OAR 291-124-0085
Charges for Elective Care or Treatment

(1) An AIC may request approval to purchase healthcare from a healthcare provider in the community. The department will only approve those requests that in the department’s judgment are medically appropriate and are otherwise consistent with the department’s concerns for institution security and order, public safety, and sound correctional practice.
(a) The AIC’s trust account must have sufficient funds to pay for the purchase of care BEFORE the treatment is scheduled unless other financial arrangements have been made. Cost of care includes expenses associated with providing the treatment, including follow-up care, as well as all costs associated with transport and security.
(b) For medical requests, the chief medical officer of the facility must review and approve follow-up care and treatment recommended by community providers. Any requests to purchase elective dental care from community providers must be reviewed and approved by the department’s dental director.
(2) Orthoses, Prosthetics Devices, Mechanical Aids, and Self Care Items: Orthoses, prosthetic devices, and mechanical aids are specialized mechanical devises used chronically to support or supplement joints or limbs, or are artificial devices to replace missing body parts.
(a) An AIC is generally required to pay for orthoses, prostheses devices, or other mechanical aids that become the personal property of the AIC. An AIC is not generally required to pay for medical aids provided for acute treatment of a limited medical condition (casts, splints, ace wraps) short-term usage of aids (e.g., canes, crutches, or braces), or hardware that is an essential part of a medically necessary procedure (e.g., heart valves, cardiac stent, inter-ocular lens implants).
(b) Health Services allows appropriate but elective orthoses, prostheses, or other mechanical aids that are not essential to prevent significant deterioration in the health of the AIC but are nevertheless reasonably expected to significantly improve the quality of life of the AIC as it relates to a proven chronic or ongoing medical condition. Examples of such items include: dentures; dental prosthetics; glasses; contact lenses; artificial eyes; artificial limbs; knee/ankle/foot braces; hearing aids; support hose; transcutaneous electrical nerve stimulation (TENS) units; non-institution issued shoes; suspenders; batteries for hearing aids or other devices; maintenance or repair of any such item.
(c) Health Services may decline to authorize elective orthoses, prostheses, or other mechanical aids that are of minimal proven medical value, and authorization decisions must be weighed against safety and security concerns. Examples of items that are not generally authorized include but are not limited to high-top tennis shoes, soft pillows, heating pads, and knee sleeves for sports.
(d) Health Services may consider the following when determining whether to allow elective orthoses, prosthetic devices, and mechanical aids and whether the AIC must pre-pay for the item prior to ordering or delivery, or whether the AIC may incur indebtedness to obtain the item:
(A) Urgency of need;
(B) Time left on sentence;
(C) Overall necessity;
(D) Morbidity;
(E) Mortality;
(F) Functional disability;
(G) Expected improvement;
(H) Alternatives;
(I) Risks and benefits;
(J) Costs and benefits; and
(K) Security concerns.
(e) Refractive Eye Examinations and Eyeglasses: Health Services offers AICs to obtain a refractive eye examination on a co-pay basis ($45 co-pay per exam) once every two years.
(A) An AIC may purchase eyeglasses, eyewear, and eyewear accessories from the department.
(B) The Health Services Eyeglasses Review Committee may approve an AIC to incur debt to obtain an eye examination or purchase eyeglasses on a case-by-case basis. The Eyeglasses Review Committee will make that approval based on a review of the AIC’s release date, past optical information, current visual acuity, and a six-month review of the AIC’s trust fund activities, and the AIC’s effort and compliance with a correctional case management plan.
(C) Health Services does not provide contact lens examinations. AICs may purchase contact lenses and lens solution.
(f) Audiogram examination and hearing aids: Health Services will authorize, as provided in this rule, an audiogram examination and hearing aid for an AIC who reports subjective hearing loss that meets the requirements of Level 3 Care or Treatment under OAR 291-124-0041 (Healthcare and Treatment).
(A) Audiogram examination: Health Services, after conducting a medical evaluation to identify possible medically or surgically correctable causes of the reported hearing loss, may refer an AIC who reports subjective hearing loss for an audiogram evaluation. Health Services will authorize recurring audiogram examinations once every three (3) years if the AIC has a pure tone hearing loss, in the better ear, of forty (40) decibels or greater, or when medically indicated. The Therapeutic Levels of Care (TLC) Committee may authorize a recurring audiogram examination for an AIC with a pure tone hearing loss that is below that 40-decibel threshold as provided in OAR 291-124-0041 (Healthcare and Treatment).
(B) Hearing aids: The Department of Corrections will authorize a monaural hearing aid once every (5) five years to an AIC with pure tone hearing loss, in the better ear, of forty-five (45) decibels or greater in the 1000-Hertz, 2000-Hertz, or 3000-Hertz ranges. The Department of Corrections may authorize binaural hearing aids for those who meet that hearing-loss threshold and who are either under 21 years of age, have other sensory deprivation disorders, or have been diagnosed with corrected vision loss of 20200 or greater.
(i) A hearing aid may be purchased for the actual cost. An AIC who meets or exceeds the hearing loss threshold may incur indebtedness to purchase the hearing aid. A purchased hearing aid becomes personal property of the AIC.
(ii) Batteries and Repairs: Unless the hearing aid is determined to be medically necessary, repairs and batteries are the responsibility of the AIC.
(g) Footwear: Health Services may approve special footwear if that footwear is a recognized and appropriate part of a medical treatment plan or may be medically necessary (e.g., peripheral vascular disorders, diabetic complications, amputation, clubfoot) if there would be serious deterioration or significant risk to the AIC’s basic health without the special footwear, and if no reasonable treatment alternative exists. An AIC may incur indebtedness to obtain special footwear approved by the department.
(h) The AIC must sign a withdrawal request form before the service or item is provided. The AIC’s trust account will be charged for the estimated or actual cost of the device. If an AIC must pre-pay before obtaining a service or item, the AIC must sign a withdrawal request form with sufficient funds available and debited before the service or item is provided.
(i) Upon delivery of the device, any variance from the actual cost will be indebted or credited to the AIC’s trust account accordingly.
(j) An AIC shall not be denied prostheses or other devices that are medically necessary because of lack of funds. However, the AIC may incur debt if his/her trust account does not have sufficient funds to cover the cost of the device.
(k) Items for self-care are available on the commissary list. An AIC may be advised to purchase a particular self-care item by Health Services employees. Such advice is intended as education in self-care and is not a directive that the item is considered medically necessary.
(3) Expenses for Medical Care for AICs on Escape, Short-Term Transitional Leave, Non-Prison Leave, Parole, Post-Prison Supervision, or Emergency Leave:
(a) Expenses incurred for healthcare of offenders on parole or post-prison supervision are the responsibility of the offender.
(b) Expenses incurred for healthcare of AICs on escape status are not the responsibility of the department.
(c) Expenses incurred for healthcare of AICs on short-term transition leave and non-prison leave are the responsibility of the AIC.
(4) Refusal of Medical Appointments:
(a) Any AIC who willfully refuses to keep a prearranged medical appointment in the community may have his/her trust account charged or indebted.
(b) A decision under this section to charge or indebt an AIC’s trust account is subject to the administrative review process in the rules on Trust Accounts (AIC) (OAR 291-158).
(5) Destruction of Property: Any AIC who willfully destroys or misuses Health Services equipment or supplies is subject to disciplinary action in accordance with the rules on Prohibited AIC Conduct and Processing Disciplinary Actions (OAR 291-105).

Source: Rule 291-124-0085 — Charges for Elective Care or Treatment, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=291-124-0085.

Last Updated

Jun. 8, 2021

Rule 291-124-0085’s source at or​.us