RULES AND REGULATIONS
DEPARTMENT OF CORRECTIONS
[37 PA. CODE CH. 93]
Prison Medical Services Program
[28 Pa.B. 2501] The Department of Corrections (Department) acting under the authority conferred by the Prison Medical Services Act (act) (61 P. S. §§ 1011--1017) (act) and section 903-B of The Administrative Code of 1929 (71 P. S. § 310-2) (AC) amends § 93.12 (relating to Prison Medical Services Program).
Background and Need for the Amendment
The amendment enables the Department to impose fees on inmates in State correctional institutions and facilities for the provision of certain medical services. The amendment also requires inmates who are covered by medical insurance to pay for the medical services through that insurance as far as the medical insurance policy may allow. Section 93.12 is amended to include subsections that contain definitions, specify what medical services will and will not be subject to a fee, require inmates who are covered by medical insurance to pay for the costs of those services through that insurance and describe the procedures to be used for the collection of the fees.
Section 93.12 is first amended by designating its current and only subsection as subsection (a). Subsection (b) is added to include definitions for the terms ''Department,'' ''fee,'' ''inmate,'' ''health care professional'' and ''medical service.'' Subsection (c) is added to designate the medical services for which a fee will be charged. Subsection (d) is added to designate the medical services for which a fee will not be charged. Subsection (e) is added to establish the amount of the fee to be charged for certain medical services and when the fee will be assessed. Subsection (e) also confers upon the Department the authority to modify the fee through regulatory amendment. Subsection (f) is added to describe how payment of fees will be accomplished. Subsection (g) is added to require inmates who have medical insurance to pay for their own medical needs through that insurance. Subsection (h) is added to require the Department to include an explanation of the medical service fee program in the Inmate Handbook.
The amendment is adopted under the act and section 903-B of the AC. The act and the AC establish the Prison Medical Services Program (Program) within the Department and direct the Department to issue regulations to implement the program and to require inmates who are covered by medical insurance to pay for their medical needs through that insurance. The act states that the regulations shall specify the medical services which are subject to fees, the fee amounts, payment procedures, medical services that are not subject to fees and fees applicable to medical emergencies, chronic care and preexisting conditions.
Implementation of the program will result in immediate savings to the taxpayers of this Commonwealth. Inmates will be required to pay for a portion of the medical services actually used. This is in contrast to the present system where inmates receive free medical services at taxpayer expense. Additionally, it is anticipated that inmates will be less likely to seek and use medical services unnecessarily when they will be partly responsible for paying for those services. The money earned through the assessment of fees for medical services for inmates will be placed in the General Fund.
Fiscal Impact
The amendment requires that inmates incarcerated within State correctional institutions and facilities pay a $2 fee for certain medical services provided to them and to pay two-thirds of the total cost of medical services that are provided to another inmate as a result of the paying inmate's assaultive conduct. The amendment also requires inmates who are covered by medical insurance to pay for their medical needs through that insurance. The amendment has no other direct fiscal impact on the private sector, the general public or political subdivisions. The additional revenue generated through the collection of fees will be deposited in the General Fund as required by the act.
Paperwork Requirements
The amendment creates minimal additional paperwork for the private sector in that few inmates are covered by medical insurance that would require the filing of many medical claims with private insurance companies. The amendment does not create any additional paperwork for the general public or political subdivisions of this Commonwealth. Minimal additional paperwork is required for the Department. The Department will collect the fees through an inmate authorization form, which will describe the medical service to be provided and advise the inmate of the fee to be deducted from the inmate's account. The authorization form will then be forwarded to the institution's business office for debiting the inmate's account. The act also requires that the Department conduct an annual audit of the program and submit an annual report to the Chairperson and minority Chairperson of the Appropriations Committee and the Judiciary Committee of the Senate and the Chairperson and minority Chairperson of the Appropriations Committee and the Judiciary Committee of the House of Representatives.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on September 24, 1997, the Department submitted a copy of notice of proposed rulemaking, published at 27 Pa. B. 5095 (October 4, 1997) to the Independent Regulatory Review Commission (IRRC), and the Chairpersons of the House and Senate Judiciary Committees (Committees) for review and comment. In compliance with section 5(c) of the Regulatory Review Act, the Department also provided IRRC and the Committees with copies of the comments received, as well as other documentation. In preparing this final-form regulation, the Department has considered the comments received from IRRC, the Committees and the public.
