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Monday, July 6, 2009

Pitkin County inmates' health-care costs in '08: $60k

Jail says it monitors inmates to make sure they're not munipulating system

ASPEN — Inmates in the Pitkin County jail cost taxpayers $60,811 last year on medical and dental treatment, and their bills so far this year are nearly $40,000.

“The [jail] population isn't in the best of health,” said jail administrator Don Bird. “Most have medical or mental health issues.”

Inmates get treated by local dentists, dermatologists, specialists and general practitioners. They are transported to medical offices in orange jumpsuits and receive treatment in restraints.

Jail officials and the medical specialists contracted with Pitkin County are keenly aware of inmates' attempts to manipulate the system so they can get outside or obtain drugs.

“A lot of people think they can get things fixed at government expense,” Bird said. “We won't treat 20 years of neglect but if you twist your ankle, have a toothache or a chronic illness then they'll get treatment.

“Medical services in jail is a way of manipulation and a con so you have to get a read on them,” he added. “A level of discernment is needed because manipulating the system is a big pastime with inmates.”

Bird said Kathy Wantor, the jail nurse, is a pro at determining whether inmates really need medical attention. A nurse at Midvalley Medical Clinic in Basalt, Wantor is on call when an inmate needs to be checked out. She also visits the jail twice a week for routine check-ups, and gives full physical and dental exams for every inmate who walks through the door.

“It's more health care than you or I receive,” Bird said.

The jail is required by Colorado law to provide medical treatment to inmates and is accredited by the National Commission of Correctional Health Care (NCCHC). Bird said the Pitkin County jail is the smallest facility accredited and has been since the 1980s.

The local jail follows the NCCHC's standards of care, and the organization provides oversight for Pitkin County officials. The organization conducts a site visit and an audit at the local jail every two years, reviewing medical records and the general health of inmates.

Bird said being accredited is important because health care is the main source of lawsuits levied against jails and correctional institutions.

The biggest costs to the jail are prescription drugs and if an inmate is hospitalized or needs to see a specialist. If an inmate is hospitalized, a deputy must stay with that person 24 hours a day, Bird said.

Last year, the jail spent $16,704 on medical supplies, which are predominately prescription medication, according to Pitkin County Fund Specialist Peggy Johnston.

“Some of the meds we've had to administer have been fairly expensive,” Bird said. “We've had to raise the line item for that because costs have risen for prescriptions.”

A significant number of inmates who are mentally ill need psychotropics to remain stable. The jail will even pay for a month's supply after inmates are released just so they can function normally in society. If they don't, it's likely they'll wind up in jail again, Bird said.

“To me, that's an expense worth paying,” he said, adding it's an expensive line item. “If we have three to five guys in here at one time who are on it, it's $500 each a month.”

Bird noted that the jail works with the Aspen Valley Medical Foundation to obtain inexpensive medication when it's available. Officials also try to limit costs when they can, like having inmates do physical therapy in the jail with exercise routines given to them instead of at the hospital or doctor's office.

Dr. David Borchers contracts with Pitkin County and inmates are brought to his office in Basalt occasionally. Three inmates this past week were scheduled for visits, Bird said.

Many inmates arrive at the jail and experience severe alcohol withdrawal, which can lead to medical treatment.

“People come in here severely wrecked,” Bird said.

The jail processes about 500 people a year and nearly half of them bond out within hours. The average stay for an inmate who is awaiting trial is about three months. The average daily population is between 17 and 18 inmates, Bird said.

All costs associated with an inmate, including food, shelter and clothing is about $125 a day.

csack@aspentimes.com
Care behind bars
Here's a breakdown of medical expenses for inmates housed in the Pitkin County jail during 2008 and 2009, year to date:

Medical services:
2008 — $6,425
2009 — $4,154

Psychiatric services:
2008 — $4,004
2009 — $2,278

Jail nurse:
2008 — $12,110
2009 — $3,783

Ambulance services:
2008 — $0
2009 — $0

Hospital services:
2008 — $3,394
2009 — $5,882

Jail physician:
2008 — $1,838
2009 — $370

Detox:
2008 — $9,176
2009 — $10,600

Medical supplies (prescriptions):
2008 — $16,704
2009 — $5,295

Right Door fees:
2008 — $7,160
2009 — $5,445

Source: Pitkin County finance department



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