County taps deeper into its reserves to pay for inmate medical care

The cost of medical care for jail inmates remains a growing drain on the county budget and county officials continue to dip into reserves to cover the expenses while looking for a plan to reduce the financial burden.

"We're hemorrhaging now, to put it in a medical term," County Manager Randall Reid told county commissioners Tuesday.

While staff looks for solutions to stop the financial bleeding in the short term and reduce costs in the long run, commissioners took $600,000 out of the county's reserves Tuesday to cover the unbudgeted costs of inmate hospitalizations at Shands at the University of Florida and North Florida Regional Medical Center during the fourth quarter of the 2008-09 fiscal year.

For the whole fiscal year, the county paid approximately $3.6 million for inmate hospital bills, with more than $2 million of that coming from reserves.

That continues a recent trend of rising costs for off-site inmate care from $855,663 in fiscal year 2006-2007 to more than $3 million each of the last two fiscal years.

Ron Akins, administrative support manager for the county, attributed part of the dramatic rise in the county's costs to the fact that some hospital bills the county was legally obligated to cover under state law went unpaid in past years.

Right now, staff with the county and Prison Health Services, the private company that provides medical care in the jail and manages off-site inmate care, are negotiating with Shands and North Florida Regional Medical Center to try to reduce costs.

"If they (the hospitals) don't reduce their rates and we continue to pay this. then there are a number of other things that benefit the public that we won't be able to continue to do," Reid said.

With talks ongoing, Akins and Prison Health Services staff did not reveal much detail on the negotiations. Akins did say that the talks with North Florida Regional Medical Center had already produced a "better deal than what we have, but we still have a long way to go."

The county's contracts with the hospitals include confidentiality clauses, which state that the hospitals' rates are trade secrets exempt from the state's public records law.

Under state law, the responsibility for paying hospital bills for any pre-existing medical conditions that inmates have or for injuries they sustain during arrest falls on county governments after attempts to potentially recoup costs through medical insurance, the inmates' personal assets or until any financial settlement the inmates may have received in relation their medical condition has been exhausted.

The Sheriff's Office is responsible for covering costs for injuries sustained while the inmate is incarcerated.

In the long haul, the county is also looking at ways to cut down on costs for medical treatment at the jail, which runs about $4 million a year.

Tuesday, Sheriff Sadie Darnell provided some details on the possibility of forming a nonprofit community group to take over medical care in the jail and serve as the administrator for off-site care.

The Marion County Sheriff's Office switched to that approach a few years back.

Should the county opt to go that route, there would be a cost to see if it was feasible -- with the consultant who worked with Marion County on its plan giving a quote of $5,500 a month for an expected one-year project.

That cost estimate met with skepticism from some commissioners.

Commissioner Cynthia Chestnut said the county needed "much more detail" on the plan before hiring a consultant at more than $5,000 a month.

Contact Christopher Curry at 374-5088 or chris.curry@gvillesun.com