BOP Program Statement 6541.03 § 5

(a) The Warden must establish procedures to provide up to two OTC medications per week for

an inmate without funds. An inmate without funds is an inmate who has not had a trust fund

account balance of $6.00 for the past 30 days.

(b) An inmate without funds may obtain additional OTC medications at sick call if health

services staff determine that he/she has an immediate medical need which must be addressed

before the inmate may again apply for OTC medications under this section.

(c) To prevent abuses of this section (e.g., inmate shows a pattern of depleting his or her

commissary funds before requesting OTC medications), the Warden may impose restrictions

on the provisions of this section.

6541.03 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 3

The Bureau National Pharmacy & Therapeutics (P&T) Committee will establish and maintain an

approved list of OTC medications and quantity limits of each for an indigent inmate to request

from the institution pharmacy. This list will be maintained in Part 1 of the National Formulary,

available through the Chief Pharmacist, Health Services Division’s page on the Bureau’s intranet

site. This list will include OTC medications used to treat or alleviate common symptoms safely

without the need for a medical examination, consistent with self-treatment practices in the

community. Other OTC medications stocked in the commissary but not on this list are for the

inmates’ convenience but are not considered medically necessary items which must be made

available to indigent inmates. Local institutions may choose to utilize a list that is more, but not

less, restrictive than approved through the Bureau National P&T Committee.

a. Procedures for providing OTC medications to indigent inmates.

 The inmate will select no more than two items from the Bureau-approved indigent OTC

list no more than once weekly and submit the request to the institution pharmacy per

local procedures. If they need more than two items, they must attend triage/sick call.

 Upon receipt of the OTC indigent request, the pharmacy will verify the inmate is indigent

via the relevant Trust Fund application or by verifying with the appropriate Trust Fund

personnel.

 A clinical encounter is not required prior to providing indigent medications.

 Pharmacy staff will record the issued OTCs in the inmate’s profile in the electronic health

record or other designated tracking system.

 If an indigent inmate desires an OTC medication that is not on the approved indigent

OTC list or has depleted their weekly allotment, the inmate may access triage/sick call

through the usual procedures and request the item. The health care provider will

determine the request’s medical necessity per the Program Statement Patient Care and

may prescribe an appropriate quantity of the item to the inmate.

b. OTCs for inmates with encumbered funds or other restrictions. Inmates may not be

indigent but still lack resources to purchase medications (e.g., new intakes whose funds have not

yet posted). These inmates may access triage/sick call through the usual procedures and request

the item. The health care provider will determine the request’s medical necessity according to the

Program Statement Patient Care and may prescribe an appropriate quantity of the item to the

inmate.

Inmates with commissary restrictions or other encumbrances are not considered indigent and will

be required to follow this program statement for the provision of OTCs through commissary.