The Pinellas County FL Jail will no longer charge an $8 co-payment to inmates seeking medical care, forfeiting an estimated $50,000 in annual revenue from a policy that jail officials said created more problems than profit.  Reported by the St Petersburg Times.

The jail used co-pays to help offset millions of dollars in medical bills and discourage requests for unnecessary treatments or bogus ailments. Most medical insurance does the same thing. In 1995, when the co-pays began, jail officials told the Times that the charges had cut demand for care in half, an early sign that they were clearing waiting rooms of all but those with real medical need. But in the years since, said Pinellas County Sheriff Jim Coats, the co-pays have bred hostility among inmates and bogged down staff with paperwork, making the tens of thousands in lost cash “not even worth it.” “The administrative reviewing and tracking of all that cost us more than we make,” said Sheriff’s Office Chief Deputy Bob Gualtieri. “The bang wasn’t worth the buck.”

Where Pinellas jail officials see a barrier to streamlining, other correctional institutions have found an opportunity for profit. From county jails near Tampa Bay to federal penitentiaries across the country, every facility charges a co-pay, returning tens of thousands of dollars annually to general funds. Jails in Hillsborough, Hernando, Pasco and Polk charge between $5 to $15 for medical visits, higher than the Federal Bureau of Prisons’ rate of $2. In 2005, when the co-pay system was instituted at all federal facilities, the bureau wrote it would encourage inmates “to be more responsible for their own health care.” A spokeswoman for the Florida Department of Corrections says the state feels the same way. Florida prisons earned $640,000 last year off a $4 co-pay, and in July state legislators increased the rate by a dollar. “The money obviously is a big part … but the other side of it is there are some inmates who would go to the doctor every day,” said department spokeswoman Gretl Plessinger. “And if they have a medical need, they need to go, we want them to go. But this minimizes inmates who might be trying to game the system.”

None of the county, jail or federal officials interviewed said they knew of plans to change their co-pay system, adding that the benefits of the charges made the collection process worth the trouble. Not so in Pinellas, Gualtieri said. Jail employees, including more than 100 floor nurses and doctors working in the jail’s $35 million health care building, said they felt weighed down by the often futile search for co-pays. The inmates didn’t like it either, filing more than 1,100 grievances complaining of medical care access, quality and cost last year. Inmate Eugene Betts, convicted of attempted murder, filed three lawsuits against the jail and two employees, claiming they charged him for treatment he didn’t request after he was beaten by other inmates. In each case, he asks for his $8 co-pay, $2 in interest and hundreds of dollars in court fees.

For a jail population that saw more than 350,000 medical visits last year, the invoices and complaints added up. With the co-pay policy gone, officials said, medical staff will be freed to deal with more hands-on care. “The nurses should be seeing inmates and treating them,” said Lt. Sean McGillen, “not filling out paperwork for co-pays.” Still, the decision to abolish the co-pays comes at a tough financial time for the Sheriff’s Office, which runs one of the state’s most populated jails. In the past 18 months, the office’s budget has been reduced by a quarter, meaning a loss of more than $67 million and 363 positions.

Coats said the Pinellas jail will continue to accrue revenue from other sources, like a recently increased $20 booking fee, to help pay for what amounted to $19 million in medical operation costs last year. The money inmates once spent on co-pays, taken out of commissary funds filled by donations from friends and family, will stay in the accounts allowing them to buy items like cookies and deodorant. Inmates at booking will no longer be informed of the co-pay, which was levied on inmates who requested treatment unrelated to mental health, pregnancy, infectious diseases or emergency care. During the co-pay period, inmates without money in their accounts were not denied medical attention, officials said.

Dr. Allen Beck, a Kansas City criminal justice planner who studied the Pinellas jail, said co-pays have grown popular because of the expensive costs of health care. Considering that the ratio of health problems like drug and alcohol abuse is higher among inmates, prison medical costs “chew up a budget in a hurry.” He added that there are valid arguments against collecting co-pays, including the amount of additional effort they demand. “It just doesn’t make good business sense,” Coats said. “You can only squeeze so much juice from an onion. Sometimes it gets to the point where it’s counterproductive.”

