Health care for jail prisoners costs counties

Physicians say treatment is equal to the outside

By Emily Mullen
Times Herald

Dr. Randy Plonka visits the St. Clair County Jail on Bard Street in Port Huron each Wednesday to see any inmates who need medical care.

Dr. Dennis Smallwood oversees the work of Hope LaPratt, the physician’s assistant who visits inmates at the Sanilac County Jail on North Elk Street in Sandusky each Tuesday and Thursday.

Offering health care to inmates through an assigned physician is nothing new at the two county jails. Still, some taxpayers say inmates are receiving an unnecessary perk. Jail officials, however, say they only are doing the right thing by offering necessary and humane treatment.

"Why should they get free health care when there are people outside of jail who don’t have any," said Bonnie French, a Sandusky resident and mother of two. "It’s like giving inmates a benefit for committing a crime."

Officials at both jails say inmates are treated equally – as they should be – to any health care patient outside of jail.

"These inmates are getting the kind of attention they should get – no more and no less," Dr. Smallwood said. "Our job is to keep the inmates healthy; it’s preventative medicine."

Costs

The Sanilac County Board of Commissioners recently renewed Dr. Smallwood’s contract as jail physician for a yearly sum of $13,800. He also is the Sanilac County medical examiner. Ms. LaPratt receives $24,000 a year from the county.

Although neither Dr. Smallwood nor Ms. LaPratt are on-call around the clock, inmates are able to fill out request forms to make an appointment to see the doctor for any kind of health problem.

Dr. Plonka makes about $64,000 a year. He and his medical assistant, Sharon Furtah, have been visiting the St. Clair County Jail since 1988. They’re on-call 24 hours a day, seven days a week for emergencies at the jail, and make visits to see inmates at their request. Visits occur 24 hours after a request.

"We’re no different in dealing with our patients at the jail than a private practice would be," Ms. Furtah said. "The only difference is in the people we care for."

Ms. Furtah acknowledged some inmates try to abuse the system. She said inmates, in the past, occasionally have claimed they need medication when they don’t, such as painkillers.

St. Clair County budgeted $287,000 this year to cover inmate health care. Sanilac County has $105,000 set aside. The money covers physicians’ wages and treatment such as hospitalization and prescriptions for the inmates.

In each county, the money comes form the general fund, generated primarily by taxpayers.

Troy Feltman, St. Clair County administrator, said money in the general funds also comes from state-shared revenues, or a percentage of tax dollars given back to the county that the state makes form local municipalities.

"It all comes back to the community," Mr. Feltman said. "One way or another, we’re all paying for it."

Lt. Mike Redman, administrator at the Sanilac County Jail, said at least 80% of their inmates don’t have personal insurance or other ways of paying for prescriptions and doctor visits, so the county ends up eating the costs.

The situation at the St. Clair County Jail is the opposite. Ms. Furtah said at least 75% of patients there who receive regular medication are covered by outside insurance.

Juanita Gittings, chairwoman of the St. Clair County Board of Commissioners, said it costs about $46.50 a day for the room and board of an inmate, not including health care.

"We have a responsibility under the law to allocate money for health care for inmates," said Ms. Gittings, D-Port Huron. "We give them the health care they need, what’s adequate and appropriate."

Lloyd Thorpe, an inmate at the St. Clair County Jail, said he pays $10 per prescription for his blood pressure medication.

"A lot of people in here that weren’t getting health care on the outside seem to be getting a lot healthier while they’re in here," Mr. Thorpe said.

Procedures

The two county jails make sure inmates receive a physical examination at least once during an incarceration that lasts more than 14 days – a practice that is mandatory according to state law.

Lt. Redman and Capt. Tom Torrey, the St. Clair County Jail administrator, said inmates must fill out lengthy questionnaires at the time of booking. The forms describe their current medical conditions, the last time they saw a doctor and any health issue concerns.

"We have to be as humane, objective and compassionate as can be when dealing with inmates and their health care," Dr. Smallwood said.

Lt. Redman and Capt. Torrey said they do background checks on the mental, physical and emotional histories of the inmates before they’re booked, and records of all conditions are updated on a regular basis.

"It’s our job to determine fact from fiction in the medical histories of the patients," Dr. Smallwood said. "With this type of health care, the information gathered on our patients must be totally honest."

Dr. Plonka sees anywhere from two to 20 inmates a week from the 240-bed facility. He said a physical consists of blood pressure and blood sugar screening, a urinalysis and tuberculosis test, and making sure there are no infections of the eyes, ears and throat.

"If an inmate needs specialized treatment, like if they’re a diabetic or cardiology patient, we make sure those needs are met," Dr. Plonka said – even if it means hospitalization.

As far as dispensing medication, Ms. Furtah said she sets up trays of pills each week for jail officers to dispense daily to the inmates who need them. Those can include insulin for diabetics, blood pressure pills and medication such as Prozac for patients with mood or psychological disorders.

Dr. Smallwood’s patient care is similar. Ms. Pratt visits between four and 20 inmates in the 120-bed Sanilac facility. He said several of the inmates suffer from anxiety and depression, and that they receive "hundreds" of complaints of sleeplessness.

In addition to the necessary medication they give inmates for illness such as the common cold, flu, fever, body aches and minor trauma, Dr. Smallwood said the jail has service to McKenzie Memorial Hospital, which neighbors the jail, for emergencies.

Lt. Redman said emergencies his staff are concerned about are any last-minute surgeries that could take place. He said, for example, if an inmate goes into cardiac arrest and needs open-heart surgery, that takes a huge chunk out of their budget.

"Overall, though, I think things are run here pretty smoothly," Lt. Redman said. "We’re fairly confident in our level of health care."

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