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(a) A prisoner will be provided medically necessary health care services regardless of the prisoner's ability to pay or arrange for payment or coverage for the services. Medically necessary health care services include medical, psychological, and psychiatric care that is necessary to enable a prisoner to participate in or benefit from rehabilitative services made available by the department.
(b) Except as provided in (c) and (d) of this section, a prisoner
(1) is financially responsible for a co-payment for health care services provided to the prisoner by the department through department employees or designated contractors; and
(2) shall arrange for the department to obtain payment or coverage from one or more of the responsible parties set out in AS 33.30.028 (a), if the prisoner receives health care services not provided through department employees or designated contractors.
(c) The department will not pursue payment by a prisoner for the following inspections, examinations, or testing required by state regulation or necessary to protect the health or safety of the general prisoner population or others:
(1) inspection upon initial admission provided under 22 AAC 05.005;
(2) a physical examination under 22 AAC 05.120(b) ;
(3) testing for pregnancy, HIV, AIDS, tuberculosis, sexually transmitted diseases, or other communicable diseases.
(d) The department will not pursue the co-payment from a prisoner for the following health care services provided under circumstances listed, so long as the prisoner arranges for the department to obtain payment or coverage from one or more of the responsible parties set out in AS 33.30.028 (a) to the extent that such payment or coverage is available:
(1) services for injuries or repair or replacement of medical equipment if the services resulted from work performed for the department or an assault or violation of facility rules or state law by another prisoner, but only if the services were not due to the prisoner's failure to follow medical instructions or to protect the equipment against loss or damage;
(2) services initiated by health care providers who are department employees or designated contractors;
(3) services for communicable diseases or pregnancy;
(4) treatment for a chronic disease or medical or mental condition, if after consulting with appropriate health care providers, the department determines that the potential for harm to the prisoner is substantial if treatment is delayed.
(e) Notwithstanding (a) - (d) and (g) of this section, a prisoner may be charged for the full cost of health care services provided by health care providers other than department employees or designated contractors, resulting from a self-inflicted injury, or an injury to the prisoner or to another prisoner resulting from an assault or other violation of facility rules or state law by the prisoner.
(f) A prisoner who is provided health care services by a departmental employee or designated contractor is financially responsible for the following co-payments:
SERVICE CO-PAYMENT Health care services by a health care provider $4 for each visit or service Health care services provided under (d)(2) of this section for injuries incurred in sports activities, if the activity was recommended against by a health care provider $4 for each visit or service Initial prescriptions or changes or renewals in prescriptions ordered at the same time $4 Use of medical equipment available in the facility, such as crutches or Neoprene braces $4 per use
(g) Notwithstanding (b) of this section, the department will not pursue payment by the prisoner for the cost of the use of medical equipment not available in the correctional facility above the first $20 charged for each use by the prisoner.
(h) The department will deduct the co-payments and cost of health care services as provided in this section for which a prisoner is responsible directly from the prisoner's prison fund account. However, such deductions are subject to outstanding obligations of the prisoner to pay that are given a higher priority under the law, such as child support orders, court-ordered restitution, civil judgments or administrative orders resulting from the prisoner's criminal conduct, court-ordered fines, and restitution ordered by the department. A prisoner residing in a community residential center has an additional priority deduction of payment for room and board as determined by the department. The prisoner must be notified in writing of the deduction made under this subsection.
(i) A prisoner may challenge the amount deducted under (h) of this section by submitting a written appeal to the health care officer in the facility within three working days of receiving notice of the deduction. The appeal must set out reasons why the amount deducted is incorrect. The health care officer shall issue a written decision. The prisoner may appeal the decision to the director of institutions of the department. The appeal must be made within seven working days of the prisoner's receiving notice of the health care officer's decision. The decision of the director of institutions is the final departmental decision, and must be made in writing. If the director of institutions grants the appeal, the prisoner's prison fund account will be adjusted consistent with that decision.
(j) In this section,
(1) "AIDS" means acquired immunodeficiency syndrome;
(2) "community jail" is a jail owned or operated by a municipality of the state that confines prisoners held under the authority of state law under a contract with the department under AS 33.30.031 ;
(3) "co-payment" is that portion of the cost of health care services provided by a department employee or designated contractor for which the department will pursue payment directly from the prisoner;
(4) "correctional facility" has the meaning given in AS 33.30.901 ;
(5) "designated contractor" means a health care provider who
(A) is not employed by the department; but
(B) does have a collaborating or supervisory relationship with a health care provider who is an employee of the department, or has a written contract that provides for payment by the department other than on a per patient visit basis;
(6) "health care officer" is the chief departmental health care provider in a correctional facility;
(7) "health care provider" includes a physician, psychiatrist, psychologist, emergency medical technician, physician assistant, registered or practical nurse, advanced nurse practitioner, dentist, dental hygienist, optometrist, pharmacist, mental health clinician, clinical social worker, psychological associate, dispensing optician, physical therapist, and occupational therapist;
(8) "health care services" means medical, psychological, and psychiatric care, including medical equipment, provided under AS 33 by a health care provider; "health care services" do not include sex offender or substance abuse treatment provided by the department;
(9) "HIV" means human immunodeficiency virus;
(10) "medical care" includes any evaluation, treatment, medication, medical equipment, or consultation given by a health care provider, related to any physical, mental, dental, auditory, or optometric condition; "medical care" does not include psychological and psychiatric care given by a health care provider;
(11) "official detention" has the meaning given in AS 11.81.900 (b);
(12) "prisoner" means a person in the custody of the department in the state in official detention; "prisoner" includes a person who has been released by the department on an authorized furlough or confined in a restitution center or other correctional facility, but not including a community jail;
(13) "psychological and psychiatric care" includes any evaluation, treatment, medication, or consultation given by an appropriate health care provider for a mental or social adjustment condition that is not "medical care" under this section.
History: Eff. 8/8/97, Register 143
Authority: AS 33.30.021
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Last modified 7/05/2006