U.S. Department of Justice
Federal Bureau of Prisons
PROGRAM STATEMENT
OPI:
CPD/CPB
NUMBER: 5875.13
DATE:
February 20, 2015

Transfer of Inmates to State Agents
For Production on State Writs

/s/
Approved: Charles E. Samuels, Jr.
Director, Federal Bureau of Prisons
1. PURPOSE AND SCOPE
§ 527.30 Purpose and scope.
The Bureau of Prisons will consider a request made on behalf of a state or local
court that an inmate be transferred to the physical custody of state or local agents
pursuant to state writ of habeas corpus ad prosequendum or ad testificandum.
The Warden at the institution in which the inmate is confined is authorized to
approve this transfer in accordance with the provisions of this rule.
State or local law enforcement agents may obtain custody of an inmate pursuant to state writs of
habeas corpus ad prosequendum or ad testificandum, if there is no detainer on file from any
jurisdiction in the receiving state.
The Interstate Agreement on Detainers (IAD) was not meant to be the sole means of obtaining an
inmate’s custody for prosecution. Legislative history suggests the IAD was enacted to provide
prisoners with a method of removing detainers lodged against them, not as a means of promoting
prosecution.
Federal Regulations from 28 CFR are shown in this type.
Implementing instructions are shown in this type.

In this Program Statement, Correctional Systems staff are referred to as institution staff.
a. Summary of Changes
Policy Rescinded
P5875.12
Transfer of Inmates to State Agents for Production on State Writs (7/31/03)
■ Eliminated references to Inmate Systems Management and Inmate Systems Officers,
replacing them with Correctional Systems (CS) and Correctional Systems Officer (CSO)
due to decision to consolidate positions in the department.
■ Added use of the Jail and Commitment Corrections System (JACCS) to verify location of
inmates while released under provisions of the IAD or on state writ.
b. Program Objectives. The expected results of this program are:
■ State or local law enforcement agents may be allowed to obtain custody of Federal inmates
for both criminal and civil cases.
■ State or local authorities will agree to provide the same level of security for each inmate in
accordance with Bureau policy.
c. MCC/MDC/FDC/FTC Procedures. Procedures in this PS apply to Metropolitan
Correctional Centers, Metropolitan Detention Centers, Federal Detention Centers, and Federal
Transportation Centers.
d. Contract Facilities. Procedures in this PS also apply to Federal inmates housed at contract
facilities operated by private organizations.
e. Institution Supplement. None required. Should local facilities make any changes outside the
required changes in the national policy or establish any additional local procedures to implement
the national policy, the local Union may invoke to negotiate procedures or appropriate
arrangements.

