Inmate Medical Care Strains S.C. Jail Budgets

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By Beaufort Gazette

Published: 06/16/2003

Planning for prisoners' health care costs at local jails often is an arduous task, but one that jail administrators have to accept.
Since jails are required by law to provide medical and dental care for all inmates, and it's impossible to predict when an inmate will need emergency surgery, unexpected medical bills can quickly burden a jail's budget.
It happened to the Jasper County Detention Center last year. And it happened again this year. In fact, over the past two years, the center has faced more than $200,000 in unexpected medical bills.
Such situations are anomalies, said county finance director Ronnie Malphrus, but they can be awfully expensive anomalies.
Jasper County officials received a bill last week for $72,000, the cost of emergency surgery for a prisoner serving a six-month sentence on a family court charge in the Ridgeland jail, and they're expecting another $15,000 doctor bill. Last year, the county paid $115,000 for brain surgery for an inmate who fell off a bed onto his head.
And beyond unpredictable emergency expenses, Malphrus said the county jail sends six to eight inmates a year to Columbia Care, a secure prison hospital in Columbia that holds prisoners when the jail can't provide medical care. The detention center, built in 1972 to hold 23 inmates and now averaging twice that many, often squeezes up to six inmates into a cell, Malphrus said. And there is no infirmary to provide medical care beyond scrapes and bruises.
The detention center can't handle patients who have serious medical needs, including AIDS, cancer, cardiac disease and kidney dialysis, said Charlie Grant, the jail's director.
'I don't have medical facilities here, nor do I have any medical personnel,' he said.
Jasper County spent $123,797 last fiscal year, 14 percent of its total budget, to pay the $300 a day it costs to house inmates at Columbia Care and the $38 a day it costs to house its female inmates in the Beaufort County Detention Center, according to the county budget. Jasper's jail isn't approved to hold women.
This fiscal year, ending June 30, the county spent $204,470 for Columbia Care and to house female inmates in Beaufort. The jail budgeted $35,000 for inmate medical care, an amount that didn't even cover half of the single $72,000 surgery bill.
The County Council approved a $200,000 budget amendment last week to pay for the surgery, as well as the Columbia Care and female housing bills.
Officials here hope these financial woes will change early next year when the county's $6.5 million solution to its overcrowded, outdated jail is expected to open with the capacity for five times the number of inmates as the current facility.
Malphrus said the jail is looking into an infirmary that could provide basic medical services.
While Jasper has faced several tough emergency surgery expenses, providing inmate medical care in Beaufort County isn't any cheaper. The Beaufort County Detention Center this year spent $405,000, 10 percent of its total budget, on its contract for medical services with Southern HealthPartner.
The Beaufort jail has a three-bed infirmary and two isolation cells where inmates with contagious diseases are held, Director Mark Fitzgibbons said recently. In 2002, Beaufort sent 40 prisoners to the Beaufort Memorial Hospital emergency room.
Jasper County sends any inmate with AIDS or HIV and anyone else whose medical condition requires special attention to Columbia Care, Malphrus said. About 1 percent of prisoners require skilled, intermediate hospital care, and many prisons set aside 10 percent to 20 percent of their budgets for medical expenses, Columbia Care officials said.
'This is the service that we provide and the health care is much cheaper for the county than it would be to send someone to the hospital where you would have to have an officer guarding that person,' said David Cooper, general manager of Columbia Care. 'Much cheaper.'
A night's stay at Beaufort Memorial Hospital costs from $500 for a medical surgical bed to $1,000 a night if the patient requires critical care, said Nora Kresch, the hospital's spokeswoman.
Columbia Care 'performs a very necessary service, especially for small facilities that don't have the ability to provide medical care,' said Fitzgibbons. 'When you can do it in-house, you've got your cost pretty much known, and you don't have your transport to and from Columbia. It doesn't matter if you're a five-bed jail or a 5,000-bed jail, you still have to provide the same level of services.'

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