Section 93.12. Prison Medical Services Program

(a) Every institution will establish procedures to permit inmates to have access to health care professionals, prescribed treatment for serious medical needs, appropriate nutrition, exercise and personal hygiene items.

(b) The following words and phrases, when used in this section, have the following meanings unless the context clearly indicates otherwise:

Fee—The portion of the actual cost of a medical service provided to an inmate which the Department has determined shall be charged to the inmate.

Health care professional—

(i) Any physician, physician assistant, nurse, dentist, optometric professional or other person licensed to provide health care under the laws of the Commonwealth.

(ii) The term does not include a corrections health care administrator performing the administrative duties of that position.

Inmate—A person confined to a correctional institution, motivational boot camp, community corrections center or other facility operated by the Department, its agent or contractor.

Medical service—

(i) The diagnosis, evaluation, treatment or preservation of the health of the human body, including its organs, structures and systems.

(ii) The term includes diagnostic testing, prescribing and administering medication, surgical procedures, dental care, eye care, the furnishing of prosthetics and any other type of treatment or preventative care, whether performed on an inpatient or outpatient basis.

(c) The Department will charge a fee to an inmate for any of the following:

(1) Nonemergency medical service provided to an inmate at the inmate’s request.

(2) Medical service provided to the inmate as the result of a self-inflicted injury or illness, including emergency medical service provided to the inmate as the result of a self-inflicted injury or illness.

(3) Initial medication prescription except as provided in subsection (d)(2), (14), (16) and (17).

(4) Medical service provided to another inmate as a result of assaultive conduct engaged in by an inmate to be charged the fee.

(5) Medical service provided to an inmate as a result of an injury or illness arising from the inmate’s participation in a sport.

(6) Medical service provided to an inmate to determine whether the inmate’s physical condition is suitable for participation in a sport unless the medical service is provided as part of an inmate’s physical examination scheduled by the Department.

(d) The Department will not charge a fee to an inmate for any of the following:

(1) Physical, dental or mental health screening provided to an inmate upon intake.

(2) Immunization, tuberculosis test, Hepatitis B vaccination or other treatment initiated by the Department for public health reasons.

(3) Institution transfer screening.

(4) Physical and dental examination scheduled by the Department.

(5) Medical service provided to an inmate during a follow-up appointment scheduled by a health care professional employed by the Department or its contractors.

(6) Mental health treatment.

(7) Medical treatment for a chronic or intermittent disease or illness.

(8) Infirmary care in a Department facility.

(9) Hospitalization outside of a Department facility.

(10) Long-term care to an inmate not in need of hospitalization, but whose needs are such that they can only be met on a long-term basis or through personal or skilled care because of age, illness, disease, injury, convalescence or physical or mental infirmity.

(11) Medical referral ordered by a health care professional employed by the Department or its contractors.

(12) Medical service provided to an inmate during a medical emergency unless the medical emergency resulted from a self-inflicted injury or illness as determined by the health care professional providing the medical service.

(13) Laboratory test, electrocardiogram, dressing change or other treatment ordered by a health care professional employed by the Department or its contractors.

(14) Prenatal care.

(15) Medical service provided as a result of an injury or illness arising from an inmate’s institutional work assignment.

(16) Medication prescription subsequent to the initial medication prescription provided to an inmate for the same illness or condition.

(17) Social service program including, but not limited to, substance abuse groups and counseling.

(18) Psychotropic medication.

(19) Medication prescribed for an inmate for public health reasons.

(20) Physical, dental and mental health screening performed at the request of the Department.

(21) Medical service provided to an inmate to determine whether his physical condition is suitable for an institutional work assignment.

(22) Eyeglass prescription.

(23) Dentures.

(24) Prosthetic devices excluding customized items.

(e) The fee for any medical service in subsection (c) is $3. This amount will be increased to $4 on July 1, 2005, and $5 on July 1, 2007, except that an inmate is required to pay a fee equivalent to the total cost of medical services provided to another inmate as a result of the inmate’s assaultive conduct.

(1) The fee will be assessed each time a medical service in subsection (c) is provided to an inmate, except when multiple services are performed at one visit at the discretion of the health care professional.

(2) Each inmate shall receive 60 days written notice of the implementation of the Prison Medical Services Program.

(3) Each inmate shall receive written notice of any changes in medical service fees and payment procedures at least 60 days after the effective date of a regulation that modifies the fee for medical services and payment procedures.