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2. PROCEDURES
§ 527.31 Procedures.
(a) These procedures apply to state and federal inmates serving sentences in
federal institutions, and shall be followed prior to an inmate’s transfer to state or
local agents other than through the Interstate Agreement on Detainers.
A state or local law enforcement agency may, with the Warden’s approval, obtain an inmate by
means of a writ of habeas corpus ad prosequendum without filing a detainer. Writs from Tribal
Courts are treated in the same manner as writs from a state or local court. Writs from the District
of Columbia Superior Court (civil and criminal) are treated in the same manner as Federal writs
(per the All Writs Act, Title 28 U.S.C. § 1651).
The state is bound by the IAD’s provisions only when a detainer has been filed. If there is no
detainer on file from the jurisdiction where the prisoner is being requested under a writ, but one or
more detainers are on file from other jurisdictions in the same state, then the IAD’s provisions
apply.
Pending arrival at a designated institution, the inmate may be removed via state writ, but not
under the IAD. Refer questionable cases to Regional Counsel.
(b) The Warden shall authorize transfer only when satisfied that the inmate’s
appearance is necessary, that state and local arrangements are satisfactory, that
the safety or other interests of the inmate (such as an imminent parole hearing)
are not seriously jeopardized, and that federal interests, which include those of
the public, will not be interfered with, or harmed. Authorization may not be given
where substantial concern exists over any of these considerations.
The Warden personally reviews and makes a decision on any production request, civil or
criminal, taking particular care with inmates who have either IN or MAXIMUM custody. This
authority may not be delegated below the level of Acting Warden.
The Warden notifies state authorities of any security concerns about a particular inmate regardless
of the inmate’s custody level. The Warden must receive the state authorities’ written agreement
that they will provide the same level of security (number of escorts, restraints, etc.) Bureau policy
requires. See the Program Statement Escorted Trips for more information. Failure of state
authorities to agree to these requirements is grounds for denying the request.
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When the inmate is a serious custody risk, or when the state refuses to or cannot abide by this PS’s
requirements, these cases are referred first to Regional Counsel for approval. A decision to the
transfer to state agents may be refused in favor of production by the U.S. Marshals Service
(USMS).
(c) The request for transfer of custody to state agents shall be made by the
prosecutor or other authority who acts on behalf of the court and shall be directed
to the Warden of the institution in which the inmate is confined. The request shall
be made by letter. The request shall indicate the need for appearance of the
inmate, name of the court, nature of the action, date of the requested appearance,
name and phone number of the state agency or other organization with
responsibility for transporting the inmate, the name and location where the inmate
will be confined during legal proceedings, and anticipated date of return. For civil
cases, the request shall also indicate the reason that production on writ is
necessary and some other alternative is not available. The applying authority
shall provide either at the time of application or with the agent assuming custody,
a statement signed by an authorized official that state or local officials with
custody will provide for the safekeeping, custody, and care of the inmate, will
assume full responsibility for that custody, and will return the inmate to Bureau of
Prisons’ custody promptly on conclusion of the inmate’s appearance in the state
or local proceedings for which the writ is issued.
Prosecutors are encouraged to use the IAD/State Writ – Prosecutor’s Certification (BP-A0565)
when requesting custody of an inmate, as it contains all information necessary for transfer.
However, if the writ, or letter accompanying the writ, contains all required information, it may be
accepted after appropriate verification is made.
If the request for transfer of custody to state agents concerns a Witness Security inmate, forward it
to the Inmate Monitoring Section, Central Office.
(d) A certified copy of the writ (one with the Seal of the Court) must be received
at the institution prior to release of the inmate. Institution staff shall verify the
authenticity of the writ.
Verification is obtained by telephoning the Clerk of the Court that issued the writ.
Verification is noted on the writ to include:

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■
■
■
■
■

Name of verifying court official.
His/her title.
Phone number.
Bureau staff member’s name and title.
Date.

The Court’s seal may be electronic or manual.
(e) Institution staff shall maintain contact with the state or local law enforcement
agency with responsibility for transfer of the inmate to determine the exact date
and time for transfer of custody. If the inmate is awaiting federal trial or has
federal civil proceedings pending, staff must clear the transfer through the U.S.
Attorney.
(f) Institution staff shall determine from the state or local agency the names of
the agents assuming custody. Staff must carefully examine the credentials of the
agents assuming custody. In any doubtful case, verification should be sought.
Verification is obtained by phoning the state agency. When a private carrier or contractor is
transporting the inmate for the state, institution staff may request in advance the names of
individuals who will assume custody.
(g) Transfers in civil cases pursuant to a writ of habeas corpus ad testificandum
must be cleared through both the Regional Counsel and the Warden. Transfer
ordinarily shall be recommended only if the case is substantial, where testimony
cannot be obtained through alternative means such as depositions or
interrogatories, and where security arrangements permit. Postponement of the
production until after the inmate’s release from federal custody will always be
considered, particularly if release is within twelve months.
The Warden must obtain Regional Counsel’s clearance before releasing an inmate on a state civil
writ. It is recommended that Regional Counsel be used for all contacts and discussions with
attorneys or court officials, or with respect to legal considerations affecting the production
decision. There is no presumption that an inmate must be released in state civil cases.
Regional Counsel, before notifying the Warden that the release is recommended, consults with
the U.S. Attorney from the district in which the inmate was prosecuted to ensure there are no

