The BOP should amend the language contained in Correctional Services Manual, 103, Section 1, so as to clarify whether the requirement to consult with medical staff prior to the use of OC spray on an inmate with a known history of respiratory or cardiovascular disease, chronic dermatitis, or psychosis applies to only calculated uses of force or both calculated and immediate uses of force.a. If, in response to recommendation 1, above, the BOP clarifies that the requirement to consult with medical staff prior to the use of OC spray on an inmate with a known history of respiratory or cardiovascular disease, chronic dermatitis, or psychosis applies in the context of an immediate use of force, then the BOP should also clarify within the Correctional Services Manual, 103, what constitutes an acceptable consultation with medical staff in such a situation. (If, based on the response to recommendation 1, there is no requirement to consult with medical staff prior to using OC spray in the context of an immediate use of force, then this recommendation (recommendation 1.a.) becomes moot and there is no need for the BOP to respond to it.)

The BOP should amend the language contained in Correctional Services Manual, 103, Section 1, so as to clarify whether the requirement to consult with medical staff prior to the use of OC spray on an inmate with a known history of respiratory or cardiovascular disease, chronic dermatitis, or psychosis applies to only calculated uses of force or both calculated and immediate uses of force.b. If, in response to recommendation 1, above, the BOP clarifies that the requirement to consult with medical staff prior to the use of OC spray on an inmate with a known history of respiratory or cardiovascular disease, chronic dermatitis, or psychosis applies in the context of an immediate use of force, then the BOP should also clarify within the Correctional Services Manual, 103, whether BOP staff must both consult with medical staff prior to the use of OC spray on an inmate with a known history of respiratory or cardiovascular disease, chronic dermatitis, or psychosis and avoid the use of OC spray on such an inmate unless other means of control have been attempted or deemed likely to be ineffective. (If, based on the response to recommendation 1, there is no requirement to consult with medical staff prior to using OC spray in the context of an immediate use of force, then this recommendation (recommendation 1.b.) becomes moot and there is no need for the BOP to respond to it.)

Evaluate its various tracking efforts for DVE-related case data to ensure that it has a holistic view of the threat and a consistent process for capturing, interpreting, and reporting DVE-related case data.

Develop a specific, multiyear plan for how the BOP will evaluate its ongoing and proposed changes to the employee discipline process, as well as key performance indicators, by year, to decrease the backlog of its employee misconduct cases and adjudications.

Develop and implement a reliable method to calculate appropriate staffing levels at the enterprise and institution levels. Such a method should seek to baseline appropriate staffing levels for the current inmate population and be flexible to account for future population changes overall and among institutions, as well as other factors (e.g., institution security level and layout) that determine appropriate staffing levels. Once such a method is developed, communicate the need to align funding levels with appropriate staffing levels to executive and legislative branch stakeholders.

Develop an infrastructure strategy to increase the overall effectiveness of facilities management. The strategy should align infrastructure decisions with the BOP's mission; include one or more methodologies for allocating resources; and include short, medium, and long-range planning goals. As part of this strategy, the BOP should consider incorporating a portfolio-based repair model; a retention or disposal decision model; and business case analyses for new construction, as appropriate.

Develop and implement key performance indicators to track whether the BOP is meeting its infrastructure goals.

Examine its domain assessment process - including the Top 100 Initiative and recall inspection activities - and refine its strategies for identifying and tracking risks, deploying resources, and accomplishing goals.

Refine the CGIC performance review process to include sufficient information to allow for an assessment of the outcomes and effectiveness of the CGIC intelligence that is shared with Industry Operations.

Establish a recurring process to assess the risk indicators that contribute to the selection of FFLs for inspection and evaluate the results of the inspections to ensure that field divisions are effectively identifying high-risk FFLs.

Implement a process to conduct ongoing formal, data-based, comprehensive reviews of inspections results to ensure consistent application of the standards and assist ATF in reaching its inspection program goals of reducing the possibility of firearms being diverted from legal commerce and maintaining the traceability of firearms.

Adopt mechanisms to improve the accuracy of its information-sharing data and the completeness of its information about the outcomes of internal and external referrals and use this information to better assess the value and effectiveness of its information sharing practices, with the goal of providing enhanced oversight of FFLs.

Conduct a thorough assessment of single-celling policies and processes, including those applicable to inmates housed in quarantine and medical isolation units and to inmates vulnerable to suicide.

Ensure that actions, including any policy revisions, the BOP takes to close the two open recommendations from our 2017 restrictive housing report that reference single-celling also apply to single-celling during quarantine and medical isolation.

Explore options for permanent changes to facility infrastructures that would allow for better implementation of social distancing and other infection control measures.

Immediately update guidance regarding (1) when staff should notify the families of inmates who become seriously ill or die, including a specific timeframe, and (2) uniform criteria for what constitutes a serious illness.

Ensure that inmate family information, or the inmate emergency contact form, is updated according to policy and readily available for BOP staff who need to notify next of kin in cases of inmate serious illness or death.

Assess how to improve staff and inmate compliance with healthcare protective equipment measures at its facilities and issue clear guidance to facilities about the importance of compliance.

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

Add fields to the Discipline and Administration Reintegration Tracking System that can be easily queried to identify the type of victim (inmate, staff, or other) and gender of the victim for all incidents involving prohibited acts by inmates, and identify the specific inmate behavior under each prohibited act code.

Ensure that staff are trained on the updated fields in the Discipline and Administration Reintegration Tracking System and that staff understand which inmate behaviors are associated with each prohibited act code, as well how to articulate the behavior in the corresponding field.

Ensure that policies and program statements that address inmate-on-staff sexual harassment are consistent with updates to systems and data tracking mechanisms.

Conduct regular risk assessments of the prevalence and severity of inmate-on-staff sexual harassment within individual institutions and across BOP institutions, with a particular emphasis on the risks for female staff.

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; CSOSA has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; CSOSA has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; CSOSA has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; CSOSA has determined that this recommendation contains information that is limited official use or classified.]