and Ankle Medicine and Surgery, Founded 1986

 

        

             

                                                                                                       

POPULAR COMPONENTS OF MY PRACTICE

I. PLANTAR FASCITIS

According to Dr. Marc Blatstein, morning heel pain’s 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 again 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 originally thought that 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 the diagnosis of 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, as well as orthopedic functional foot orthotics, may be prescribed. Should any or all of these treatments fail, and after a detailed review of X- Rays, Lab results with your physician; surgical intervention may be considered, and according to Dr. Marc Blatstein, is very effective. Here an Endoscopic Plantar Fasciotomy is one (of many) of the possible procedures that could be recommended. A plan then is formed between you and your doctor for a successful outcome that is 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 the prevention of 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 such 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 the formation of 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. TARSAL TUNNEL 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 as well as the patient’s history of their complaint. 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, both 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 there be a soft tissue mass compressing the nerve, then 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 a 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 actually 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, as well as 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, also utilizing a functional orthotic. This conservative treatment also consists of hammertoe and buttress pads all available over the counter, in addition, to 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, it is very important to follow your surgeon’s after-surgery instructions in order 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. There are several people who wait far too long to have the   procedure and they have more complications 

Most of the time people do not think that an ingrown toenail will get in the way of their profession, but for one person it did. Victoria Azaranka who is 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.

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

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

Entering The BOP – Verifying The Availability of Your Medications

Verifying Medication  Availability

Will Go A Long Way To Easing Your Client’s Fears

    • They assume that they will still get medical care on the inside.
    • The assumption may also be that they will also get the same medications that they got on the outside,
    • This will likely be a False assumption.

 

Medication availability (~ 3500 different drugs), falls into 3 categories.

1st) On Formulary -Available:

      • These medications are available for BOP healthcare providers for inmate use.

2nd) Non-Formulary -These require a lengthy Preauthorization Process

      • These medications while they are stocked, are not available and require a lengthy Pre-authorization.
      • As the BOP Formulary is available online, and should your medication fall into this category, this discussion should take place long before the Presentence Interview for obvious reasons.

3rd) Similar equivalents – Not On Formulary (Not Available)

      • Here similar or equivalent substitutions are used. It is before this point, and long before the PSI, after consulting with the current treating physician of record, that defense needs to make appropriate decisions regarding this medical problem.
      • Albeit, addressing it before the PSR is complete, with the backing of the US Attorney, and finally the court.
        1. Examples of medication confusion for Cholesterol Control:
          • PCSK9 Inhibitors vs. Statins. Statins are a popular treatment that has been available since the 1980s. PCSK9 inhibitors, on the other hand, are a new type of cholesterol drug. They were approved by the Food and Drug Administration in 2015.

Generics

    • These are the drug of choice for the BOP as they are cheaper than brand-name medications.
    • It may be beneficial to inform your client ahead of time that, while they’ll be taking a generic medication
      • since there are many manufacturers who each produce similar generic drugs
      • these same drugs, while may differ in color, size, and shape;
      • they should be the same
    • Nobody likes surprises, especially if they are entering prison for the first time.

                                                              Generic Lipitor Good Rx

 

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

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