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facts about the inmate, bearing on the decision to authorize transfer, which are not known to
Bureau staff.
(h) Release of inmates classified as Central Inmate Monitoring Cases requires
review with and/or coordination by appropriate authorities in accordance with the
provisions of 28 CFR part 524, subpart F.
28 CFR part 524, subpart F, refers to the Program Statement Central Inmate Monitoring
System.
3. RELEASE PROCEDURES
CS staff follow the procedures in the Program Statement Correctional Systems Manual for
releasing inmates on writ. Also refer to the Program Statement Escorted Trips for information
regarding escorts and security levels. The Release Authorization (BP-A0392) serves as the
receipt of the official taking custody of an inmate released on writ. The receiving state agent’s
name must be obtained on the Release Authorization.
CS staff present and explain the IAD/State Writ – Acknowledgment form (BP-A0567) to the
inmate before release on state writ. If the inmate is released improperly to the community by local
authorities, or improperly transferred to a non-Federal facility or agency while on state writ, this
form requires the inmate to call the person designated on the BP-A0567 immediately (collect or
through any other communication system available), or upon the release or transfer.
CS staff have the inmate sign the BP-A0567 before release to state agents. If the inmate
refuses to sign, staff advise him/her of the form’s contents and document the refusal to sign. The
Warden designates the contact person to be listed on the BP-A0567.
CS staff provide a copy of the BP-A0567 to the Control Center and Operations Lieutenant. This
form provides the basis for accepting an inmate’s collect call. If the inmate is released to the
community improperly, the contact person instructs him/her to surrender to the nearest USMS
Office.
Information that must be given to the state agent to accompany the inmate is contained in the
Program Statement Receiving and Discharge Manual.

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Inmates released on writ remain in custody and are returned to the sending institution when court
proceedings are completed. At 60 calendar day intervals, CS staff will contact custodial authorities
to determine the inmate’s status.
Document all contacts in the Inmate Remand or Judgment & Commitment File. Each institution
documents the:
■ Date.
■ Phone number.
■
■
■
■

Name of person contacted.
Inmate’s current location.
Inmate’s current status.
Name of staff member making contact.

If the inmate is housed in a Federal institution, SENTRY may be used to verify his/her custody.
CS staff document where the inmate is currently housed and that the information was verified by
SENTRY. Upon the inmate’s return to the parent institution, this documentation may be
discarded. See the Correctional Systems Manual for more information.
JACCS may be used to verify the necessary information for an inmate housed with the District of
Columbia Department of Corrections. CS staff note the date, institution where the inmate is
currently housed, and that the information was verified by JACCS, with documentation
discarded once the inmate is returned to the institution at the discretion of the local manager.
4. ASSISTANCE
Refer questions on these procedures to the Correctional Programs Branch, Central Office:
202-307-0222.
5. AGENCY ACA ACCREDITATION PROVISIONS
■ Standards for Adult Correctional Institutions, 4th Edition: None.
■ Performance -Based Standards for Adult Local Detention Facilities, 4th Edition: None.
■ Standards for Administration of Correctional Agencies, 2nd Edition: 2-CO-4B-02.

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REFERENCES
Program Statements
P5180.05
Central Inmate Monitoring System (12/31/07)
P5538.06
Escorted Trips (08/29/14)
P5800.12
Receiving and Discharge Manual (8/12/14)
P5800.15
Correctional Systems Manual (1/1/09)
Federal Regulations
Federal Regulations cited in this Program Statement are contained in 28 CFR 527.30-31.
Records Retention Requirements
Requirements and retention guidance for records and information applicable to this program are
available in the Records and Information Disposition Schedule (RIDS) on Sallyport.

