SICK AND IN JAIL: Taxpayers foot the bill for inmate illness or injury behind bars, but not preexisting conditions

May 13—Inmates must be provided with medical care while in custody, and in Cherokee County, the cost to taxpayers averages between $30,000 and $40,000 a year. But local jail officials say that's a "drop in the bucket" compared to what other facilities are paying out.

There are stipulations to the requirement. According to the Oklahoma state statute, Title 19-746, the custodial county is only liable for the cost of medical care for conditions that are not preexisting prior to arrest.

"A preexisting condition is a condition for which the person received medical treatment or advice, or a condition which was diagnosed in the six months preceding the custody of the person by the law enforcement agency. An accidental injury sustained during the six months preceding the custody of that person by the law enforcement agency will also be considered a preexisting condition," the statute reads.

Cherokee County Detention Center Jail Administrator T.J. Girdner said his facility has an advantage, due to W.W. Hastings Hospital being in the area.

"Ours won't be the same as other jails because of our population with Native Americans and [W.W.] Hastings Hospital, and so their health care is covered," said Girdner.

Girdner said the jail has contracts with medical professionals who drop by a few times a week.

"I have contracts with NeoHealth, where we get a discounted rate for services that we have to pay for. I have contracts with dental where we pay for that if someone comes in here with dental pain," he said.

Inmates must be taken to doctors' appointments if there are preexisting conditions, but Girdner said most of those who do time behind local bars are eligible for Medicare or Medicaid.

"We have to get them medically cleared, and if they are not medically cleared by a doctor, we get to foot the bill," said Girdner. "If an inmate falls and breaks their arm, then we pay for it. If a fight breaks out and the inmate doesn't have insurance, then we pay for it."

The jail has a "med aid" on staff who distributes medication to inmates, and a doctor is on call.

"We basically have to start all over by getting the meds started back up because we just can't call the pharmacy and say a certain person is in here and ask for their medication. It doesn't work that way; you have to go through a whole process of getting a doctor a new prescription, and most of these prescriptions have already been voided," Girdner said.

The same process is in place for inmates who suffer from mental illness, and it can take about two days before they are given their proper prescriptions.

Some inmates who are in and out of the facility have to be re-evaluated and re-examined each time they are housed there.

"You see the problem here. It can take days or weeks to get them lined back out on their medication," Girdner said. "Then an individual has the right to refuse medication — and they can tell me they aren't on any medication when I know they are, but I can't make them take it."

Girdner said if it's a life-threatening situation for which an inmate must see a doctor or take medication, but the inmate refuses, Girdner would need to get a court order from a judge.

"There was one individual who was wearing a ring that was so tight it was cutting off circulation, and his finger was black, but he wouldn't let us cut off the ring. I had to get a court order to take him to the doctor to cut that ring off to save his finger," he said.

And at least in Oklahoma, an inmate would not be able to get procedure like a facelift, breast implants, or gender reassignment surgery, since those wouldn't be life-threatening.

However, Girdner said that while some folks make "honest mistakes" and are taken to jail for the repercussions, some will intentionally commit crimes to reap the benefits of the shelter, food, and medications provided at the facility.

"There's statues out there, and there are laws that if someone comes in here with a preexisting condition, then we are not liable for those," Girdner said. "There are different scenarios so it can go one way or another."

According to the statute, jails don't pay the medical costs for preexisting conditions, but there are even exceptions to that.

"Unless a contract exists between a hospital and the county for medical care and treatment of inmates in the county jail, a hospital shall accept, as payment in full, reimbursement from the county according to the current fee schedule of the State and Education Employees Group Insurance Board in effect at the time services were rendered," the statute states.