Prisoner Health

This page is dedicated to a free exchange of information concerning the health care needs, provision, logistics, concerns, and problems encountered within the Arkansas penal system.  No information appearing anywhere on this website, either expressed

 or implied,  shall be construed to be professional medical information and/or advice.  Readers are strongly advised to consult competent professionals to assist in making responsible decisions concerning health care.

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Posted 10/31/05

FROM: Arkansas Department of Corrections

                P O Box 8707

                Pine Bluff, AR 71611-8707

                Phone: 870-267-6999

                FAX: 870-267-6258

                www.state.ar.us/doc

APPLICABILITY: All inmates and health service providers

REFERENCE: AR 893-Medical Co-Pay PAGE 1 of 4

APPROVED: Original signed by Larry Norris      EFFECTIVE DATE: 01/15/2005

I. POLICY:

    It is policy of the Board of Corrections to encourage responsible use of health care services by inmates, and to improve the quality of the services rendered. No inmate will be denied necessary health care services because of inability to pay.

A. Chronic care clinic is a clinic for tracking long-term medical conditions or disabilities such as diabetes, HIV, hepatitis, hypertension, heart disease, and the like.

B. Co-pay is the amount set by the Board of Corrections to be charged for inmate-initiated services. That amount is currently $3.00, but may be adjusted by the Board of Corrections.

C. Emergency is a condition that is life threatening, or could cause serious harm if not immediately addressed.

D. Follow-up refers to any appointment initiated by health care staff subsequent to previous examination or treatment.

E. Inmate-initiated services are those services requested by the inmate, typically through Sick Call Request.

F. Necessary Care is treatment that if not provided will reasonably be expected to result in deterioration of a health condition or will result in permanent functional impairment or loss of function, or intractable pain.

G. Preventive care is any service scheduled by infectious disease control or the health care provider to maintain the health of the inmate population. Examples include intake physical examinations, eye examinations, scheduled dental hygiene, tuberculosis testing, PAP smears for females, and regularly scheduled recurrences of these services.

H. Safeguarded account balance is any balance of five dollars ($5.00) or less that cannot be taken to satisfy a lien for health services co-pay.

III  PROCEDURE

A. Notification of Inmates

1. Notice will be posted in all inmate living spaces, the law library, and bulletin boards as permitted by unit policy advising inmates of the policy and procedures, no less than thirty days in advance of the effective date of this Administrative Directive.

2. Each new commitment or violator returned to the Arkansas Department of Correction will be informed of the co-pay policy during orientation and will be asked to sign a co-pay notice indicating awareness of the policy.

3. One witness will co-sign the form. Should the inmate refuse to sign the form, the refusal will be noted, and two witnesses will sign the form. Witnesses may include any agency or contract staff, but may not include inmates.

4. The signed copy will be placed in the inmate’s Health Record.

B. Assessment of Fees.

1. There is no co-pay for initial assessments during reception, intra-system transfer evaluations, or healthcare staff initiated periodic physical examinations.

2. $3.00 dollars for each inmate-initiated request for health care services.

3. $3.00 dollars for each initial contact with health care services due to fights, or sports injuries; self-inflicted injuries, not associated with mental illness.

4. There will be no charge for emergency services, preventive care or follow-up visits scheduled by the health care provider.

5. $3.00 dollars for any request for HIV testing beyond that done at reception or when clinically indicated.

6. There will be no charge for visits to reorder medications.

7. There will be no charge for Chronic Care Clinics.

8. There will be no charge for infirmary or hospital care.

9. There will be no charge for preventive care initiated by health care staff.

10. There will be no charge for medications, X-rays or laboratory tests initiated by healthcare staff.

11. There will be no charge for mental health services, substance abuse treatment or sex offender treatment.

12. There will be no charge for pre- or pos-natal care or labor and delivery.

13. No inmate will be refused necessary health care due to inability to pay.

C. Collection of fees

1. Upon completion of an inmate-initiated health care contact the inmate’s ADC number, name, and co-pay Charge, will be logged. The inmate will be requested to sign the log after his/her name. A health services staff member will sign in the signature block after the inmate, attesting that the service(s) have been provided.

2. If the inmate refuses to sign, the health services representative will enter "Refused to Sign" in the Inmate’s Signature block, and will sign after the entry. Another health services representative or, if not available, a Corrections Officer, will sign in the Health Services signature block.

3. The Log sheet will be maintained by the Unit Health Services Administrator for reference purposes and to help resolve inmate questions and complaints.

4. When co-pay charges are posted to the inmate’s account, the balance in the account will not be reduced below the safeguarded account balance of $5.00 dollars. Any amount not charged for health care services to the inmate’s account due to a safeguarded account balance will be set up as a co-pay lien to the inmate.

5. When an inmate who has a co-pay lien receives funds from outside the system or from another inmate those funds may be used to satisfy the co-pay lien.

6. "Christmas funds", "Gate Money", or other such funds provided by the State will not be taken to satisfy co-pay liens. Aid to indigent inmates will not be reduced.

7. All co-pay liens or charges will be deducted before commissary charges are allowed when the balance of the inmate trust fund account rises above the safeguarded account balance of five dollars ($5.00).

8. Out-of-state inmates housed in ADC facilities will be subject to the same co-pay guidelines as an Arkansas inmate. These inmates will not be charged for services required by Interstate Corrections Compact guidelines.

D. Refund of fees.

1. If an inmate feels that a charge has been assessed for health services that were not requested by the inmate, a written request for refund is to be sent to the Unit Health Services Administrator, who will review the charge and determine if a refund is due.

2. If the inmate is dissatisfied with the findings of the Unit Health Service Administrator, the inmate should then follow the established inmate grievance procedure.

    American Correctional Association: Standards for Adult Correctional Institutions, 4^th Edition, 2003. 4-4345.

    National Commission on Correctional Health Care. Position Statement, 31 March, 1996.

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