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U.S. Department of Justice
Civil Rights Division
Office o/Special Counsel/or Immigration-Related
Unfair Employment Practices - NYA
950 Pennsylvania Ave, NW
Washington, DC 20530
Main (202) 616-5594
Fax (202) 616-5509

January 8, 2015

BY EMAIL (afela@polarislaserlaminations.com)
Anna Fela
Polaris Laser Laminations, LLC
2725 Norton Creek Drive
West Chicago, IL 60185
Dear Ms. Fela:
This is in response to your email dated November 12,2014, to the Office of Special
Counsel for Immigration-Related Unfair Employment Practices ("OSC" or "Office"). We
apologize for the delay in responding. In your email, you request guidance for an employer that
accepted an employee's work authorization documents that appeared genuine, where the
employee later presents "a new social security number and [work authorization] documents and
states that the previous documents were not real." You ask whether "this situation opens [the
employer] up to any discrimination issues in any way if [it] choose[s] to keep or terminate the
employee," and you request guidance on "the correct steps going forward."
OSC cannot provide an advisory opinion on any set of facts involving a particular
individual or entity. However, we can provide some general guidelines regarding employer
compliance with the anti-discrimination provision of the Immigration and Nationality Act
("INA"), 8 U.S.C. § 1324b, which OSC enforces. The anti-discrimination provision prohibits
four types of employment-related discrimination: (1) citizenship or immigration status
discrimination; (2) national origin discrimination; (3) unfair documentary practices during the
employment eligibility verification (Form 1-9 and E-Verify) process ("document abuse"); and (4)
retaliation for filing a charge, assisting in an investigation, or asserting rights under the anti
discrimination provision. 8 U.S.C. § 1324b. For more information about OSC, please visit our
website at: http://www.justice.gov/crt/about/osc.
As you may know, an employer is required to verify the identity and employment
authorization of all newly-hired employees by completing the Form 1-9. 8 U.S.C. § 1324a.
During that process, an employee may choose to present either one unexpired document from
List A of the Form I-9's List of Acceptable Documents or a combination of one unexpired List B
document and one unexpired List C document. See Form 1-9 Instructions, p.3. When reviewing
the documentation presented, an employer must accept documents that reasonably appear to be
genuine and to relate to the person presenting the document(s). Id. The employer should then
record information about the document(s) presented in Section 2 of the Form 1-9. Id.

In a situation where an employer has,properly completed these steps, and an employee
later provides the employer with new work authorization documentation and explains that the
previously-presented documentation was not genuine, u.s. Citizenship and Immigration Services
("USCIS") - the agency that publishes the Form 1-9 -- provides additional guidance. According
to the USCIS Handbook for Employers, Guidance for Completing Form 1-9 (Form M-274 Rev.
04/30/13), available at http://www.uscis.gov/sites/defaultlfileslmes/form/m-274.pdf:
"You may encounter situations other than a legal change of name where an
employee informs you or you have reason to believe that his or her identity is
different from that previously used to complete the Form 1-9. For example, an
employee may have been working under a false identity, has subsequently
obtained a work authorized immigration status in his or her true identity, and
wishes to regularize his or her employment records. In that circumstance you
should complete a new Form 1-9. Write the original hire date in Section 2, and
attach the new Form 1-9 to the previously completed Form 1-9 and include a
written explanation.
In cases where an employee has worked for you using a false identity but is
currently work authorized, the 1-9 rules do not require termination of
employment. ..."
USCIS Handbook for Employers at 24.
This Office cannot identify any violation of 8 U.S.C. § 1324b when an employer
consistently accepts documents that employees choose to present that reasonably appear to be
genuine and relate to the individual, regardless of whether an employee admits that the
documents previously presented for employment eligibility verification were "not real." Nor can·
this Office identify any 1324b violation when an employer allows an employee to continue
employment under the circumstances you present. However, to the extent an employer rejects
valid work-authorization documentation or terminates employees because of their citizenship
status or national origin, the employer could violate the anti-discrimination provision.
An employee who is terminated under the circumstances you describe may allege
citizenship status discrimination. Citizenship status discrimination under the anti-discrimination
provision of the INA occurs when an employer treats individuals differently during hire or
termination on the basis of citizenship or immigration status. U.S. citizens, recent lawful
permanent residents, refugees, and asylees are protected from this type of discrimination. To the
extent a protected individual files a charge alleging discriminatory termination based on
perceived or actual immigration status or the perceived lack of authorized status, this Office
would investigate the charge. We note that an employer with a consistently-followed policy of
terminating individuals for providing false information during the hiring process may have a
legitimate non-discriminatory reason for the termination. Accordingly, whether or not this
Office concludes that such a termination violates the anti-discrimination provision depends upon
the facts presented.
Similarly, an employee who is terminated in this context may also allege national origin
discrimination. National origin discrimination ul1der 8 U.S.C. § 1324b occurs when an employer
treats employment-authorized individuals differently during hire or termination on the basis of
2

