Jail inmates needing treatment for mental illness, addictions and other conditions are putting a strain on county finances in Minnesota.
For the first time, medical care costs more than food at the Washington County jail, where inmates often arrive with complex health problems that strain county finances. Sheriff Bill Hutton and the jail commander, Chuck Yetter, say they’re forced into constant reviews of the jail budget because of unpredictable surges of illnesses ranging from chronic diseases to depression, alcoholism and drug abuse. “We have these conversations everyday because they’re budget busters,” Hutton said.
In metro counties and elsewhere in Minnesota, medical costs in jails are surging, driven by what the director of the Minnesota Sheriffs Association calls a “perfect storm” of circumstances. “It’s well known that our mental institutions have basically closed so by default our jails have become our mental institutions,” said director Jim Franklin. “It boils down to who’s going to pay? Out of what budget? In the end, it all comes out of the taxpayer’s pocket.”
Inmates bring more medical needs than ever.
In many cases, they require expensive medications. Some haven’t seen doctors in years, others skip from one emergency room to another seeking treatment for their ailments, and often it’s discovered that inmates booked into jail carry contagious diseases. To avoid legal, moral and ethical dilemmas, sheriffs must treat jail inmates despite occasional public concern that money’s being wasted. “A sheriff may be an elected official but nobody’s appointed him to be God,” Franklin said. “For public safety and all other kinds of reasons you have to address those issues.”
In Washington County, 35 percent of jail inmates are treated for mental illnesses. Thirty percent have drug and alcohol problems, 30 percent have dental decay, 25 percent have diabetes and 25 percent have heart disease. Many inmates suffer from several afflictions at once. A physician’s assistant comes to the jail three days a week. Nine nurses work part-time from 6:30 a.m. to 10 p.m. The jail also contracts with a doctor, a dentist, and pharmacy and laboratory services. About 160 inmates occupy the Washington County jail on weekdays, about 200 on weekends. The average length of stay is about a month.Washington County plans a 10 percent increase in next year’s jail medical budget for a total of nearly $800,000. And that’s after a steep decline in the number of methamphetamine arrests in recent years.By comparison, the jail’s food budget for 2009 will be $545,000, same as this year.
Other metro counties in MN are reporting similar challenges.
Dakota County’s medical costs last year were up nearly 30 percent over the $1 million budgeted in 2006. About $325,000 was spent on medicine for inmates and $420,000 for nurses. In Scott County, Capt. Bonnie Case said the jail contains many mentally ill inmates who need psychotropic medicine and many who have dental problems related to methamphetamine use. In Anoka County, the medical costs of just two inmates totaled about $200,000, said Capt. Dave Pacholl, the jail administrator. That’s more than one-fifth of the total budget for a jail that houses 200 to 230 inmates per day.
In Hennepin County, the number of inmates who received mental health assessments jumped from 1,990 in 2005 to 3,200 in 2007. “It’s a sign that the mental health system is breaking down,” said Mandy Dageford, the jail’s nurse manager. “We have people who have been arrested on minor charges, and in the past they went to beds elsewhere after they were released. Now there’s nowhere else to take them.”
The Minneapolis-St Paul Star-Tribune article has more details.
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