Inmate health care costs decreasing

Marion County Sheriff Jason Sandholdt (from Facebook)

Inmates in the Marion County Jail receive proper medical care while in custody. Recent moves made by Sheriff Jason Sandholdt and Jail Administrator Lt. Justin Kingrey have decreased the costs of providing this service to Marion County taxpayers.

The County has contracted with Advanced Correctional Healthcare (ACH), which provides on-call doctors and nurse practitioners to answer questions jailers have regarding the health of inmates. Now, instead of transporting an inmate to a hospital or doctor’s office, jailers first call the ACH hotline and provide symptoms displayed by the inmate. They are then advised what treatment the inmate may need.

“I didn’t feel comfortable having jailers make medical decisions,” Sandholdt said. This process puts the onus on ACH regarding decisions.

“We have a nurse who comes out on Tuesdays to do medical calls,” Kingrey said. The nurse, a local resident paid by ACH, is also available to make follow-up calls other days of the week. A mental health professional also visits the jail to meet with inmates once a week and otherwise when necessary.

“We want to provide the best medical care for inmates while saving money for the taxpayers of Marion County,” Sandholdt said.

The MCSO negotiates its contract with ACH, as there are other companies that provide a similar service. Estimated cost of health care provided to inmates at the jail for the past year is under $100,000.

The jail’s health care services includes ensuring inmates’ access to proper pharmaceuticals for mental and physical ailments. The above stated costs include the fee the County pays to Gerber Life Insurance, which covers inmate medical costs over $10,000. The County has not had to file any claims with this insurance for the past couple of years, but Kingrey and Sandholdt believe having this insurance is wise.

“We’re pretty fortunate that our costs are lower,” Sandholdt said.

During the 2019 Iowa Legislative session, the Iowa State Sheriffs and Deputies Association was asked to work with the Iowa Hospital Association to create standardized medical costs for all 99 counties. Local jails can be charged a range of fees by different hospitals throughout the state. Kingrey and Sandholdt are part of this discussion, as well as Knoxville Hospital and Clinics CEO Kevin Kincaid. These three had a strong relationship prior to this task.

“After listening to other counties, I’m thankful we have a great relationship with both hospitals,” Kingrey said. Though the number of trips to the hospital has decreased since contracting with ACH, there are still occasions to do so. Inmates have been taken to KHC and Pella Regional Health Center when necessary.

“Both hospitals understand that the expense comes back to the taxpayers of Marion County for services,” Sandholdt said. “They are very conscientious about what the County is charged.” Kingrey reports that inmates have only required transport to the hospital an average of once or twice every two months.

When a situation demands dental care, the County sees to it that inmates receive it. The nurse or another medical professional makes that determination. Sandholdt does not believe the jail is required to provide health care to inmates, but it is the right thing to do. In some cases, inmates are more likely to receive health care if incarcerated than if they were not.

“There are individuals who receive better medical care here than they would if not incarcerated,” Kingrey said.

The jail averages about 30 inmates every day. This includes inmates Marion County houses for other counties – primarily Warren County and Polk County.

“The benefit of housing out-of-county inmates is guaranteed payment,” Sandholdt said. “We receive those fees.”

Marion County charges between $45-50 a day to house inmates. Inmates, upon their release, are billed for the days they are in the jail. The County does not always receive payment from released inmates, but other county governments cover debts for inmates they ask Marion County to hold.

A significant amount of money is owed the County by former inmates. Sandholdt has tasked his staff with finding ways to recoup what is owed the County for past room and board billings. When a criminal is found guilty and sentenced, financial obligations are usually passed down to them. However, the County’s costs are not paid until after restitution, court costs and attorney fees.

“We are usually at the end of the line,” Sandholdt said. “We want people who owe to pay.”

The amount of time an inmate spends in jail is left to a judge and an inmate’s ability to bond out. Suspects see a judge the morning after their arrest and can typically get out within a week.

Overall, the County has tried to best utilize the jail, which opened in December 2006. They have also taken measures to make the facility more energy efficient, such as adding motion-sensitive lights in areas that do not require constant illumination.