foreign birth, ancestry, or the appearance of foreign birth or ancestry. All employment
authorized individuals are protected from this type of discrimination; however, this Office only
has national origin jurisdiction over employers with four to 14 employees, whereas another
federal agency, the Equal Employment Opportunity Commission, has national origin jurisdiction
over employers with 15 or more employees.
Unfair documentary practices, also known as "document abuse," may also be implicated
in the scenario you describe. An unfair documentary practice occurs when an employer rejects
valid Form 1-9 documentation, demands more or different Form 1-9 documentation, or requests
specific Form 1-9 documentation based on an employment-authorized individual's citizenship
status or national origin. All employment-authorized individuals are protected from this type of
discrimination. Accordingly, an employer that treats individuals differently when updating Form
1-9 information because of citizenship status or national origin may violate the anti
discrimination provision.
We hope this information is helpful. Thank you for contacting OSC.

Sincerely,

./2

1

Alberto Ruisanchez
Deputy Special Counsel

3

9


U.S. Department of Justice
Federal Bureau of Prisons
PROGRAM STATEMENT
OPI:
HSD/SAF
NUMBER: 1640.05
DATE:
January 7, 2015

Smoking/No Smoking Areas
/s/

Approved: Charles E. Samuels, Jr.
Director, Federal Bureau of Prisons
1. PURPOSE AND SCOPE
§ 551.160 Purpose and scope.
To advance towards becoming a clean air environment and to protect the health
and safety of staff and inmates, the Bureau of Prisons will restrict areas and
circumstances where smoking is permitted within its institutions and offices.
The Bureau recognizes the right to negotiate issues pertaining to this policy consistent with the
Master Agreement, statute, case law, and regulation.
Medical and public health authorities have established the hazards of tobacco smoke. Of
particular concern are risks posed to nonsmokers by passive inhalation of environmental tobacco
smoke (ETS). The Surgeon General has long concluded that, as scientific research indicates,
second-hand tobacco smoke is a cause of lung disease in otherwise healthy nonsmokers.
On January 7, 1993, the Environmental Protection Agency (EPA) officially endorsed a report by
an outside panel of scientific advisers to the agency, which stated that “exposure to second-hand
cigarette smoke causes lung cancer in adults and greatly increases the risk of respiratory illness
in children.”
Federal Regulations from 28 CFR are shown in this type.
Implementing instructions are shown in this type.

The Bureau recognizes that when smokers quit, they may face physical discomfort, weight gain,
and stress-related difficulties; however, these symptoms may be lessened with the appropriate
interventions of a smoking cessation program. According to the Centers for Disease Control and
Prevention, many who quit smoking relapse. Effective smoking cessation programs should
provide counseling and monitoring to enhance success. Since 2011 Office of Personnel
Management (OPM) has mandated that ALL FEHB plans offer 100% coverage to assist staff in
quitting.
a. Summary of Changes
Policy Rescinded
P1640.04
Smoking/No Smoking Areas (03/15/2004)
■ On April 15, 2006, the BOP discontinued the sale and inmate use of both smoke and
smokeless tobacco products in institutions; therefore, inmate smoking cessation program was
amended to be available only to incoming inmates, not existing inmates.
■ Staff smoking cessation program was removed based on the guidelines placed by the
previous program statement.
b. Program Objectives. The expected results of this program are:
■ The designation of smoking areas may reduce exposure to second-hand smoke.
■ All Bureau facilities will be free of second-hand smoke, except staff residences, perimeter
patrol vehicles, and towers when occupied by one person.
■ Areas where smoking is permitted will be clearly identified.
2. DEFINITIONS
§ 551.161 Definitions.
For the purposes of this subpart, smoking is defined as inhaling the smoke of any
substance through the use of smoking apparatus including, but not limited to,
cigars, cigarettes, or pipes.
An area designated as free of second-hand smoke is defined as one in which there are no
lighted tobacco products (e.g., cigars, cigarettes, pipes).
Designated area is defined as a smoking area which the Warden has clearly identified.

