BOP Program Statement 6031.06 § 6

Medical Classification is the system of assigning a care level to each Bureau institution, and a

medical and mental health care level assignment to each inmate. The system has four care levels.

For medical care levels, see clinical guidance on Care Level Classification for Medical

Conditions or Disabilities located on the Health Services Division (HSD) page of the Bureau’s

intranet site. For mental health care levels, see Program Statement Psychology Services

Manual.

The HSD assigns institution care levels based on an analysis of the physical plant, community-based resources, local labor market, and impact on other correctional programs. Increased

staffing levels and ancillary/specialty services are needed at institutions that have higher care

level assignments as determined by the Assistant Director, HSD.

Medical care levels are:

 Care Level 1 institutions house inmates who are generally healthy but may have limited

medical problems easily managed by Health Services staff and supplemented by existing

community resources.

 Care Level 2 institutions house inmates who have stable chronic conditions managed by

Health Services staff and supplemented by existing community resources. Care Level 2

inmates generally self-manage their conditions and need infrequent visits to medical

specialists or community facilities.

 Care Level 3 institutions house inmates who have more complex medical conditions and are

more fragile. They require frequent clinical contacts with Health Services staff and more

visits to community medical specialists. They may also periodically require hospitalization to

stabilize their conditions.

 Care Level 4 institutions are the Bureau’s MRC. Inmates housed at MRCs may require

extensive medical and nursing care. Some inmates may require 24-hour nursing care

including assistance with activities of daily living such as feeding, toileting, and dressing.

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These inmates may have frequent visits to medical specialists or hospitalizations for

specialized medical care that isn’t available in the MRC.

The CD or designee physician makes a care level assessment upon an inmate’s arrival, and

regularly reviews and revises medical care levels at each chronic care clinic visit, and as the

inmate’s health needs change. Institutions are required to review and update inmate care levels at

every comprehensive medical evaluation encounter.