INMATE MEDICAL COSTS BREAK OUT OF JAIL'S BUDGET

Rising medical expenses are taking a bigger chunk of the Pratt County
Sheriff's Department budget.

Medical expenses this year are at a point that if they continue at the
present rate, they will double the total for 2004, said Pratt County
Sheriff Vernon Chinn.

The medical expenses have reached $12,000 this year. The total for all of
2004 was $10,500 so with four months of the year left the final amount will
approach if not surpass the 2004 amount.

These expenses are coming from the usual types of medical problems that are
associated with prisoners that have drug and alcohol problems. but there
has been no unusually big medical expense. The increase is not being caused
by any unusual medical expense like surgery, Chinn said.

Surgery can cause a dramatic jump in medical expenses. A jail in Kansas had
to pay for an open heart surgery that cost over $100,000. With an annual
budget of $720,000, that would cause a serious problem for the department.

During his term as sheriff, Chinn has had to deal with a couple of
appendicitis's and half a dozen surgeries. Whether it's a new medical
problem or a pre existing issue, the sheriff's department has to cover it.

From 40 to 50 percent of the department budget the expenses of housing
prisoners, Chinn said.

Increasing medical costs is a reoccurring problem because of the number of
prisoners who have drug and alcohol problems.

"The bulk of the people in jail have abused their bodies with drugs and
alcohol," Chinn said.

When a person is arrested their medical expenses become the responsibility
of the sheriff's department. The only time the jail doesn't have to cover
medical expenses is if the person has their own medical insurance or are
covered by a state agency but those times are rare.

When a person is incarcerated and has been getting medical assistance from
Social and Rehabilitation Services or Social Security, those agencies can
and do revoke those medical privileges.

Nearly 100 percent of the people who come through the jail system either
don't have or can't afford their own insurance.

"I've seen it twice in five years," Chinn said. "Most of the people we see
can't afford it and don't have it."

The other agencies have the option to drop medical assistance but the jail
can't. They have to handle any medical problem no matter how large or small.

Without outside insurance, the people in the jail system frequently don't
take care of medical problems. The abuse their bodies and don't get a
checkup, Chinn said.

Some of the problems Chinn sees in the jail include addiction, bad teeth,
liver problems, brain damage, increased chance of stroke, a high risk of
exposure to HIV and hepatitis. The use of methamphetamine is a leading
cause of the more serious problems, Chinn said.

Severe depression is also a serious problem. All of these issues have made
the risk of suicide rise.

"The suicide risk in jail is higher than it ever has been just because of
those issues," Chinn said.

The use of medicines to counter act the effects of drug use has increased
with the number of patients. When a drug addict leaves a drug society and
enters the jail system they sometimes need medication to help their bodies
adjust to the lack of drugs. Some prisoners are easier to deal with if they
don't give up drugs "cold turkey."

The number of prisoners in the jail has been increasing because of stiffer
laws and over crowding in prisons which has resulted in more prisoners
serving time in the county jails, Chinn said.

With increasing populations the number of medical issues rises as well.

Budgeting for medical expense is a difficult task at the least. Since it is
unknown how many prisoners will go through the jail system and what kind of
medical issues they will have to face, the budget can vary greatly from
year to year.

The number of female prisoners is increasing because of drug related
arrests. As those numbers increase so does the number of pregnant inmates
and any health issues specific to a pregnancy have to be covered by the jail.

Prisoners have been known to take advantage of being in jail to have
medical problems taken care of that they had ignored. Some have even
bragged that they will more expensive to deal with on the inside of the
jail than they were on the outside, Chinn said.

The Pratt County Jail has a 30 prisoner capacity and averages 55 to 60
percent capacity during the year.