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3. STAFF SMOKING/NO SMOKING AREAS
This section also applies to visitors, volunteers, and contractors.
§ 551.162 Smoking generally prohibited.
(b) For Bureau staff and official visitors, smoking is permitted only in smoking
areas designated by the Warden.
Only outside locations can be designated by the Warden as smoking areas for staff and official
visitors.
Indoor Smoking. Indoor smoking is permitted only in perimeter towers and perimeter patrol
vehicles when occupied by one person.
Outdoor Smoking. The Warden designates outdoor smoking areas that are reasonably
accessible to employees and are protected from the elements. Designated areas are for use only
by employees.
4. INMATE SMOKING
§ 551.162 Smoking generally prohibited.
Smoking is generally prohibited in and on the grounds of Bureau institutions and
offices, with the following two exceptions:
(a) Smoking is permitted as part of an authorized inmate religious activity; and
On April 15, 2006, the Bureau discontinued the sale to and prohibited use by inmates of both
smoke and smokeless tobacco products.
§ 551.163 Possession of smoking apparatus and tobacco prohibited.
Possession of smoking apparatus and tobacco in any form is prohibited for
inmates, unless as part of an authorized inmate religious activity.
Inmate possession or use of smoke or smokeless tobacco products is subject to disciplinary
action.
The Warden must designate a smoking area for use in instances where smoking is part of an
authorized religious activity. See the Program Statement Religious Beliefs and Practices.

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5. INMATE SMOKING CESSATION PROGRAMS
a. Components and Creation. Wardens must establish an institution Smoking Cessation
Program consistent with local resources for newly committed inmates within the first 90 days of
incarceration.
The institution A&O Booklet will inform inmates of a Smoking Cessation Program’s
availability, including application and participation procedures. A Smoking Cessation Program
must, at a minimum, address:
■
■
■
■

Nutrition.
Physical activity (exercise).
Stress management.
Nicotine Replacement Therapy (NRT).

Institutions conduct these activities through a combination of:
■
■
■
■
■

Videos.
Classroom presentations.
Recreation activities.
The sale of nicotine replacement patches in the Commissary.
Group or individual counseling.

b. Nicotine Replacement Therapy (NRT). Nicotine replacement patches may assist with the
gradual tapering of nicotine consumption. Each institution Commissary will stock or sell patches
through the Special Purchase Order (SPO) process. Inmates may purchase patches with staff
approval.
An inmate requesting NRT must have an initial medical assessment to purchase a six to ten-week
supply of patches (see below). The inmate then obtains an initial written approval from a Bureau
health care provider using the Nicotine Replacement Therapy Approval form (BP-A1019),
certifying that the inmate’s health status has been reviewed and he or she is approved to use the
patches.
The health care provider will:
■ Discuss the patch’s proper use, describe possible side effects, and warn the inmate about
problems associated with overuse (such as the use of two or more patches at the same time,
or the use of a patch and continued use of cigarettes).
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■ Record the inmate’s health status in his/her medical record (e.g., weight, blood pressure,
post-prandial blood sugar, pulmonary function, exercise tolerance, how many cigarettes are
smoked per day, and other clinically pertinent information).
■ Provide a signed BP-A1019 recommending a specific NRT dosage program to the inmate.
The inmate takes the signed BP-A1019 to the Commissary, which allows him/her to purchase
two weeks of NRT at a time. The Commissary staff member initials the BP-A1019 each time the
inmate purchases NRT. The inmate keeps the BP-A1019 until the final supply of patches has
been purchased.
When the inmate completes the NRT (6 or 10 weeks), the Commissary staff member takes the
BP-A1019 from the inmate and sends it to the Health Services Unit for inclusion in the Inmate
Health Record within 30 days of when the inmate should have made the last authorized purchase.
6. INSTITUTION SUPPLEMENT
Each institution must develop an Institution Supplement containing information on smoking
restrictions, and identifying any authorized outdoor smoking areas within the institution.
The Warden forwards a copy of the Institution Supplement to the Regional Health Systems
Administrator for review and approval.
REFERENCES
Program Statements
P4500.10
Trust Fund/Deposit Fund Manual (5/29/14)
P5270.09
Inmate Discipline Program (7/8/11)
P5290.14
Admission and Orientation Program (4/3/03)
P5360.09
Religious Beliefs and Practices (12/31/04)
Other Policy
■ Executive Order 13058, 62 FR 43451, August 9, 1997.
■ Justice Property Management Regulations 128-20.105-3; 128-20.105-50; 128-20.105-51;
128-20.105-52.
■ Comptroller General Decision B-231453, Smoking Cessation Program for Federal
Employees, February 3, 1989.
■ Office of Personnel Management FPM Letter 792-20, Clarification of FPM Chapter 792,
Federal Employees Health and Counseling Programs, May 17, 1989.