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Northumberland County PA Prison inmates will pay more to live in a cell than most city apartment dwellers because of a 50 percent increase in the daily boarding fee, according to the Daily Item.

The prison board has approved Warden Roy Johnson’s recommendation to increase inmate boarding fees from $10 a day to $15 a day. Johnson said the county’s recent financial struggles to narrow a projected $1 million deficit this year prompted him to look at ways to save money. “I’m trying to do my part in helping so the prison is not a burden on taxpayers,” he said. “I can’t always save dollars, but if I can save a dime, I will.” In supporting the boarding fee hike, District Attorney Anthony Rosini said the county’s actual daily cost to house one inmate is more than $55.

A recent edition of The Daily Item included advertisements for 12 apartments in Sunbury and just one of them had monthly rent of more than $450.

Johnson said any little bit the county can collect will be worth the effort. The prison collects well below 20 percent of the owed fees from sentenced inmates after their release. Work-release inmates have the boarding fee automatically deducted from their paychecks, but less than 10 percent of the 200 or so prisoners are participating in the program. “Most inmates simply ignore the boarding fee once they’re released,” Johnson said. After 90 days, the bill is turned over to Central Credit Audit, a Sunbury collection agency, but Johnson said the company hasn’t been successful … “I haven’t seen any checks coming in,” Johnson said, before correcting himself and adding that a former female inmate has been sending $5 each month.

The prison board also unanimously agreed to charge inmates a $1.50 transaction fee for each check they give the jail for commissary items. Johnson said the prison handles an average 5,700 check or money-order transactions every year and the fee will offset some costs. “It won’t be a revenue generator,” the warden said.

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Prisoners at the Knox County IL jail soon will have to pay for their stay in the county lockup, according to the Galesburg Register-Mail.

Sheriff David Clague told the Knox County Board Wednesday he hopes to raise over $100,000 a year by charging inmates $5 for each night they spend in jail. He also plans to put prisoners to work picking up trash and fixing area roads.  The Knox County Board voted in favor of Clague’s proposal Wednesday. Clague said all county department heads had been asked to try and find new revenue streams to offset reductions in state funding and the pressures of a weak economy.

The sole County Board member to vote against the plan to charge inmates for their stay in jail was Lyle Johnson.  He said the burden of paying the $5 charge could fall on relatives of inmates who have not committed a crime. “Somebody’s going to have to pay and it’s going to have be the family,” Johnson said.   Clague acknowledged that families would likely end up footing the bill, but said that might make criminals think twice before breaking the law. “If that’s a concern then they should consider that before going out and committing a crime,” he said. “I’m not making them pay the money, that family member is.”

Clague said inmates enjoy good living conditions at the public’s expense and he didn’t think it was unreasonable to expect them to pay for their time in jail. He said the practice is common in southern states and has been instituted in Peoria County.  “They are sitting in a cell paid for by the taxpayers with heating, air conditioning and three meals a day,” Clague said. “In return, why can’t we benefit somewhat?”

Most inmates will be able to afford the $5 nightly fee, Clague said. He explained that prisoners have special accounts where they lodge money to buy small items such as phone cards and painkillers while in jail. Money from those “commissary accounts” will now be used for the nightly fee. “About 92 percent of our current inmates have money on the books,” Clague said.  Prisoners who can’t pay, however, could be offered a chance to work on area roads to cover their bill. Clague said he had already hatched a plan to put prisoners to work in “menial” jobs that could save the county money.  Any prisoners selected to work outside will be carefully screened to make sure they don’t pose a safety risk. “Were not going to give them a chain saw or a knife or anything like that,” Clague said. He added that he had discussed his plan to put prisoners to work with the county’s highway department.

Clague estimated the county could net $110,000 a year by charging prisoners for their time behind bars and he expects to launch the scheme within the next week. He said the $5 fee was reasonable considering that some southern states charge up to $60 for a night in a cell … Some inmates are held in the county jail ahead of trial or court hearing, meaning they have yet to be found guilty. Clague said those inmates will still have to pay the $5 fee.

