page is dedicated to a free exchange of information concerning the health care
needs, provision, logistics, concerns, and problems encountered within the
Arkansas penal system. No information
appearing anywhere on this website, either expressed
or implied, shall be construed
to be professional medical information and/or advice. Readers are strongly
advised to consult competent professionals to assist in making responsible
decisions concerning health care.
Arkansas Department of Corrections
P O Box 8707
Pine Bluff, AR 71611-8707
Health Care Co-Pay
04-18 SUPERSEDES: None
All inmates and health service providers
AR 893-Medical Co-Pay PAGE 1 of 4
Original signed by Larry Norris EFFECTIVE
It is policy of the Board of
Corrections to encourage responsible use of health care services by inmates, and
to improve the quality of the services rendered. No inmate will be denied
necessary health care services because of inability to pay.
A. Chronic care clinic is a clinic for
tracking long-term medical conditions or disabilities such as diabetes, HIV,
hepatitis, hypertension, heart disease, and the like.
B. Co-pay is the amount set by the Board
of Corrections to be charged for inmate-initiated services. That
amount is currently $3.00, but may be adjusted by the Board of Corrections.
C. Emergency is a condition that is life
threatening, or could cause serious harm if not immediately addressed.
D. Follow-up refers to any appointment
initiated by health care staff subsequent to previous examination or treatment.
E. Inmate-initiated services are those
services requested by the inmate, typically through Sick Call Request.
F. Necessary Care is treatment that if
not provided will reasonably be expected to result in deterioration of a health
condition or will result in permanent functional impairment or loss of function,
or intractable pain.
G. Preventive care is any service
scheduled by infectious disease control or the health care provider to maintain
the health of the inmate population. Examples include intake physical
examinations, eye examinations, scheduled dental hygiene, tuberculosis testing,
PAP smears for females, and regularly scheduled recurrences of these services.
H. Safeguarded account balance is any
balance of five dollars ($5.00) or less that cannot be taken to satisfy a lien
for health services co-pay.
A. Notification of Inmates
1. Notice will be posted in all inmate
living spaces, the law library, and bulletin boards as permitted by unit
policy advising inmates of the policy and procedures, no less than thirty
days in advance of the effective date of this Administrative Directive.
2. Each new commitment or violator returned
to the Arkansas Department of Correction will be informed of the co-pay
policy during orientation and will be asked to sign a co-pay notice
indicating awareness of the policy.
3. One witness will co-sign the form. Should
the inmate refuse to sign the form, the refusal will be noted, and two
witnesses will sign the form. Witnesses may include any agency or contract
staff, but may not include inmates.
4. The signed copy will be placed in the
inmate’s Health Record.
B. Assessment of Fees.
1. There is no co-pay for
initial assessments during reception, intra-system transfer evaluations, or
healthcare staff initiated periodic physical examinations.
2. $3.00 dollars for each inmate-initiated
request for health care services.
3. $3.00 dollars for each initial contact
with health care services due to fights, or sports injuries; self-inflicted
injuries, not associated with mental illness.
4. There will be no charge for emergency
services, preventive care or follow-up visits scheduled by the
health care provider.
5. $3.00 dollars for any request for HIV
testing beyond that done at reception or when clinically indicated.
6. There will be no charge for visits
to reorder medications.
7. There will be no charge for Chronic
8. There will be no charge for
infirmary or hospital care.
9. There will be no charge for preventive
care initiated by health care staff.
10. There will be no charge for
medications, X-rays or laboratory tests initiated by healthcare staff.
11. There will be no charge for
mental health services, substance abuse treatment or sex offender treatment.
12. There will be no charge for pre- or
pos-natal care or labor and delivery.
13. No inmate will be refused necessary
health care due to inability to pay.
C. Collection of fees
1. Upon completion of an inmate-initiated
health care contact the inmate’s ADC number, name, and co-pay Charge,
will be logged. The inmate will be requested to sign the log after his/her
name. A health services staff member will sign in the signature block after
the inmate, attesting that the service(s) have been provided.
2. If the inmate refuses to sign, the health
services representative will enter "Refused to Sign" in the
Inmate’s Signature block, and will sign after the entry. Another health
services representative or, if not available, a Corrections Officer, will
sign in the Health Services signature block.
3. The Log sheet will be maintained
by the Unit Health Services Administrator for reference purposes and to help
resolve inmate questions and complaints.
4. When co-pay charges are posted to
the inmate’s account, the balance in the account will not be reduced below
the safeguarded account balance of $5.00 dollars. Any amount
charged for health care services to the inmate’s account due to a safeguarded
account balance will be set up as a co-pay lien to the inmate.
