County must pay for inmates' dialysis expenses

[okarol]

November 17, 2007 11:22 PM EST

County must pay for inmates' dialysis expenses

By J.D. Prose, Times Staff

HOPEWELL TWP. — Two Beaver County Jail inmates have cost county taxpayers nearly $200,000 this year because they require dialysis treatments three times a week and the county is liable for their health care.

“Probably all of our cost overruns will be attributable to those two guys,” said Warden William Schouppe. The inmates weren’t identified because of privacy laws.

At the prison board’s October meeting, Beth Harris, the nurse employed by Southern Health Partners, the jail’s medical provider, told officials that one man spent seven months getting dialysis treatments, costing the county $111,000, while a second man, who remains in the jail, had up to that point cost the county $75,000 for three months of treatments.

Dialysis is for people whose kidneys don’t function properly or have stopped working altogether.

Schouppe said the inmates required dialysis three times a week at a cost of $1,200 per visit. Each treatment lasts between four to six hours, not including time spent traveling between the jail in Hopewell Township and Liberty Dialysis near Aliquippa Community Hospital.

One or two deputies accompany each inmate, depending on how long they’ve been in jail and the seriousness of their crime, said Capt. Tom Shane of the county’s sheriff’s office, which transports inmates.

A trip with a dialysis patient takes up an entire shift, said Shane, who suggested that dialysis be done in the jail to reduce costs and improve security.

So far this year, Shane said his office has spent at least $11,700 on escorting inmates to dialysis treatments. Combined with the medical costs of the procedures that brings the county’s total cost to $196,700.

Besides the expense, transporting inmates out of the jail at regular times every week just invites trouble, Shane said. “The chances of an escape are greater,” he said. “From a security standpoint, it would be safer to have (dialysis) in-house.”

Harris, though, told the prison board last month that she spoke with Southern Health officials and they balked at bringing dialysis to the jail because of liability issues. She also said doing so wouldn’t make sense because the jail only occasionally has dialysis patients.

“It’s kind of like a hit-or-miss thing,” Harris said.

And, she’s right. Most of the time, the county doesn’t have to worry about inmates with major health problems, Schouppe said.

Before the two dialysis patients arrived this year, he said the last major health issue was in 1999 when an inmate requiring brain surgery cost the county $167,000.

Schouppe said he will discuss dialysis with Southern Health executives, but he doubted that the liability risk to the county could be overcome. Also, he said the only savings incurred by doing dialysis in the jail would be the transportation costs because the county would still have to pay for the treatments.

One of the two inmates requiring dialysis has since been released, but another remains in the jail and is still receiving county-paid treatments three times a week, said Schouppe, who expects that man to stay incarcerated for at least another five or six months.

Butler County Jail Deputy Warden Arthur Marx Jr. said his facility also sends patients out for major medical treatments. Providing health care to inmates simply comes with the territory of running a jail, he said.

“If we’re going to keep people, we have to be responsible for them,” Marx said. “It’s a problem that we have, but there’s really not much we can do about it.”

J.D. Prose can be reached online at jprose@timesonline.com.

FREE DIALYSIS

Beaver County has spent about $200,000 this year on dialysis treatments and transportation for two jail inmates. One such inmate remains in the jail and could be there for another six months, which means the county could pay nearly an additional $90,000 for treatments.

Warden William Schouppe said one inmate was diagnosed in the jail. The other had a pre-existing condition, but the county became responsible for his health-care needs when he was booked into the jail, Schouppe said.

BY THE NUMBERS

$200,000 equates to about one-tenth of a mill in county taxes.

NO CHOICE

“We just have to pay the bills.”  -- Butler County Deputy Warden Arthur Marx Jr. on the options for jails that have inmates with severe medical problems

http://www.timesonline.com/articles/2007/11/18/news/doc473fbb1666503848439612.txt

[BigSky]

Here they do not put people in jail if they are on dialysis just to avoid such costs.  If the crime is bad enough requiring jail time they would put the person on house arrest as to still avoid medical costs.

Makes my wonder if the sheriff in the article is just trying to fatten his budget since the sheriff doesnt use the option of house arrest to avoid such medical expenses.

[goofynina]

When i was in-center, afternoon shift, they would bring in at least 8 inmates, shackled and cuffed and carrying their sack lunches (cuz they were there for their dinner time)  there were at least 4 cops there, just sitting there, reading their paper, or talking on their phones, i can definetly see how it could be expensive to have these inmates treated. 

[okarol]

I wrote to the journalist and asked why these patients are not on Medicare, like anyone else. No reply yet.

[angela515]

Backstory.

In 1999 I was young and dumb, and I had finally left a boyfriend who was beating me. Well, he wouldn't give me back my stuff.. so I took matters into my own hands, and entered the house with him not there since I knew it was kept unlocked, and I went in and got my clothes and some of my other things. To make a long story short, he called the police and I was arrested for breaking and entering. I was sent to jail, and I was there for 7 days. During this time, I was going through renal failure, and I tried explaining this to the medical person there, and she didn't seem to care too much. They removed me once a day and took my blood pressure and that's it. I felt very sick everyday, all day, and finally passed out during my stay. They took me in shackles to the hospital where I was treated and they were told how they were supposed to care for me. Another long story short, my ex left harassing messages on my pager and the judge dropped the charges. Ty God! I learned my lesson... just forget your stuff and move along.