Under section 5.1(d) of the Regulatory Review Act (71 P. S. § 745.5a(d)), the final-form regulation was deemed approved by the Committees on February 18, 1998. IRRC met on February 26, 1998, and approved the final-form regulation in accordance with section 5.1(e) of the Regulatory Review Act.
Statutory Authority
The Department's authority to establish the program and impose the fees established by the amendment is in section 3(b) of the act (61 P. S. § 1013(b)) and section 903-B of the AC.
Effective Date
The amendment to § 93.12 is effective upon final publication in the Pennsylvania Bulletin.
Contact Person
Interested persons are invited to submit written questions regarding the amendment to Kathleen Zwierzyna, Director, Bureau of Health Care Services, P. O. Box 598, 2520 Lisburn Road, Camp Hill, PA 17001-0598.
Findings
The Department finds that:
(1) Notice of proposed rulemaking was published at 27 Pa.B. 5095, as required by sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202) and the regulations thereunder, 1 Pa. Code §§ 7.1 and 7.2.
(2) A public comment period was provided as required by law and that the comments received were considered.
(3) The adoption of the amendment in the manner provided by this order is necessary and appropriate for the administration of the authorizing statutes.
Order
The Department, acting under the act orders that:
(a) The regulations of the Department, 37 Pa. Code Chapter 93, are amended by amending § 93.12 to read as set forth in Annex A.
(b) The Department shall submit this order and Annex A to the Office of General Counsel and to the Office of Attorney General for approval as required by law.
(c) The Secretary of Corrections shall certify this order and Annex A and deposit them with the Legislative Reference Bureau for publication in the Pennsylvania Bulletin as required by law.
(d) This order shall take effect upon publication in the Pennsylvania Bulletin and the program shall be imple-mented 60 days after all current inmates receive written notice of the implementation of the program.
MARTIN F. HORN,
Secretary(Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this document, see 28 Pa.B. 1362 (March 14, 1998).)
Fiscal Note: 19-1. (1) General Fund; (2) Implementing Year 1997-98 is $30,000; (3) 1st Succeeding Year 1998-99 is $180,000; 2nd Succeeding Year 1999-00 is $185,000; 3rd Succeeding Year 2000-01 is $191,000; 4th Succeeding Year 2001-02 is $197,000; 5th Succeeding Year 2002-03 is $203,000; (4) Fiscal Year 1996-97 $735,771,000; Fiscal Year 1995-96 $826,878,000; Fiscal Year 1994-95 $720,826,000; (7) State Correctional Institutions; (8) recommends adoption. This amendment will also increase revenue to the General Fund from the $2 inmate fee. The increased revenue is estimated at $63,000 for Fiscal Year 1997-1998 and $380,000 annually beginning in Fiscal Year 1998-1999. The increased revenue will augment the State Correctional Institutions Appropriation in the Department of Corrections.
Annex A
TITLE 37. LAW
PART III. AGENCIES AND OFFICES
CHAPTER 93. STATE CORRECTIONAL INSTITUTIONS AND FACILITIES
CARE AND TREATMENT§ 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:
Department--The Department of Corrections of the Commonwealth.
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--Any physician, physician assistant, nurse, dentist, optometric professional or other person licensed to provide health care under the laws of the Commonwealth.
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--The diagnosis, evaluation, treatment or preservation of the health of the human body, including its organs, structures and systems. 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 his physical condition is suitable for participation in a sport unless the medical service is provided as part of an inmate's initial, annual or biennial physical examination.
(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) Annual and biennial physical and dental examination.
(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 disease or illness.
(8) Infirmary care in a Department of Corrections facility.
(9) Hospitalization outside of a Department of Corrections 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 and who needs the 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 $2, except that an inmate is required to pay a fee equivalent to two-thirds of 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.
(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. A nonemergency medical service will not be provided to an inmate who refuses to sign the authorization form after having been advised that a fee will be charged for the medical service. 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 submitting the proper paperwork to the insurance carrier.
(h) The Department will include an explanation of the program in the Inmate Handbook.
[Pa.B. Doc. No. 98-850. Filed for public inspection May 29, 1998, 9:00 a.m.]
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