5. When an inmate who has a co-pay
lien receives funds from outside the system or from another inmate those
funds may be used to satisfy the co-pay lien.
6. "Christmas funds", "Gate
Money", or other such funds provided by the State will not be taken to
satisfy co-pay liens. Aid to indigent inmates will not be reduced.
7. All co-pay liens or charges will
be deducted before commissary charges are allowed when the balance of the
inmate trust fund account rises above the safeguarded account balance
of five dollars ($5.00).
8. Out-of-state inmates housed in ADC
facilities will be subject to the same co-pay guidelines as an
Arkansas inmate. These inmates will not be charged for services required by
Interstate Corrections Compact guidelines.
D. Refund of fees.
1. If an inmate feels that a charge has been
assessed for health services that were not requested by the inmate, a
written request for refund is to be sent to the Unit Health Services
Administrator, who will review the charge and determine if a refund is due.
2. If the inmate is dissatisfied with the
findings of the Unit Health Service Administrator, the inmate should then
follow the established inmate grievance procedure.
American Correctional Association:
Standards for Adult Correctional Institutions, 4th Edition, 2003.
National Commission on Correctional
Health Care. Position Statement, 31 March, 1996.
HEALTH CARE CO-PAY
FREQUENTLY ASKED QUESTIONS
services will I have to pay for?
requests for medical and dental services and self-inflicted injuries and
sports injuries. This usually means when you come to sick-call and ask
for medical or dental services that have not been scheduled for you by
the health care provider. You will also be charged co-pay if you do not
show up for a scheduled appointment, unless this is due to circumstances
beyond your control.
Q. Does this mean, I pay for
seeing the nurse, and then have to pay again when I see the doctor or
A. No. You pay only for the sick call. All
follow-up visits that result from this encounter are at no cost to you.
Q. Isn’t this unfair for
guys with diabetes, HIV or cancer who have to have regular medical care?
A. No. There is no charge for visits to
chronic care clinics, or doctor or nurse recommended follow-up.
Q. What about emergencies?
A. There is no charge for emergency
services, but if you abuse emergency services you may be charged and/or
disciplined. If the emergency is the result of a self-inflicted injury or
sports injury, you will be charged.
Q. What about update
physicals, dental exams or eye exams?
A. There is no charge for these regularly
scheduled services. If you make a request for any of these services
outside of the schedule, you will be charged. For women this includes PAP
smears and mammography.
Q. If I get hurt on my job
assignment, do I have to pay for medical care?
A. No. Not unless the injury is
Q. If I am at work, school, or
barracks and I get ‘sick’ and my supervisor, teacher, or barrack
officer wants me seen, will I be charged?
A. No, you will not be charged when you
are for referred for evaluation/treatment by staff. However, if it is
determined that you are abusing this ‘referral process’ then you will
be charged and disciplined.
Q. If I try and get something
for a headache and I’m told to "put in a request for sick
call" will I be charged when I go to sick call?
A. Yes. Sick call is the established
procedure where inmate health requests are initially addressed. Regardless
of ‘who’ informed you to put in the "request" that person
was simply giving you correct information as to how to get your headache
addressed. It is your decision whether you do so or not.
Q. Will I be charged for
A. No. There is no charge for any medical,
dental, or mental health ordered medications.
Q. What if I believe that I
have been charged for a service that should be free under this policy?
A. There will be a form available for you
to request a review of the charge by the unit Health Services
Administrator. If the administrator agrees, the co-pay will be refunded.
Q. What happens if I don’t
have any money?
A. You still receive services. Your inmate
trust fund account will show that you owe $3.
Q. Does that mean if my family
sends me money, it will all go to pay my medical debts?
A. No. At least $5 will be left in your
inmate trust fund account.
Q. What about Christmas Money
and Gate Money?
A. Neither will be touched to satisfy
medical co-pay debits.
Q. CMS already gets paid, why
do they need to take money from inmates?
A. CMS does not receive any of the medical
Q. ADC already gets tax money
to take care of inmates health needs, so isn’t this double-dipping?
A. ADC will not keep any of the money. At
this point it will all go toward paying an outside agency that will
examine the quality of health care being provided to inmates.
Q. So why are you taking money
from inmates, when you don’t pay us for working?
A. Unfortunately some inmates abuse
medical services for a variety of reasons that you probably already know.
The purpose of medical co-pay is to make sure that inmates have an
investment in their own health care and use the services responsibly. This
allows the staff to spend more time and focus better on the inmates who
have real problems. It may cost you, but should help you get better
medical services when you need them.
Living In Truth
"And ye shall know the Truth, and the Truth shall make you
--St. John 8:32