News Photo by Steve Schulwitz Corrections Officers Sirena McPherson, left, and Travis Marciniak distribute medications at the Alpena County Jail. The county is responsible for medical costs of inmates, but contracts with a nurse to handle most medical needs. Corrections officers also can provide limited care when the nurse is out of the building.

ALPENA — Each year the Alpena County Board of Commissioners budgets more than $100,000 that will be spent to ensure inmates at the jail have quality health care. However, it is rarely reimbursed after the inmate is released.

Once an inmate is incarcerated, the county is liable for health issues inmates may have while in custody. Many of the health and dental issues are dealt with in-house, but at times trips to the emergency room are needed and the bills from those fall to the county. Those expenses are never recouped.

Holly Wyman, administrative assistant to the sheriff and undersheriff, said jail administrators, commissioners and Treasurer Kim Ludlow are always trying to find ways to make sure inmates are healthy. One way is to have medical staff available on site who can handle health and injuries.

Wyman said the sheriff’s department contracts with a company that provides nurses to assess and treat many health matters, but when there are more serious issues a doctor comes to the jail to treat the inmate. She said psychiatric therapists also are under contract to help inmates with mental health issues.

Ludlow said in 2015 the county absorbed medical and treatment contract costs from the jail of $92,494, and $98,045 in 2016.

Through April 27 the county already has paid $36,329 from the $125,000 the commissioners budgeted for 2017. Ludlow said the five-year average is $99,090

Wyman said in-house services help to keep health care costs lower than what they would be than if a trip to the emergency room was taken every time an inmate fell ill or hurt themselves.

“I would say with the 22 years of experience I have, that it would cost between $300,000 and $400,000 if we didn’t have the nursing contract,” she said.

Wyman said an account is set up for each inmate and of money deposited the county can take 25 percent of it when expenses regarding arise. She said if an inmate needs to see an on-site nurse they get billed only $5 and $10 if a doctor is needed. Despite the low cost, when the medical expenses are added to the daily lodging charge, many inmates have large bills when they are released and most times the county sees little of that repaid.

“We work hard to bill and collect from them, but many times they bounce from place to place and we can’t find them,” Wyman said. “We do turn over the debt to a collection agency that will pay us 100 percent if the debt is paid in 30 days, but after that we only get back 50 percent.”

Jail Administrator Scott Gagnon said when an inmate is sick, he fills out a brief request to see the nurse — who is on site between 30 and 35 hours — describing their condition. When the nurse sees an inmate, they do an assessment and contact a doctor who will order what type of treatment is needed. If an inmate requests medical attention after the nurse leaves for the day, correction officers will do a basic assessment, including vital signs and call the doctor, who will recommend if the inmate should go to the emergency room, receive medication, or wait for the nurse to give a more thorough examination.

Gagnon said the inmate always has the option of demanding a second opinion, but it rarely happens and most times the recommendation of the doctor is followed.

“If someone wants to get a second opinion, they must pay for it in advance and also pay for the transportation and other charges,” Gagnon said. “This rarely happens because many of these people don’t have the type of money to pay those for types of services.”

There are occasions where inmates become ill with something contagious and special accommodations are made. Gagnon said at times that means isolating the inmate from the others.

“We have a policy that we won’t subject people to undue harm, so we will isolate someone until they are no longer a risk to themselves or other, for as long as they are lodged,” he said.

Commissioner Cam Habermehl said making sure inmates are healthy and in good care is important, but he said the cost of doing so is a burden on county finances. He said he believes inmates should be responsible for all medical treatment, whether it is at the jail or hospital.

“I think they should have to pay for it, but the law says we have to so we do,” Habermehl said. “There are a lot of things that would be fixed or paid for with the money we use for inmate health care, like a new jail, but we can’t.”

Besides the nursing contract saving the county money for hospital visits, Habermehl said it also helps protect the county from potential lawsuits. He said corrections officers used to distribute medications and did a good job, but if a mistake was made the fallout could be costly.

“It helped us eliminate a large liability issue while also freeing up corrections officers to do other parts of their job,” Habermehl said. “Things would be a lot more costly if we didn’t have that contract.”

Steve Schulwitz can be reached via email at sschulwitz@thealpenanews.com or by phone at 358-5689. Follow Steve on Twitter ss_alpenanews.

News Photo by Steve Schulwitz
Corrections Officers Sirena McPherson, left, and Travis Marciniak distribute medications at the Alpena County Jail. The county is responsible for medical costs of inmates, but contracts with a nurse to handle most medical needs. Corrections officers also can provide limited care when the nurse is out of the building.

Alpena County

inmate health care expenditures.

2012 $112,467

2013 $88,531

2014 $103,494

2015 $92,494

2016 $98,045