Anyways, even after the hospital visit, they changed nothing and treated me the same... they could careless in there what your medical problems are.

[Black]

I wrote to the journalist and asked why these patients are not on Medicare, like anyone else. No reply yet.

Maybe someone should tell them about NxStage too.

[okarol]

From: Karol
Sent: Monday, November 19, 2007 3:02 AM
To: Prose J D
Subject: Times article

Hi JD - I read your article and am so confused. You say "Two Beaver County Jail inmates have cost county taxpayers nearly $200,000 this year because they require dialysis treatments three times a week and the county is liable for their health care." Renal failure requiring dialysis is one of the few disabilities that is quickly covered by Medicare - once the patient begins dialysis they qualify (after a short waiting period) and their transportation costs are covered as well. Any explanation why these prisoners aren't covered like any other patient?
Thanks,
Karol
http://www.ihatedialysis.com

-----

Date:    Tue, 20 Nov 2007 16:08:25 -0500
From:   "Prose J D" <JProse@timesonline.com> 


Karol,

Don’t know. Officials never brought it up and I never knew to ask. I’ll check it out. Thanks.

jdp

[angela515]

Great job brining it to his attention Karol.

[ahamner]

I wrote to the journalist and asked why these patients are not on Medicare, like anyone else. No reply yet.

Just a guess, but Medicare may consider themselves to be the secondary payor for the first thirty months.  That is what they do when you have other insurance.  They may consider the jailors as the primary payor since they are responsible for the costs.

BTW, Davita is pushing to have a bill passed in Congress to extend the 30 month waiting period to 42 months since they receive much higher payments for dialysis services from others than they do from Medicare.  Congress likes the idea as well since it would reduce medicare costs by shifting the costs to private insurers.

[kitkatz]

Davita sucks rocks!

[okarol]

From: Karol
Sent: Monday, November 19, 2007 3:02 AM
To: Prose J D
Subject: Times article

Hi JD - I read your article and am so confused. You say "Two Beaver County Jail inmates have cost county taxpayers nearly $200,000 this year because they require dialysis treatments three times a week and the county is liable for their health care." Renal failure requiring dialysis is one of the few disabilities that is quickly covered by Medicare - once the patient begins dialysis they qualify (after a short waiting period) and their transportation costs are covered as well. Any explanation why these prisoners aren't covered like any other patient?
Thanks,
Karol
http://www.ihatedialysis.com

-----

Date:    Tue, 20 Nov 2007 16:08:25 -0500
From:   "Prose J D" <JProse@timesonline.com> 


Karol,

Don’t know. Officials never brought it up and I never knew to ask. I’ll check it out. Thanks.

jdp

Today - note from the journalist:

I got your answer. The warden said inmates lose their benefits when they’re jailed.

[Chris]

Now to think of it, i think it says so in the Medicare book you get every year. I haven't read it since about 2000 though. I get it and it just sits there for a year till the next one comes.

[Wattle]

   What about Meds? Would they also pay for meds?

Note to oneself..... If I am unable to pay for insurance, dialysis or meds..... just do something to get myself in jail and all my problems will be solved!

[tamara]

  What about Meds? Would they also pay for meds?

Note to oneself..... If I am unable to pay for insurance, dialysis or meds..... just do something to get myself in jail and all my problems will be solved!

[/b]


Sally, if you ever need a getaway driver I'll be there ! 

[qwerty]

I wrote to the journalist and asked why these patients are not on Medicare, like anyone else. No reply yet.

Just a guess, but Medicare may consider themselves to be the secondary payor for the first thirty months.  That is what they do when you have other insurance.  They may consider the jailors as the primary payor since they are responsible for the costs.

BTW, Davita is pushing to have a bill passed in Congress to extend the 30 month waiting period to 42 months since they receive much higher payments for dialysis services from others than they do from Medicare.  Congress likes the idea as well since it would reduce medicare costs by shifting the costs to private insurers.

Our Pt "Ambassador" arranged for a Congressman to visit recently in the Davita I work at regarding the bill and to speak with pts's. He stayed in the pt area a whooping 5 mins and was out of there. We are also attempting to get a Senator and Presidential Canidate in within the next month. Be interesting to see. I know several others that have been contacted responded "thier schedule didnt permit".  And you can bet they had more than enough staff that day and plenty of shrimp rings. Lots of balloons and so on. The day after and every day since it's been the same old grind with 1 nurse who is also the charge nurse and 2 techs. That day we could take bottled drinks and coffee out to the pts yet next day we are back to only the little medicine cup (1oz) from the tap LOL. Pray for me that my resume gets looked at else where this week as I agree "davita sucks"!!!! They only retirement they even contribute to for employees is if we buy thier stock LMAO. I worked yesterday from 4:30 am to 10pm as the only nurse. Wish congress would come in unannounced and shadow us for a day and see just how it really is for (excuse me I hate the word Patient) "Clients" . ok ok, back on subject lol.

[KT0930]

  What about Meds? Would they also pay for meds?

Note to oneself..... If I am unable to pay for insurance, dialysis or meds..... just do something to get myself in jail and all my problems will be solved!

[/b]


Sally, if you ever need a getaway driver I'll be there ! 

Just be sure to get locked up in a county where the jail is accredited, otherwise you'll end up with Angela's nightmare treatment!