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The McCracken fiscal court approves a managed care program and county leaders hope it will create substantial savings.

By Anne Thrower athrower@paducahsun.com--270.575.8653

Thursday, October 06, 2005

Having paid a half million dollars for medical coverage for inmates last year and expecting to pay even more this year, the McCracken County Fiscal Court agreed Wednesday to be the first county in the state to try a managed care program for inmates.

The program, a joint proposal through the Kentucky Association of Counties and Peel & Holland Financial Group, will cost the county $12 per inmate per month or about $40,000 annually for the roughly 300 county inmates. The remaining 100 or so state inmates have their health care covered by the state.

It’s not immediately known how much the county will actually save since it depends on what medical services are needed. But county officials hope there will be a substantial savings, or at the very least, the plan will keep costs from rising even higher because the inmates will be part of a network that can negotiate discounts.

Last year the county spent $511,000 for inmate medical care. But since July 1, the county has already spent $204,000 of the $350,000 budgeted for medical care. “That’s what is driving this,” said Will Reed, an account executive with Peel & Holland in Paducah.

Currently, the county does get a 25 percent discount from Paducah’s two hospitals. But the discount is based on the full price, not a negotiated discount arranged through a third-party administrator.

Commissioner Zana Renfro was concerned the public might conclude the county was providing insurance for inmates or the county employees would think their medical coverage is not as good as the inmates.

By law, the county has to provide life-threatening medical care for inmates. Three inmates needed intensive care treatment in the past two weeks.

The managed care program, which starts Oct. 15, does not address the issue of who pays medical costs if a person injured while in the process of being arrested. The plan, however, requires that all patients be accompanied by a deputy jailer in order to receive treatment.

The third-party administrator — which will be Employee Benefit Consultants — will make sure the county gets the best discounts the program offers, Reed said. It will also check for double billings, he said. Jailer Bill Adams said he found one bill in which the county paid $1,900 twice.

The plan could include drug coverage, but Reed was not sure if the county would see a savings there. Currently, the county spends about $10,000 a month for prescriptions, as little as half as much as it spent in recent years.

The plan as approved doesn’t cap the amount the county pays; it simply offers discounted rates for medical services. Reed said he would like to see a limit on the county’s liability added in the future. The county can opt to get out of the plans with 30 days’ notice.

Reed suggested the county try the plan for six months and then compare what it would have cost if the plan had not been in place. ical facilities.

By Anne Thrower athrower@paducahsun.com--270.575.8653

Wednesday, September 14, 2005

The tone of Tuesday's visit by a medical specialist with the U.S. Department of Justice was noticeably better than in past years, McCracken County officials said.

"I would have to say it was one of the best visits we have had," said Jailer Bill Adams, referring to the visit by Dr. Joseph Fowlkes, who spent Monday and Tuesday reviewing medical practices at the facility.

The medical area has been one of the more intensely probed areas by U.S. Justice Department officials since its first visit in 1998. Almost half of the county's 30-page agreement signed with the Justice Department in 2001 related to the physical and mental health of inmates.

Justice officials do not talk to the media during their visits. Andrew Barrick, an attorney with the special litigation section of the Justice Department, is in charge of the follow-up visit.

No major concerns were brought up, Adams said, but they were interested in the jail's procedures for testing inmates for tuberculosis. Two prisoners tested positive for the disease earlier this year, forcing the jail to test all inmates.

County Administrator Steve Doolittle said justice officials requested information related to the TB incident prior to the visit. But he declined to talk about specifics of the conversations with federal officials, saying he was concerned about future litigation.

Neither Doolittle, Adams nor County Attorney Dan Boaz thought the TB incident would hurt the county's ability to meet the conditions agreed upon in 2001.

During Fowlkes visit last year, he suggested the county should hire a physician's assistant. Since that time, the county hired Reetha Guminski, who started giving TB skin tests as well as other tests to inmates within 14 days of their arrival. Doolittle said Guminski has saved the county thousands of dollars in medical costs since her arrival earlier this year.

On Monday, Jim Balsamo, an environmental consultant, pointed out a few areas of concern in his exit visit with county officials. For example, he cited some dark spots in the jail that needed better lighting, Doolittle said.

Balsamo was also concerned that the carts used to take inmate food from the kitchen to their cell areas needed to be smaller and carry fewer trays of food so the food would stay warmer, Doolittle said.

Balsamo noticed the effect the smoking ban has had on the cleanliness of the jail, Doolittle said. Also, all the alarms worked and the water in the sinks was hot enough, he said.

Justice officials will write a report based on this week's visit and will decide if future visits are necessary. Barrick and a corrections specialist plan to complete his visits later today.