(f) Payment for any medical service in subsection (c) shall be accomplished according to the following procedures:

(1) At the time any medical service is to be provided to an inmate, the inmate will be informed by the Department or a health care professional contracted by the Department whether a fee will be charged for the medical service and will be provided with an authorization form. The authorization form will describe the medical service to be provided and authorize the institution to deduct the fee from the inmate’s account.

(2) An inmate who wishes to receive a medical service after being advised that a fee will be charged for the medical service, shall sign the authorization form acknowledging that his inmate account will be debited for the fee. An inmate who refuses to sign the authorization, who does not sign a refusal of treatment form and who accepts medical treatment will receive the services and his account will be debited. An inmate will not be denied access to medical services because of an inability to pay the required fee. If an inmate lacks sufficient funds to pay a medical service fee, the inmate’s account will be debited and the fee recouped as soon as sufficient funds are deposited in the inmate’s account.

(3) The Department may seek to recover any amount owed for medical services fees by an inmate upon release under section 5 of the Prisoner Medical Services Act (61 P. S. § 1015).

(g) An inmate who has medical insurance shall pay for his own medical needs through that insurance by cooperating with the Department in submitting the proper paperwork to the insurance carrier.

(h) The Department will include an explanation of the program in the Department of Corrections Inmate Handbook.

The provisions of this § 93.12 adopted October 22, 1971, effective October 23, 1971, 1 Pa.B. 2017; amended March 9, 1973, effective March 10, 1973, 3 Pa.B. 447; amended February 17, 1984, effective February 18, 1984, 14 Pa.B. 534; amended May 29, 1998, effective 60 days after all current inmates receive written notice of the implementation of the program, 28 Pa.B. 2501; amended April 15, 2005, effective April 16, 2005, 35 Pa.B. 2279. Immediately preceding text appears at serial pages (296516), (286437), (261599) to (261600) and (266457).

Notation

Authority

The provisions of this § 93.12 amended under section 3(b) of the Prison Medical Services Act (61 P. S. § 1013(b)); and section 903-B of The Administrative Code of 1929 (71 P. S. § 310-2).

Notes of Decisions

Assessment

The Department of Corrections had the authority to withdraw funds for medical restitution from an inmate’s account, where the inmate was found guilty of misconduct for his involvement in a fight with another inmate. Anderson v. Horn, 723 A.2d 254 (Pa. Cmwlth. 1998).

Constitutionality

The Prison Medical Services Act and regulations (policy bulletins) do not violate the constitutional prohibition against ex post facto laws, where neither the Act nor the regulations are penal in nature because they do not criminalize any type of conduct that was legal before their enactment nor do they deprive a criminal defendant of any defense that was available to him at the time of the alleged crime, and, even assuming arguendo that the Act and regulations could be considered penal in nature, they did not become enforceable until published and apply only prospectively, not retrospectively. Silo v. Ridge, 728 A.2d 394 (Pa. Cmwlth. 1999).

The Prison Medical Services Act and regulations do not violate the constitutional prohibition against bills of attainder, where they do not determine guilt or impose punishment on the inmates, but rather they simply require that inmates pay a small fee for the provision of certain medical services, and the $2.00 fee is imposed regardless of whether an inmate is legitimately seeking medical treatment or is abusing the prison’s sick call procedure. Silo v. Ridge, 728 A.2d 394 (Pa. Cmwlth. 1999).

Medical Service

The estate of a pretrial detainee who committed suicide while detained brought a civil rights action against jail officials for failure to provide treatment services required by Pennsylvania law and erroneously claimed that such failure constituted ‘‘deliberate indifference.’’ Herman v. Clearfield County, 836 F. Supp. 1178 (1993); affirmed 30 F. Supp. 1486 (3.d Cir. (Pa.) 1994).

The Prison Medical Services Act (61 P. S. § § 1011—1017) requires that Department of Corrections develop by regulation a program with consistent medical services guidelines specifying the services subject to fees, fee amounts, payment procedures and services not subject to fees; Department was not required to exempt treatment of all chronic conditions from co-pay fees and regulations did not prohibit assessing co-pay fees for any conditions. Portalatin v. Department of Corrections, 979 A.2d 944, 950 (Pa. Cmwlth. 2009).

Prospective Application

The order of the Secretary of the Department of Corrections assessing the medical costs against an inmate for medical services rendered in 1993 is reversed, where the Prison Medical Services Act and its implementing regulations apply only prospectively and, in this case, the assault and subsequent medical services took place 3 years before the effective date of the act and 5 years before the effective date of the regulations. Byrd v. Department of Corrections, 743 A.2d 532 (Pa. Cmwlth. 1999); reargument denied (jan. 2000).