BOP Program Statement 5335.02 § 8

HEALTH UNITS

a. Rounds. A credentialed health care professional (e.g., Advanced Practice Provider, nurse,

paramedic etc.) will conduct daily rounds to determine any urgent requests for care and arrange

for timely evaluations as clinically indicated. Emergency medical care is always available either

at the institution or provided by community resources. The Health Services Administrator or

designee will at a minimum make weekly administrative rounds. Refer to the Program Statement

Patient Care for information regarding medical care provided to inmates restricted from general

population.

b. Disabilities and Activities of Daily Living (ADL). Health Services provides special

accommodations and/or supports for personal hygiene to those SMHU inmates who have

impaired ability to perform ADLs in accordance with the Program Statements Management of

Inmates With Disabilities and Patient Care.

c. Psychiatric Providers. Inmates in these programs are entitled to the full range of psychiatric

services and medications available to all inmates in the custody of the Bureau and will be

provided, if clinically indicated, the following services:

■ The SMHU psychiatric provider is a member of the Secure Treatment Team and attends

each Secure Treatment Team meeting.

■ If an SMHU inmate is not currently prescribed psychotropic medication but is referred

for evaluation of need, the SMHU psychiatric provider meets with the inmate to

determine a psychiatric plan of treatment within 14 days of referral, consistent with the

Program Statement Psychiatric Services.

■ For each SMHU inmate who is prescribed psychotropic medication, the SMHU

psychiatric provider meets with the SMHU inmate at least monthly to determine

improvement in mental health, adjust psychotropic medications, and to aid the Secure

Treatment Team in monitoring mental decompensation. This care is also provided

consistent with the Program Statement Psychiatric Services.

■ Psychiatric consultations occur in a private setting unless significant security concerns

exist.

■ Health Services will arrange to administer medication at mealtime whenever feasible, as

food is necessary to offset negative side effects of some medication. The Secure

Treatment Team will coordinate with departments to ensure a supply of shelf-stable

snacks is stored on the SMHU to be accessed by staff conducting pill line should facility

operations necessitate pill line administration at a time that does not coincide with

mealtime. When ordering medication that should be taken with food, either because of

5335.02 3/19/2026 PROPERTY OF US GOVERNMENT 17

the medication or the inmate’s medical condition, the psychiatric provider should note the

food requirement in the medication order instructions. These snacks can be purchased by

Food Service, Health Services, or Psychology Services.

■ The Secure Treatment Team will determine which inmates and medications are permitted

to be retained amongst an inmates’ personal property based on each inmate’s treatment

needs, safety risks, and goals.

■ For those on pill line, psychotropic medications will be administered under direct

observation to ensure adherence and provide adequate data for documentation.

■ Psychiatric providers and mental health treatment providers are responsible for

monitoring patient adherence with medication. Adherence intervention (reeducation,

treatment plan modification, etc.) should be considered when inmates refuse or

consistently miss their prescribed medication for three consecutive doses, 50% of doses

within one week, or when an otherwise clinically significant pattern of missed doses is

present. It will be determined locally who is responsible for notifying both the Chief

Psychologist and psychiatric provider when there are adherence concerns. Medication

adherence concerns should also be discussed in Secure Treatment Team.

■ Psychotropic medication will not be withheld from any inmate solely for disciplinary

reasons. If an inmate has diverted a psychotropic medication, the psychiatric care

provider will make the determination as to whether discontinuation of the medication is

clinically warranted. When a staff member becomes aware of medications being diverted,

they will inform the Health Services Administrator who will inform the provider.

■ In cases where involuntary psychotropic medication may be warranted, the SMHU

psychiatric provider participates in the due process hearing and otherwise acts in

accordance with the Program Statement Psychiatric Evaluation and Treatment.

■ In cases where the Secure Treatment Team, the SMHU psychiatric provider, or a

psychologist refers an SMHU inmate for evaluation of emergency psychotropic

medication needs, the Program Statements Psychiatric Evaluation and Treatment,

Patient Care, and Psychiatric Services will be followed with special attention to the

definition of gravely disabled as defined within this program statement.

d. Other Health Services Staffing. Ordinarily each facility with an SMHU will be staffed with

an adequate number of healthcare professionals, including a psychiatric provider. Those

professionals will ensure mental health chronic care needs are facilitated, administer pill-line,

and participate in the Secure Treatment Team in addition to other healthcare duties not directly

related to the SMHU as assigned. As staffing is available, Health Services is encouraged to

provide support services (e.g., chronic illness education groups, nutrition seminars, etc.).