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Federal Regulations
■ Rules cited in the Program Statement are contained in 28 CFR 551.160 et seq., revised as of
July 1, 2011.
■ Federal Service Impasses Panel Decision on Case Number 01, FSIP 184, Department of
Justice, Federal Bureau of Prisons, Washington, DC, and Council of Prison Locals 33,
AFGE, AFL-CIO, dated November 8, 2001.
ACA Standards
■ American Correctional Association Standards for Adult Correctional Institutions, 4th
Edition: 4-4214M, 4-4226, 4-4227, 4-4228, 4-4361
■ American Correctional Association Performance Based Standards for Adult Local Detention
Facilities, 4th Edition: 4-ALDF-3A-01, 4-ALDF-4C-21
Other Standards
■ Joint Commission On Accreditation of Healthcare Organizations, 1998 Comprehensive
Accreditation Manual For Ambulatory Care: EC.5
■ Joint Commission on Accreditation of Healthcare Organizations, 1998 Comprehensive
Accreditation Manual for Hospitals: EC.5; EC5.1
BOP Forms
BP-A1019

Nicotine Replacement Therapy Approval

Records Retention Requirements
Requirements and retention guidance for records and information applicable to this program are
available in the Records and Information Disposition Schedule (RIDS) system on Sallyport.

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INMATE NICOTINE REPLACEMENT THERAPY APPROVAL

BP-A1019
JAN 15

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

INMATE NAME:

DATE:

INMATE REG. NO. ______________________ INSTITUTION: ________________
Six (6) Week NRT Dosage Program

Expiration date:

21 mg Patches (2 WEEK SUPPLY)
Commissary)

Purchased on ___________ (initialed by

14 mg Patches (2 WEEK SUPPLY)

Purchased on

7 mg Patches

Purchased on

(2 WEEK SUPPLY)

Ten (10) Week NRT Dosage Program

Expiration date:

21 mg Patches (2 WEEK SUPPLY)
Commissary)

Purchased on

21 mg Patches (2 WEEK SUPPLY)

Purchased on

21 mg Patches (2 WEEK SUPPLY)

Purchased on

14 mg Patches (2 WEEK SUPPLY)

Purchased on __________

7 mg Patches

Purchased on __________

(2 WEEK SUPPLY)

(initialed by

Health Services Provider Signature
Health Services Provider Name Stamp
When a purchase is made on this authorization, the Commissary staff member
shall initial the Purchased on line.
This authorization is to be returned to Health Services by the
Commissary when the inmate has made the last authorized purchase.
Three (3) month smoking status:

smoking

non-smoking

Six (6) month smoking status:

smoking

non-smoking

Smoking Cessation Program completed on:

