BOP Program Statement 6031.06 § 16

Each institution is required to utilize the Device/Equipment section of the flow sheets in the EHR

to track and manage the assignment of inmate issued-durable medical equipment and devices

(DME). The HSA or designee will develop standard procedures regarding the management of

DME, including storage, retrieval of DME assigned as temporary aid to restoration of unaided

functionality, and accountability for DME as property to ensure safe and secure management of

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the correctional environment. The HSA, in collaboration with the Captain, will determine

standard procedures for retention of DME when an inmate is placed in restrictive housing.

Clinicians assigning DME to inmates will document issuance in the EHR and indicate the time

frame for approved use. Clinicians will reassess the need for DME before extending the

assignment of DME.

In the event of a power outage, every effort will be made to accommodate those inmates requiring

ongoing use of DME to include relocation of the inmate and equipment to an area of the

institution with appropriate utilities (e.g., power, running water, etc.).

DME must accompany the inmate when transferring to SHU, another facility, upon release to an

RRC, or upon direct release to the community. Where security concerns may arise from

possession of DME in SHU, limiting or adjusting access to DME, will occur after consultation

with a clinician. If certain DME items are restricted while housed in SHU, the MDS form must be

updated in the EHR to reflect any adjustments. When medical needs cannot be accommodated in

SHU, and in the interest of preserving life or limb, alternative housing or disciplinary options will

be pursued.

Local standard procedures will address the management of specific equipment and devices that

may raise local security concerns (e.g., continuous positive airway pressure [CPAP] machines,

Transcutaneous Electrical Nerve Stimulation [TENS] machines, etc.). The HSA and CD will

coordinate communication of the medical necessity for DME when justifying issuance and

protocol for inmate use of DME. Guidance for common DME is outlined below.

There are several DME, that while infrequently used, warrant special mention due to network

connectivity capabilities and the life-preserving nature of the devices (e.g., life vests, insulin

pumps, holter monitors, etc.). These devices are medically necessary and cannot be removed

from the inmate’s possession without the approval of the CD.

a. Eyeglasses. The Bureau will furnish prescription eyeglasses to any inmate who has a

documented need for corrective lenses and a valid written prescription.

Inmates may purchase reading glasses at commissaries that stock them. The HSA, in

consultation with the CD and consultant optometrist, may elect to stock a supply of reading

glasses in various magnifications that the optometrist may dispense when the inmate only

requires magnification.

Inmates may retain personal prescription eyeglasses at admission, provided these devices do not

have wireless or Artificial Intelligence components. Such eyeglasses are subject to inspection for

contraband. The Bureau will not repair personal eyeglasses. Inmates will not be allowed to

obtain prescription glasses from outside sources. If an inmate chooses not to retain personal

eyeglasses at admission, they will be disposed of as indicated in the Program Statement Inmate

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Personal Property.

The only exception to the above is non-sentenced inmates who are housed in Bureau institutions.

These non-sentenced inmates housed in Bureau institutions may obtain prescription glasses from

outside sources. Outside sources may include family members, Bureau-funded orders, etc. to

ensure non-sentenced inmates have access to eyeglasses given their typical shorter length of stay

before sentencing.

b. Contact Lenses. Contact lenses will only be prescribed when, in the clinical judgment of a

Bureau or contract optometrist or ophthalmologist, and with the concurrence of the CD, an eye-

refractive error is best treated by contact lenses. Specific eye conditions appropriate for

treatment are included in guidance provided by the Medical Director.

When the recommendation of a consultant is inconsistent with guidance issued by the Medical

Director, the CD will defer to the Medical Director’s guidance.

HSU staff will evaluate sentenced inmates arriving at an institution with contact lenses and refer

them to a Bureau or contract optometrist or ophthalmologist to determine whether they may

retain the lenses. Unless contact lenses are medically necessary, HSU staff will inform the

inmate that prescription glasses will be obtained and issued by the Bureau.

The only exception to the above is non-sentenced inmates who are housed in Bureau institutions.

Once the eyeglasses are received, the contact lenses must be returned to the inmate’s personal

property per the Program Statement Inmate Personal Property or mailed home.

HSAs will ensure adequate contact lens cleaning and disinfection supplies are available in the

HSU or commissary for inmates having an authorized prescription for contact lenses, non-sentenced inmates, or those awaiting ordered eyeglasses.

c. Hearing Aids. The CD, in consultation with an audiologist or otolaryngologist, will

determine if a hearing aid is medically necessary. Health Services will supply hearing aids and

batteries if there is a documented medical necessity.

If an inmate brings a personal hearing aid into the institution, they will be allowed to keep it

when the medical necessity has been verified. Hearing aids are subject to inspection for

contraband. However, the inmate may not purchase a personal hearing aid once admitted to an

institution. The Bureau may replace an existing hearing aid that is ill-fitting or malfunctioning

based on the results of the most recent hearing test. The replacement device purchased by the

Bureau is not required to be the same model or brand. The HSA will purchase the most cost-effective model that meets the inmate’s medical need.

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d. Medical Footwear. The Bureau is responsible for providing each inmate with one pair of

safety shoes suitable for their job assignment. Refer to the Program Statement Inmate Personal

Property for instructions on allowable footwear inmates may bring into the institution or

purchase in the commissary at their own expense.

 Alternate Shoes. Clinicians may authorize alternate institutional shoes (formerly “soft

shoe pass”) for patients who do not have insensate feet, but do have a medical condition

that increases the risk of injury to the foot if safety toe boots are worn. Alternate shoes

are issued through Laundry Services. Alternate shoes may be temporarily authorized for

acute injuries or issued for a period not to exceed 12 months. Alternate shoe permits will

not exceed 12 months. Clinicians will evaluate the need for alternate shoes prior to

reissuance of the permit, document the need in the clinical encounter, and update the

MDS with the alternate shoe permit and expiration date.

 Institutional safety toe boots must be exchanged for the pair of alternate shoes. An

inmate cannot work in an area requiring safety toe boots when authorized alternate

shoes.

 Medical Shoes. Clinicians will authorize medical shoes, utilizing the MDS form located

in the EHR, to accommodate a significant foot deformity or to decrease the chance of

injury to feet with impaired sensation. Medical footwear should be purchased from

Medline or directly through the shoe manufacturer. If a medical shoe permit is issued to

replace the institution-issued safety shoe, the inmate will be assigned to a job that does

not require the safety shoes. Medical shoe permits will not exceed 12 months. Clinicians

will evaluate the need for medical shoes prior to reissuance of the permit, document the

need in the clinical encounter, and update the MDS with the medical shoe permit and

expiration date.

 Custom Orthotics. Occasionally, custom orthotics may be medically necessary to

accommodate a significant foot deformity or to decrease the chance of injury to feet with

impaired sensation. Custom orthotics are to be approved through the Utilization Review

Committee and provided through the contracted Prosthetic/Orthotic company.

The need for medical shoes or custom orthotic devices will be re-evaluated annually, or sooner

as determined by the CD or Chief Therapist. If the clinician recommends renewal of the medical

shoes or orthotic device, the CD or Chief Therapist will review before approving renewal. The

CD or Chief Therapist must approve all requests for purchase of medical shoes and orthotic

devices. The HSA will purchase custom shoes or orthotic devices using the institution’s Health

Services Cost Center.

e. Blood Glucose Meters. Inmates diagnosed with diabetes may be authorized to have blood

glucose meters (glucometers) to self-monitor their blood sugar levels as clinically indicated and

prescribed by the physician, APP, or pharmacist with a CPA.

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