03/18/07 — Who is paying their bills? You are.

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Who is paying their bills? You are.

By Lee Williams
Published in News on March 18, 2007 2:12 AM

Wayne County taxpayers paid $78,200 to pay the medical expenses and housing costs to keep an inmate at a Raleigh prison facility. His bill for one month cost about $3,500.

Another offender racked up a $5,000 bill to cover his dialysis treatments, while it cost $3,174 to pay the prescription drug bill for an HIV-infected inmate.

Inmate medical bills and rising medical costs are putting a dent in the jail's bottom line, Wayne County Sheriff's Office officials said. They have been scrambling to find ways to address the problem, said Maj. Ray Smith, who oversees all operations at the sheriff's office.

While they don't cut corners when caring for inmates, they also want to raise awareness about the issue in hopes of reaching a compromise about who is placed behind bars.

Officials say an overburdened court system, lawyers taking on too many cases, a law that mandates convicted persons serve a sentence of 180 days or less in jail instead of prison, law enforcement officials jailing suspects for minor offenses and a rising jail population have translated into higher medical costs for the jail each year.

Roy George Legg, 58, who is accused of killing a store owner's son-in-law during an armed robbery in Seven Springs May 24, 2003, is scheduled to have his day in court Monday.

But the bill to keep him at Raleigh's Central Prison has been substantial, Smith said.

"It's costing $1,700 per month to house Legg," Smith said. "It cost $1,142 per month alone just to pay for his medical expenses and sometimes it's more."

Legg was shot multiple times as he allegedly ex-changed gunfire with 43-year-old Ricky Avon Thompson when Thompson tried to stop him from robbing Ralph Casey's Grocery.

Officials said the 12-year-old jail was not equipped to house the suspect, so they relocated him to Central Prison for safekeeping where he could receive more specialized care.

"We are not capable of handling handicapped inmates," Smith said. "This jail was not built to handle handicapped persons because it doesn't have handicapped facilities. At the time the plan for the jail was approved, it was not a requirement. It is now."

Jail officials also noted Legg is accused of killing the father of Randy Thompson, who now works for the sheriff's office in the K-9 Division. Housing Legg in Raleigh could benefit all parties involved.

"His expenses including the hospital bill when he was shot cost the county roughly $100,000 alone," Smith said.

That is the amount that has been spent during his nearly four-year stay at the prison for the pending murder case.

Wayne County District Attorney Branny Vickory said it's in the sheriff's office's power to reduce medical costs from Legg's incarceration.

"There was no medical reason to keep him in safekeeping, and if they wanted to, they could have put him back in the jail months ago. He had injuries from the shooting, but he could have been brought back a while ago."

Wayne County Sheriff Carey Winders disagrees.

He said the jail is not equipped to house a person in Legg's condition. Legg sustained permanent injuries during a shootout with his alleged victim and now relies on a walker to get around, officials said.

Court records suggest Legg's physical condition could be further complicated by mental illness. During the trial, his lawyers planned to introduce testimony that Legg was insane at the time of the murder.

Legg is not the only one who has increased bills for the jail.

One recent inmate who was charged with armed robbery required dialysis treatments three times a week and the cost of each treatment was $1,000 a day. He received treatment five times during his stay at the jail.

Winders said the jail has even had to pay for inmates to have babies delivered.

"A lot of them need blood pressure medicine or heart medication or they have diabetes and they can't afford the treatment," said Capt. James Tadlock, who runs the jail. "They stay in to get treatment for a few days and then they bond out when their check comes through."

Tadlock knows the cost of caring for inmates has steadily risen, but he said there is little he can do about the costs. He is required to look after the health and safety of the inmates despite the costs.

"The jail is a service that you can't cut out," he said. "You've got to treat people and feed them."

Even with increasing numbers of mentally ill inmates and repeat offenders, some of whom have serious health problems, Winders said the jail must provide care.

"Even though they are sick, we have to care for them," he said. "No matter what the costs, they are going to be attended to."

But huge medical bills play a large part in the growing jail budget.

"Many people don't realize that this is a cost and expense that is reflected in our budget, which also inflates our budget," Winders said. "Oftentimes, these costs are because of special medical needs, which we are not equipped to handle in our current facility."

Even though he can't cut corners on providing health care for inmates, Smith said jail officials do find ways to minimize the impact on the jail's $3 million budget -- and on the taxpayers who ultimately fund the jail.

Of the $3 million, about 10 percent is earmarked for medical costs. Jail officials allotted $150,000 for adult safekeeping, $126,000 for doctor expenses and $26,000 for prescription medication.

Safekeeping is where jail officials take adult inmates who are sick, terminally ill or who have behavioral problems, Smith said.

Smith said it is his job to get the medical costs as cheap as they can before the sheriff's office pays the bill. Many health care facilities the jail deals with have been compliant.

"Wayne Memorial Hospital works with us extremely well as far as keeping the cost down," Smith said. "They adjust the bills upon request."

The commissioners have also worked to lower medical costs through awarding a contract to a local doctor who also provides a nurse practitioner in the jail.

Having a nurse practitioner on duty during normal business hours and a doctor at the jail's disposal helps lower the cost of taking an inmate to the emergency room.

Smith has strived to keep drug costs down by negotiating deals with local pharmacists and others.

"Our jail physician is working with us," he said. "He gives us oodles of samples to keep the costs down."

Sheriff's officials have also implemented a small co-pay for inmates.

Overpopulation has also contributed to rising medical costs at the jail.

The jail holds 200, but the population generally hovers at 250 to 260. And keeping medical costs down isn't easy, Smith said.

"We're doing what we can," he said. "The Day Reporting Center is getting them out. They're putting the ankle bracelet on their leg, so they can be monitored and they can still work. The quicker they get out, we don't have to pay their medical expenses."

In the case of the dialysis patient who was in jail for armed robbery, Smith negotiated a deal with his health care provider and got the original $5,000 bill lowered to $1,600.

He also worked with the district attorney's office to get the case heard sooner. The inmate has now been released from jail and is serving a prison sentence with the Department of Corrections, he said.

Smith said there have been victories since the jail has been working to keep a cap on rising medical costs, but he knows there's still the public's safety to consider.

"It's a double-edge sword," he said. "On one hand, we have to keep the bad guys in, and on the other hand, let the not-so-bad guys out."

Offenders charged with failure to pay child support, probation violation, traffic violations such as driving without a license and no valid insurance could possibly be given a ticket instead of being taken to jail.

"We end up with a lot of people on minor violations," Smith said. "They have to start weighing that issue and decide whether they need to write a citation or take them to jail because it would be a great savings to us."

Rising medical costs at the jail affects all Wayne County residents, Smith said.

"We all pay county taxes," he said.

By sharing how rising medical costs at the jail are affecting the sheriff's office, he hopes it will encourage people to view the jail differently.

"The general perception is, 'Lock them up. I don't care,'" Smith said. "But they don't think about the thousands of dollars it costs to pay for medical expenses. This is a cost factor that taxpayers don't know about."