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Bill Would Lower Jail Health Care Costs: State Medical Groups Opposing Measure

Posted on: Wednesday, 15 February 2006, 06:00 CST

By Owen Covington, Messenger-Inquirer, Owensboro, Ky.

Feb. 15--FRANKFORT -- In recent years, just a handful of Daviess County jail inmates have had health insurance to help cover medical treatment they required while being held at the facility, Daviess County Jailer David Osborne said.

One inmate required treatment that cost about $20,000, and a current inmate has been hospitalized for more than a week after he was seriously injured in a fight at the jail, Osborne said.

With the county picking up the tab to treat inmates who are indigent, which includes almost all inmates, Osborne said, lowering what the jail pays for treatment could bring substantial savings.

"I think it would be absolutely beneficial for our county and for every county to get that lower price," Osborne said.

Under a bill proposed by Rep. Brad Montell, a Shelbyville Republican, counties would only be required to pay Medicaid rates for medical procedures.

Although House Bill 84 was approved by the House Local Government Committee on Tuesday, it faces opposition from the Kentucky Medical Association and the Kentucky Hospital Association.

"We have not reached a compromise," Montell said, adding that he is working with the hospital association on an amendment to the bill.

People eligible for Medicaid lose that eligibility if they are jailed, and the cost of their health care falls to the county if they are not a state or federal inmate, Montell said.

"It can be a tremendous burden on our counties to try to fund the health care needs of our inmates," Montell told the committee.

The state helps pay for that medical treatment, but only $400,000 is allotted each year, which leaves many counties covering the medical bills for their indigent inmates, Montell said.

The Daviess County Detention Center receives a 20 percent discount from Owensboro Medical Health System on medical treatment, which has helped ease the financial burden, Osborne said.

But not all counties have been able to work out arrangements with their health care providers, Osborne said.

Bob Doll, an attorney speaking on behalf of the medical association, said he has been working with Montell to perhaps adopt a fee schedule in line with Medicare, which would have higher rates than the Medicaid fee schedule but lower than what many jails are paying now.

Osborne attended a Kentucky Jailers Association meeting Tuesday in Frankfort, where he said most jailers approved of adopting Medicare rates but would prefer Medicaid rates.

"That would be a substantial savings right there," Osborne said of the Medicare rates.

Montell said it has been difficult to work out the Medicare fee schedule because of variances in charges and the fact those fees are determined at the federal level.

"We have a lot of sympathy for the situations with which the counties in this state and jailers in particular are confronted," Doll said. "At the same time, while they may have a funding problem ... to shift it to us from them doesn't seem to us to make a whole lot of sense."

Montell said he will continue to work with the hospital and medical associations before the bill is presented to the full House for a vote.

"I'm very hopeful that we can work out a compromise," Montell said.

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Copyright (c) 2006, Messenger-Inquirer, Owensboro, Ky.

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Source: Messenger-Inquirer

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