The Unhealthy State of Prison Medical Care: Sam Mangel, Federal Prison Advisor

The quality of medical care in the Bureau of Prisons (BOP) has been a subject of concern and criticism over the years and is one of the top worries clients and their families have when they reach out to us.

While the quality of care can vary significantly across different institutions and regions, the top criticisms are usually the same:

  1. Understaffing: Some BOP facilities have been reported to suffer from significant understaffing, which can lead to delays in treatment and reduced access to care for inmates. This can particularly be a concern in specialty areas like mental health, where adequate staffing is crucial for appropriate treatment.
  2. Delayed or Inadequate Treatment: There have been reports and lawsuits suggesting that inmates have experienced significant delays in receiving necessary medical treatments. In some cases, the delays or denials have had serious or even fatal consequences.
  3. Facility Issues: Some BOP facilities are old and may not be equipped with up-to-date medical equipment or facilities. This can limit the types of treatments that can be offered on-site, leading to potential delays or transfers to other facilities.
  4. Specialized Care: Inmates with special medical needs or chronic illnesses sometimes face challenges in receiving specialized care. While the BOP does have facilities designed for inmates with severe medical needs, not all inmates can be accommodated there.

BOP Formulary:

The Bureau of Prisons (BOP) maintains a formulary, which is essentially a list of medications that are approved for use within BOP facilities. This formulary is part of the BOP’s efforts to provide consistent medical care across its institutions. The question of whether the BOP formulary is “good” is somewhat subjective and can depend on various factors, including one’s perspective and specific medical needs.

Criticisms and Concerns:

  1. Limited Options: Like many formularies, the BOP’s might not include every available medication, which can be problematic if an inmate requires a specific medication not on the list.
  2. Delays in Access: Even if a needed medication is on the formulary, bureaucratic processes or other administrative issues might cause delays in inmates receiving their medications.
  3. Specialized Needs: In some cases, inmates with unique or specialized medical needs might find that the formulary doesn’t adequately address their requirements.

This is not to say that every inmate will receive inadequate medical care, or that every facility has these problems, although given the importance of healthcare, inmates and their families are right to be concerned.

If you or a loved one are in federal prison, or will be reporting to one shortly, it is absolutely critical that you are aware of these issues and how to address them ahead of time. The BOP will not go out of its way to provide extra medical attention, even if it is your right as a federal inmate.

A Federal Prison Consultant can walk you through the ins and outs of the prison healthcare system and advise you on the obstacles you will likely face, and how to best overcome them in order to ensure that your health and/or medical needs are taken into account while in custody.

Please do not hesitate to get in touch for a free consultation and to ask any questions you may have with the prison healthcare system!

Sam Mangel


Member: American Bar Association