Healthcare plan for inmates could save jail money

The jail has a medical budget of $3 million and a staff of five doctors and 38 nurses to care for inmates, according to jail officials.
The jail has a medical budget of $3 million and a staff of five doctors and 38 nurses to care for inmates, according to jail officials.

HUNTSVILLE, AL (WAFF) - Administrators with the Madison County Jail could save hundreds of thousands of dollars spent providing health care for inmates by taking advantage of provisions in the Patient Protection and Affordable Care Act, officials said.

On Thursday, the jail's administrator Chief Deputy Steve Morrison met with Norman Johnson, CEO of the jail's healthcare provider, Advanced Correctional Healthcare, to discuss strategies to seek state or federal coverage for some of the facility's medical expenses.

"The Madison County Jail I think is way ahead of the curve because they're well aware of this," said Johnson.

"People don't realize that Social Security, Medicaid, Medicare is cut off once you are incarcerated," said Morrison.

Morrison said medical expenses for the jail's detainees awaiting hearings and trials become the jail's responsibility, a responsibility that can be costly as the jail takes in older, unhealthier criminal suspects.

"If you come to this jail, you will be healthier when you leave this jail than if you go to your own doctor or if you're living out on the streets," said Johnson. "While we are not a health spa, clearly people are healthier after they come to the jail."

"They come in here, there's a variety of illnesses that they have to treat from diabetes to hepatitis to HIV," said Morrison. "Some of those require huge monthly costs for pharmaceutical medications. Some we have to take off-site to the hospital which is usually a catastrophic amount of money."

The jail has a medical budget of $3 million and a staff of five doctors and 38 nurses to care for inmates, Morrison said, but sometimes inmates must be admitted to expensive outside hospitals for treatment. Morrison explained that the jail has a reserve of $800,000 for outside care but that those funds can be quickly depleted with just a few catastrophic cases

"We had an inmate that had some type of illness from all the psychotropic drugs that he'd been taking throughout his lifetime. He was in a coma for a long time and it was almost $300,000 for him. Now when you get just one of those out of a thousand inmates that can really cripple your budget," said Morrison said.

Johnson said Advance Correctional Healthcare and the jail were exploring approaches to have some Medicare or Medicaid coverage for at least a share of outside medical expenses. "I will be working with him to see if we can get a navigator into the jail to assist in the signup of these people," he said. "If that happens, a portion of their hospitalizations will be covered by the public aid system."  Johnson said it was unclear whether such a navigator could be a jail staffer or would have to be hired from outside.

Part of the challenge, Morrison said, was keeping up with changing provisions and applications of relevant portions of the Affordable Care Act. Ideally, Morrison said, the jail could eventually have all inmates registered for Medicare or Medicaid sponsored health care coverage as soon as they were booked in, a process he acknowledged would be daunting. "The registration process is really intense," he said. "So it's going to take 20 to 30 minutes per inmate as they come through here and we run like 29,000 through each year."

Morrison said any steps to line up navigators and register inmates were still likely several months away but that any cost benefits from such an initiative could materialize quickly. "Once this thing's in place, it's almost immediate," he said. "We could see savings probably the first year."

Johnson said Madison County's jail was rare among the hundreds of jails Advanced Correctional serves in its aggressive pursuit of such savings. "They're very up on all the latest changes," he said. "And I think that they will probably benefit from the use of navigators and getting people into the insurance program probably more aggressively than other jails that we're presently working with."

"Constitutionally we're supposed to provide medical care," Morrison said. "It doesn't say we have to pay for it."

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