Medical Care Will Be Billed To Prisoners County Commissioners Approve New Fees

There may be a free lunch in jail. But a visit to the doctor isn’t - not anymore.

Spokane County commissioners on Tuesday unanimously approved new medical-care fees for prisoners. That could likely save taxpayers thousands of dollars.

Those in jail are now billed if they need a doctor. If they have insurance, their providers pay.

Either way, the bill will equal what an outside clinic would charge for the same treatment. “We’re not going to pay for them if they’re not indigent,” Commissioner John Roskelley said.

The uninsured poor will be billed only small fees - $12 for a doctor, $10 for a nurse, $6 for X-rays. If they can’t pay, the county eats the cost.

The county used to pretty much lick that plate clean, jail nursing supervisor Margy Triplett said. “Basically, the taxpayers just paid for it - 100 percent.”

Close, anyway. Prisoners paid a total of about $5,000 for medical care last year. “It was just pennies really,” said Triplett.

That’s because nursing salaries and doctor contracts will cost the county about $776,000 this year, jail office supervisor Kay Donder said.

Until now, inmates of all stripes were asked to pay $5 for any visit to a nurse or doctor. But hardly any of them paid. The jail clinic didn’t even have a billing department until Sept. 2.

Now, “all care gets billed somewhere,” Triplett said.

State law has allowed such billing for years.< King and Pierce counties also bill their jailed patients. But they do it differently than Spokane now does, Triplett said. “We are the only ones doing what we are doing.”

King County uses a co-pay billing system, said Jim Harms, a program analyst for that county’s jail. But prisoners there pay a flat fee, not a service-based charge as Spokane County now does.

Spokane worked on its plan for a couple years, finally designing one modeled after that of federally-funded community clinics.

That’s somehow fitting. “We serve a small town,” Triplett said. It’s one that’s sicker than any other type of burg.

Jail has become not just a punishment mill, but a home for the extremely ill. There are intravenous drug users. And increasing numbers of inmates with tuberculosis, HIV, hepatitis.

“We also have a large number of mentally ill people in jails,” Triplett said. In years past, she said, they’d be in mental institutions.

Spokane’s jail holds about 700 prisoners, Triplett said. A whopping 800 of them get medical care each month. On a given day, as many as 40 see a nurse or doctor.

Triplett’s not sure why there are so many medical visits. Still, she has a theory: There seem to be more felons and career criminals. They’re older, more experienced, behind bars longer - and more likely to have health problems.

Prisoners in for misdemeanors are often young rookies, “just starting out,” Triplett said.

The rest can be in pretty bad shape.

“The standard is, they’re sicker and have more injuries than average.”

, DataTimes