Eligibility criteria. A U.S. national incarcerated abroad is considered eligible to receive funded medical treatment under the following general criteria:

Adequate treatment cannot or will not be provided by prison authorities or the host government;

All reasonable attempts to obtain private resources (prisoner's family, friends, etc.) have failed, or such resources do not exist;

There are medical indications that the emergency medical assistance is necessary to prevent, or attempt to prevent, the death of the prisoners, or failure to provide the serviced will cause permanent disablement.

Services covered. Funds, once approved, may be expended for:

Medical examination, when required;

Emergency treatment;

Non-elective surgery;

Medications and related medical supplies and equipment required on a routine basis to sustain life;

Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc.) required to combat epidemic conditions (general or intramural);

Childbirth attendance, including necessary medical care of newborn children; and

Within the consular district, transportation for the U.S. national and attendant(s) designated by incarcerating officials between the place of incarceration and the place(s) of treatment.

Consular responsibility. As soon as the consular officer is aware that a U.S. national prisoner in the consular district faces a medical crisis, the officer should take the following actions, setting forth the order or priority based on an evaluation of the facts received:

Make every effort to contact the ill or injured prisoner as soon as possible;

Take steps to obtain a professional medical diagnosis and prognosis of the ill or injured prisoner;

Determine as accurately as possible the estimated costs of recommended treatment or surgery;

Obtain the names and addreses of family or friends who might serve as a source of private funds for medical services, and attempt to obtain the necessary funds;

Request the prisoner to execute a promissory note, since funds expended by the Department to cover medical services normally are on a reimbursable basis; and

Submit the above information, along with recommendations and evaluations, to the Department for approval and authorization.

Emergency expenditure authorization. When a medical emergency prohibits the delay inherent in contacting the Department and receiving authority to expend funds, the consular officer can expend up to an amount to be established by the Department without prior Departmental approval if:

Symptoms determine eligibility for emergency medical treatment; or

An immediate medical examination is warranted in order to verify the alleged abuse of a U.S. national prisoner by arresting or confining authorities; or

Immediate emergency medical treatment or surgery is necessary to prevent death or permanent disablement, and there is insufficient time to explore private funds or obtain Department approval; and

A promissory note already has been executed by the prisoner, or if the circumstances warrant, by the consular officer without recourse.