PDF

Prescribed by P1640


U.S. Department of Justice

U.S. Department of Education

Civil Rights Division

Office for Civil Rights

Information for Limited English Proficient (LEP) Parents and Guardians and
for Schools and School Districts that Communicate with Them
This fact sheet answers common questions about the rights of parents and guardians who do
not speak, listen, read, or write English proficiently because it is not their primary language.
Must my child’s school provide information to me in a language I can understand?
Yes. Schools must communicate information to limited English proficient parents in a
language they can understand about any program, service, or activity that is called to the
attention of parents who are proficient in English. This includes, but is not limited to,
information related to:
 registration and enrollment in school and

 grievance procedures and notices of













school programs
language assistance programs
report cards
student discipline policies and procedures
special education and related services, and
meetings to discuss special education
parent-teacher conferences

nondiscrimination
parent handbooks
gifted and talented programs
magnet and charter schools
requests for parent permission for
student participation in school activities

Must a school provide language assistance if I request it even if my child is proficient in
English and I am somewhat proficient in English?
Yes. Schools must respond to a parent’s request for language assistance and remember that
parents can be limited English proficient even if their child is proficient in English.
May my child’s school ask my child, other students, or untrained school staff to translate
or interpret for me?
No. Schools must provide translation or interpretation from appropriate and competent
individuals and may not rely on or ask students, siblings, friends, or untrained school staff to
translate or interpret for parents.
What information should I expect from the school if my child is an English learner?
When your child enrolls, you should receive a home language survey or similar form to fill out
that helps the school identify potential English learners, who are eligible for language
assistance services. If your child is identified as an English learner, the school must notify you
in writing within 30 days of the school year starting with information about your child’s
English language proficiency level, programs and services available to meet your child’s
educational needs, and your right to opt your child out of a program or particular services for
English learners. For more information about the rights of English learners, visit
http://www2.ed.gov/about/offices/list/ocr/docs/dcl-factsheet-el-students-201501.pdf.
[OCR-00087]

U.S. Department of Justice
Civil Rights Division

U.S. Department of Education
Office for Civil Rights

What type of processes can school districts use to identify limited English
proficient parents?
 School districts must develop and implement a process for determining whether
parents are limited English proficient and identifying their language needs.
 The process should be designed to identify all limited English proficient parents,
including parents and guardians whose primary language is not common in the district
or whose children are proficient in English.
 A school district may, for example, use a home language survey, to inquire whether a
parent requires oral and/or written communication in a language other than English.
 The school’s initial inquiry should, of course, be translated into languages that are
common in the school and surrounding community so that that the inquiry is designed
to reach parents in a language they are likely to understand.
What steps must school districts take to provide effective language assistance to LEP
parents?
 School districts must provide effective language assistance to limited English proficient
parents, such as by offering translated materials or a language interpreter. Language
assistance must be free and provided by appropriate and competent staff, or through
appropriate and competent outside resources.
 School districts should ensure that interpreters and translators have knowledge in both
languages of any specialized terms or concepts to be used in the communication at
issue, and are trained on the role of an interpreter and translator, the ethics of
interpreting and translating, and the need to maintain confidentiality.
 It is not sufficient for the staff merely to be bilingual. For example, a staff member who
is bilingual may be able to communicate directly with limited English proficient parents
in a different language, but may not be competent to interpret in and out of that
language, or to translate documents.
What can I do if I have questions, want additional information, or believe a school is not
complying with these requirements?
 You may visit the website of the U.S. Department of Education’s Office for Civil Rights
(OCR) at www.ed.gov/ocr or contact OCR at (800) 421-3481 (TDD: 800-877-8339) or at
ocr@ed.gov. For more information about filing a complaint, visit
www.ed.gov/ocr/complaintintro.html.
 You may visit the website of the U.S. Department of Justice’s Civil Rights Division at
www.justice.gov/crt/about/edu/ or contact DOJ at (877) 292-3804 or at
education@usdoj.gov. For more information about filing a complaint, visit
www.justice.gov/crt/complaint/#three.
 For more information about school districts’ obligations to English learner students and
limited English proficient parents, additional OCR guidance is available at
http://www2.ed.gov/about/offices/list/ocr/ellresources.html.
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