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The rates have been set: A bed at the Springfield Municipal Jail in Oregon is $60 a night. But the City Council’s decision Monday night to approve the fee did not come without a lengthy debate among the six-member board about whether the fee is fair, and whether the city can expect to collect enough from convicted inmates to break even for its efforts.  This report from the Eugene Register-Guard.

Councilors’ approval, in a 4-2 vote, came with the caveat that they expect an update in six months on the fee’s effectiveness.  “If this is something that within a certain period of time looks like it’s not working out … I see no point in wasting our time if it’s not cost-­effective,” Mayor Sid Leiken said.

The 100-bed jail is expected to open in October, and initial estimates are that the inmate housing fees could provide $18,000 of the jail’s $2.5 million budget.  But the ordinance will go into effect before the municipal jail’s opening, which means Springfield will soon begin charging inmates for part of the $109 a night the city pays for each of its five spots at the Lane County Jail …

Though he said he supports finding a way to charge inmates, Councilor Joe Pishioneri noted that many criminals are poor to begin with.   “Are we squeezing blood out of a turnip?” asked Pishioneri, a special services deputy with the county jail. “We need to keep a very close eye on it to see if it is worth our while. “There’s a reason many institutions don’t charge the housing fee, because it’s just not worth it,” he said.

Lane County does not charge a jail fee, but Klamath and Douglas counties both have daily rates.  Douglas County recently lowered its fee from $60 ­— the maximum charge allowed by state law — to $20 and is seeing better returns, jail administrators there have said.

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Salt Lake County UT Sheriff Jim Winder will pitch a pay-to-stay program that would require wrongdoers to pay a portion of their room and board while incarcerated.

“People who commit crimes ought to pay for them,”  Councilman Jim Bradley said.  So the County Council will consider a six-month pilot program that will charge inmates $40 a day to bunk at the 2,000-bed Adult Detention Center in South Salt Lake. That’s about half the actual cost, now pegged at $82 a day.  The policy would not apply to state and federal inmates. Nor would the jail pursue claims against “indigent” inmates.  “Are we going to offset the jail budget with this program? No,” Sheriff Winder said. “But in cases where people can pay, they should” …

It’s not much compared with the half-million dollars the jail in Logan spends on food or the $6.1 million needed for its overall operation. But it’s money “the taxpayer doesn’t have to pay,” said Capt. Kim Cheshire, commander of the Cache County Jail. The idea is hardly groundbreaking. Jails have imposed similar rules elsewhere in Utah, including in Cache County. There, officials likely will collect up to $100,000 this year from a jail population of about 310 inmates …

Yet Winder’s proposal could run into resistance in Salt Lake County, where some council members fear the policy would prove too burdensome for inmates already strapped financially. Bill dodgers wouldn’t have to serve more time for not paying, but they could face collections.  “My concern is that we will be sending people out the door with a bill that they cannot pay,” Councilwoman Jenny Wilson said. “These are people who are already down and out. It may just be too much.”

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Time in prison is supposed to reform inmates. Tacking on a bill for certain medications or room and board, and the reform might go further. So goes the thinking behind some draft laws winding through the Georgia State Capitol this session.

House Bill (HB) 464 proposes charging state prisoners a co-pay on every prescription from the prison dispensary that treats a passing illness, such as a cold. The bill excludes drugs for chronic conditions or pregnancy.   “It’s estimated that the cost of medication for our inmates this year will be in excess of $25 million. This is a way that they can pay a reasonable amount toward their healthcare,” bill author Rep. Barbara Massey Reece (D-Menlo) told a House State Institutions and Property Committee hearing.   She expects the fee would be $5 per prescription, though that’s ultimately up to the people in charge at each institution. Any inmate with less than $10 in their account wouldn’t be charged.

