More than $700,000 of tax payer’s money is spent every year keeping inmates healthy at the Troup County Jail. It’s one of the biggest budget items on the list and even with new cost-reducing policies, it’s a growing problem.
“In 1993, when I took office, we had 95 inmates in the jail,” said Troup County Sheriff Donny Turner. “Back then if someone needed to see a doctor, we put them in a patrol car and took them to Clark Holder Clinic.”
As the jail population grew, deputies found themselves taking two and three inmates at a time to the clinic. Later, there were so many going for medical visits, it took a bus to transport them. When an inmate escaped from one of those buses, Turner hired a nurse to come to the jail.
“That cut our transportation down, but when the nurse got off at 5 p.m., it started again,” Turner said.
He hired 24-hour staff in 1995 when the jail population hit 270 inmates.
“Now we’re averaging 463 inmates daily and we’ve had as many as 500 at one time,” Turner said. “When you deal with that many inmates you’re going to have to deal with substance abuse, poor health care and mental health.”
Medicaid and other government benefits stop when someone becomes an inmate and private insurance is rare, so 100 percent of the health care is paid for from the county budget.
One of the biggest budget items is medication, especially for mental health issues, said Marty Reeves, Troup County Jail administrator.
“We spent $103,000 on medication last year and a lot of that was for mental health,” he said.
The jail hired Dr. Kenneth Genova, a LaGrange psychiatrist, to oversee the mental health aspect of inmate health care. Currently, there are about 150 inmates receiving medication and 80 of those are for mental health.
“Dr. Genova has really helped the budget. He’s prescribing generics and basic drugs that saves us a lot. We had one inmate who had one prescription that cost $800 a month. Now it’s a lot less than that,” Reeves said.
A contract with Blue Cross Blue Shield to regulate prescription costs has also helped save money. In 2011, the total cost of medication was $103,624.90, a savings of $69.251.57 attributed to that program. Medication is delivered to the jail from Holmes Pharmacy and no narcotics are given, even if prescribed by a doctor.
On Aug. 1, We Care took over the jail infirmary and there has been a significant decrease in hospital visits and other costs since that time.
“The first two months we were here, we sent out 20 inmates to the emergency room. Once we got rolling, we sent out only 20 in the next six months,” said Eddie Lindley, lead nurse for the Troup County Jail medical department.”We know that 70 percent of the visits to the ER are avoidable with disease management. That’s what we do here.”
For inmates who need to be watched closely, there are three cells in the jail infirmary. However, there are usually three inmates to a room, with two sleeping on mats on the floor.
When inmates are first booked, they are asked a standard set of medical questions. Certain answers will trigger an immediate physical with a nurse, although the state only requires a medical visit within 15 days of entering a jail.
“This is a stressful environment. If someone has a chronic disease, coming here can put them over the top. If we identify it quickly, we can manage it better,” Lindley said.
While the inmate population has typical diseases seen in the general population, such as diabetes, heart disease and hypertension, they also have a high incidence of mental health issues and substance abuse. The jail infirmary provides detox services there.
“Inmates have a constitutional right to health care, but it’s no frills,” said Donna Barger, regional nurse manager for We Care clinics including the jail, the Correctional Institute and the primary care clinic that the city and LaGrange College use.
“If you come in with a hernia, but it’s safe and stable, we’re not going to repair it. If it becomes dangerous, we’d have to intervene,” he said.
Sick calls are seen five days a week, averaging 25 inmates a day. If an inmate is referred to the clinic, it’s a free call. If an inmate requests to be seen, it costs $5.
“What we do here is part of the community health care system. It pays to treat them here,” Lindley said. “They’re going to go out in the community and the more we manage the disease, the cheaper it will be in the long run.”