04/13/05 — Inmate medical bills up $200,000

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Inmate medical bills up $200,000

By Barbara Arntsen
Published in News on April 13, 2005 1:49 PM

For almost a year, the Wayne County Sheriff's Office has been paying an average of $340 per month in medical costs -- for one inmate.

That prisoner, charged with breaking and entering, is in jail awaiting trial. While he's there, the sheriff's office is footing his medical bills.

The inmate's medical problems aren't unusual. And neither is the fact that the county has to pick up the tab. So far this fiscal year, the department has had to pay $350,000 in medical bills for inmates -- $200,000 more than it had planned for in its budget.

The inmate that is costing $340 per day is simply receiving medication commonly associated with increasing age, such as medicine for high blood pressure, said Sheriff Carey Winders.

Paying medical costs for inmates is not something the Sheriff's Office chooses to do. State law requires it.

"We're mandated by law to provide medical service to inmates," Winders said. "And it's a real problem for our budget because it inflates it and we have no control over it."

"It's a huge cost," said County Manager Lee Smith. "When we have to spend $200,000 over budget, that's a half-cent on the tax rate."

Many counties don't include such expenses in the sheriff's budget, Winders said, because it is an unknown figure. The money comes from a contingency fund maintained by the county.

A handful of prisoners with more severe medical problems has been the source of most of the extra cost this year, Winders said.

Some of the prisoners costing Wayne so much in medical bills are incarcerated outside the county but they are still considered Wayne's responsibility.

Some are considered too violent to be kept in the county jail. Others are handicapped and must be kept in facilities that can accommodate them better than the local lockup.

Oftentimes, Smith said, county officials aren't even aware that an inmate being kept elsewhere has undergone medical treatment until the bill arrives.

What people don't realize, Winders said, is that not everyone who commits a crime is in good health.

"We've got cancer patients, some on dialysis, and AIDS patients," he said. "Medicine to treat HIV can run around $2,000 a month."

Sometimes inmates scheduled to serve a short time can end up costing the county thousands of dollars because of unforeseen medical problems.

"A few years ago we had a boy come in the jail to serve seven days," said Capt. James Tadlock, the jail administrator. "His jaw began to swell after he got in jail and we had to send him to the hospital."

The county ended up paying $16,000 in medical costs for his jaw infection, Tadlock said.

The Sheriff's Department also has no control over how long inmates have to wait before going to trial. That is determined by lawyers, judges and court officials and can be months.

Winders said the inmate costing the county $340 monthly in medical costs was arrested last summer.

"I don't know why he hasn't gone to trial yet," Winders said, "but this is an on-going problem. His is not an isolated case."

The sheriff said that if inmates went to trial quicker, it could help keep the medical costs down. A committee of lawmen and county and court officials has been formed to study the problem.

The county and sheriff's office try to keep inmates with medical problems out of the jail, when possible.

"The guy that drove the car into Delmus' Hardware Store a couple of years ago is an example," said Winders. "He came in here in a wheelchair, with all sorts of tubes coming out of him."

Winders said that the county could have let the man stay in jail and paid for his treatments. But because he was not considered a risk to escape, the magistrate set a lower bond and the man wasn't put on trial until his injuries healed.

That doesn't always work, jail officials concede.

"We have to be responsible to the public," said Major Ray Smith. "So we have to weigh the cost of what it would be for the criminal to not be in jail, versus the medical costs we might have to pay."

Smith said jail officials work on cutting costs wherever possible, and review the inmate list daily.

Winders said they also try to offset some costs by having a medical co-op for in-house inmates.

"The inmates, if not indigent, pay $10 for non-emergency needs, like getting an aspirin or seeing a doctor for something minor," he said. "This has deterred inmates from making a big deal out of little things, like ingrown toenails."

Wayne and Pitt counties were the first in the state to start such programs in the jails, but Winder says the idea has now caught on with other counties looking for ways to trim expenses.

County Manager Lee Smith said that Wayne provides prisoners with the medical help that the law requires, but that jail officials try to avoid paying for unnecessary treatments.

"Inmates don't get fillings put in their teeth," he said. "If they have a bad tooth, it gets pulled."

Smith said that though he knows that some of the prisoners' medical complaints are valid, that some also try to use them to delay going to court.

"We're looking at providing additional training for detention officers to recognize minimal things," he said. "So they can determine what's really going on, and decide what complaints really trigger calling 911."

Smith says he believes that some of the $200,000 in unexpected medical expense was legitimate, but he's not sure that all of it was necessary.

"I think it has peaked this year, but I don't know," Smith said. "We're looking to save money where we can, and to release the inmates when possible. There's got to be a better way."