It won’t do much for the prison budget, but it may teach a “civics lesson,” according to Alan Adams, division director for health services at the department.  “The intent is for the inmates to shoulder some of the responsibility for their own healthcare, to make informed and adult decisions about when to access healthcare and when not to,” Adams testified to the committee, which approved the bill.  Most cold medicines and the like are prescribed after a prisoner initiates a sick call and is taken to the prison doctor. That call is already subject to a $5 co-pay.   “This will further discourage a malingerer or an inmate without a real problem from going to medical,” Adams said.  The co-pay could net the Department of Corrections some $1.8 million a year, according to their own calculations …

The more radical bill is House Bill 295, which would impound prisoners’ property on the outside to pay their medical bills.   It would also charge a $40 per Diem for a prison stay – $14,600 per year. The state’s average cost per prisoner per day was $46.27 as of March 2008.   Right now, the bill language excludes prisoners who are ruled unable to pay by a judge.

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Seeking ways to raise revenue, Philadelphia Prisons Commissioner Louis Giorla floated a proposal yesterday to charge criminals money to get in to city jails.

One previous study found Philadelphia inmates had an average of $35 on hand during the intake process, Giorla said. Acknowledging that many offenders wouldn’t be able to pay, he estimated the so-called admission fee would generate $300,000 a year …

[T]he admission-fee proposal [was] discussed during the second of three PhillyStat meetings that Mayor Nutter is holding to focus on the spending plans of specific city departments as his administration grapples with closing a $1 billion budget gap in the next five years.

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Several months after it was eliminated by the state of Indiana, Porter County officials have come up with a plan to reintroduce a jail booking fee that has funded a successful drug and alcohol program for inmates.  As reported by the NWTimes.

The proposal calls for again charging the $25 fee of everyone booked at the county jail, but returning the money to anyone found not guilty or whose charges are dismissed, County Attorney Gwenn Rinkenberger said … The state did away with the booking fee last summer on the grounds it was not fair, Porter County Commissioner Bob Harper said when the issue surfaced during a meeting in December … Rinkenberger said she disagrees with the state’s ability to eliminate the former version of the fee. She believes the county was within its rights to collect a fee to cover the cost of booking anyone at the jail, despite the outcome of cases.

The move left the county with a diminishing amount of money for the intensive outpatient treatment program provided for inmates by Porter-Starke Services … Until the revamped fee can be approved, the commissioners will dedicate $30,000 to $40,000 of county income tax revenue to keep the inmate treatment program alive, Harper said.  The treatment program costs the county $120,000 a year, Porter County Sheriff David Lain said.

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Inmates at the Des Moines County jail in Burlington IA may have to begin paying for toilet paper, according to the AP.

The county is facing a more than $1.7 million deficit in this year’s budget and the Board of Supervisors gave department heads the option of cutting costs or facing the possibility of unpaid furloughs or layoffs.  The county also is moving forward with a $1 million bond issue later this month, leaving department directors to make up the balance.   County Budget Director Cheryl McVey says billing inmates for toilet paper could save more than $2,300.

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From a press release issued by the Bristol County MA Sheriff’s Office:

Aware of the economic crisis facing government at every level — federal, state and local — Bristol County Sheriff Thomas M. Hodgson is calling for legislation that will allow the Department of Corrections and all Sheriffs to adopt the $5-a-day cost of care fee that enjoyed such success while it was in effect from 2002 to 2004 in Bristol County … Sheriff Hodgson is suggesting a daily custodial care fee of $5, and a $5 fee for sick call visits, dental visits, a prescription eyeglasses fee and a $3 co-pay for prescription drugs.

Sheriff Hodgson gave an interview to a local TV station where he expanded on his plans.

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• Dallas County TX is set to impose a $10 medical screening fee, and wants a $25 room and board fee as well.
• Montgomery County PA looks to house arrest for work release inmates.

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• Prison populations in England & Wales are “out of control“, say reform groups; more than 10,000 over capacity.
• New superintendents for Coyote Ridge and Walla Walla Prisons in Washington State.
• Three top officials at CDCR have resigned their positions, two to work for the medical Receiver.
• Alabama’s DOC continues to sell land to raise operational revenues.
• Dallas County TX is considering charging bed-and-board to inmates.

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• Canada’s only military prison is far tougher than any civilian prison.
• Tougher sentences and yet another reorganization expected in the UK.
• A $25 inmate booking fee in Porter County IN is questioned by the State Audit Board
• The Gov of Kansas’s son sells a “Don’t Drop The Soap” prison board game.
• Nurses launch whistleblower suit against CCA.

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