Company ends medical service contract with Lawrence jail

Jun. 28—MOULTON — Already faced with skyrocketing medical costs for inmates, the Lawrence County Jail is having to switch medical providers after the current one unexpectedly canceled its contract.

One county commissioner worries that the financial burden is a disincentive for sheriffs to jail defendants with underlying medical conditions.

Quality Correctional Health Care (QCHC) will terminate services after July 13, and the County Commission last week voted unanimously to hire Chattanooga-based Southern Health Care. Southern agreed to begin providing services July 14, although the contract term is from Aug. 1 to Sept. 30, 2023.

County officials said the agreement with QCHC allowed the company to terminate the contract at any time. "We will work with the county to facilitate an orderly transition," according to a letter to the county from Dr. Johnny Bates, the chief executive officer of the company.

Sheriff Max Sanders called the letter "unexpected."

Spiraling inmate health care costs have surpassed this year's budgeted amount by more than $4,000, according to sheriff's department records, with more than three months remaining in the fiscal year.

Chief Deputy Brian Covington said $264,000 was budgeted this fiscal year and through June 7 the jail medical costs were $268,757.

The county also put additional money into a pool for the inmates' off-site health care and it has been depleted, he said. The pool money paid for hospitalizations, major chronic care procedures, dental care, X-rays, mental health procedures, emergency room visits and specialists.

The Sheriff's Office has been receiving bills directly from Lawrence Medical Center instead of QCHC handling the billing.

"I understand Lawrence Medical Center only got paid periodically," District 3 Commissioner Kyle Pankey said. "It might be a blessing in disguise that they gave us the 30-day notice. They were hurting us financially. They were not doing us any favors, and they were hurting our service providers."

County Administrator Heather Dyar said the county was most recently paying QCHC a base of $22,655 a month and an additional $8,000 to $12,000 more each month for the pool. Southern Health Care's pending contract has a base cost to the county of $21,600 a month with about $5,000 more a month going toward a $60,000 annual pool.

Dyar and Covington said the pandemic caused the inmate medical costs to skyrocket, and it is difficult to predict the off-site medical expenditures.

"It is a forecast and nobody knows who is going to be sick and when," Covington said of the pool. He said the county's pool "was at a plus at the start of COVID."

"There's no more pool left. Now we're absorbing the full costs of the health care of the inmates on a day-to-day basis. We're now feeling the brunt of that," Covington said.

The inmate health care budget could surpass $500,000 this fiscal year, he said.

QCHC did not return phone calls or emails.

Covington said the county has an obligation to provide adequate health care to the inmates.

"We're obligated to be good stewards of the money, but the majority of the inmates in the jail are unable to provide their own health care service," he said. "We have a moral obligation to society to take care of those inmates — make sure they have the best health care possible under the contract we have until their litigation is over."

District 4 Commissioner Bobby Burch said he wants the Legislature to update the law requiring counties to pay inmate costs.

"When something uncontrollable like this occurs, it can have a domino effect on all budgets in the general fund," he said. "While we are fortunately in a financial position to absorb this predicament, it doesn't make it any less frustrating."

He said saddling county budgets with inmate health care costs creates potentially dangerous incentives.

"The current law entices a sheriff, who is sworn to uphold the law, to possibly show leniency if the person in question has a preexisting condition. I've never known any Lawrence County sheriff which I've worked directly with to do this, but there is no doubt the temptation is there ... and that's just flat wrong when it comes to protecting the public," Burch said.

— mike.wetzel@decaturdaily.com or 256-340-2442. Twitter @DD_Wetzel.