	Plan to cut inmate health care costs
		The McCracken fiscal court approves a managed care program and county leaders hope it will create substantial savings. By Anne Thrower athrower@paducahsun.com--270.575.8653 Thursday, October 06, 2005 Having paid a half million dollars for medical coverage for inmates last year and expecting to pay even more this year, the McCracken County Fiscal Court agreed Wednesday to be the first county in the state to try a managed care program for inmates. The program, a joint proposal through the Kentucky Association of Counties and Peel & Holland Financial Group, will cost the county $12 per inmate per month or about $40,000 annually for the roughly 300 county inmates. The remaining 100 or so state inmates have their health care covered by the state. It’s not immediately known how much the county will actually save since it depends on what medical services are needed. But county officials hope there will be a substantial savings, or at the very least, the plan will keep costs from rising even higher because the inmates will be part of a network that can negotiate discounts. Last year the county spent $511,000 for inmate medical care. But since July 1, the county has already spent $204,000 of the $350,000 budgeted for medical care. “That’s what is driving this,” said Will Reed, an account executive with Peel & Holland in Paducah. Currently, the county does get a 25 percent discount from Paducah’s two hospitals. But the discount is based on the full price, not a negotiated discount arranged through a third-party administrator. Commissioner Zana Renfro was concerned the public might conclude the county was providing insurance for inmates or the county employees would think their medical coverage is not as good as the inmates. By law, the county has to provide life-threatening medical care for inmates. Three inmates needed intensive care treatment in the past two weeks. The managed care program, which starts Oct. 15, does not address the issue of who pays medical costs if a person injured while in the process of being arrested. The plan, however, requires that all patients be accompanied by a deputy jailer in order to receive treatment. The third-party administrator — which will be Employee Benefit Consultants — will make sure the county gets the best discounts the program offers, Reed said. It will also check for double billings, he said. Jailer Bill Adams said he found one bill in which the county paid $1,900 twice. The plan could include drug coverage, but Reed was not sure if the county would see a savings there. Currently, the county spends about $10,000 a month for prescriptions, as little as half as much as it spent in recent years. The plan as approved doesn’t cap the amount the county pays; it simply offers discounted rates for medical services. Reed said he would like to see a limit on the county’s liability added in the future. The county can opt to get out of the plans with 30 days’ notice. Reed suggested the county try the plan for six months and then compare what it would have cost if the plan had not been in place. ical facilities. By Anne Thrower athrower@paducahsun.com--270.575.8653 Wednesday, September 14, 2005 The tone of Tuesday's visit by a medical specialist with the U.S. Department of Justice was noticeably better than in past years, McCracken County officials said. "I would have to say it was one of the best visits we have had," said Jailer Bill Adams, referring to the visit by Dr. Joseph Fowlkes, who spent Monday and Tuesday reviewing medical practices at the facility. The medical area has been one of the more intensely probed areas by U.S. Justice Department officials since its first visit in 1998. Almost half of the county's 30-page agreement signed with the Justice Department in 2001 related to the physical and mental health of inmates. Justice officials do not talk to the media during their visits. Andrew Barrick, an attorney with the special litigation section of the Justice Department, is in charge of the follow-up visit. No major concerns were brought up, Adams said, but they were interested in the jail's procedures for testing inmates for tuberculosis. Two prisoners tested positive for the disease earlier this year, forcing the jail to test all inmates. County Administrator Steve Doolittle said justice officials requested information related to the TB incident prior to the visit. But he declined to talk about specifics of the conversations with federal officials, saying he was concerned about future litigation. Neither Doolittle, Adams nor County Attorney Dan Boaz thought the TB incident would hurt the county's ability to meet the conditions agreed upon in 2001. During Fowlkes visit last year, he suggested the county should hire a physician's assistant. Since that time, the county hired Reetha Guminski, who started giving TB skin tests as well as other tests to inmates within 14 days of their arrival. Doolittle said Guminski has saved the county thousands of dollars in medical costs since her arrival earlier this year. On Monday, Jim Balsamo, an environmental consultant, pointed out a few areas of concern in his exit visit with county officials. For example, he cited some dark spots in the jail that needed better lighting, Doolittle said. Balsamo was also concerned that the carts used to take inmate food from the kitchen to their cell areas needed to be smaller and carry fewer trays of food so the food would stay warmer, Doolittle said. Balsamo noticed the effect the smoking ban has had on the cleanliness of the jail, Doolittle said. Also, all the alarms worked and the water in the sinks was hot enough, he said. Justice officials will write a report based on this week's visit and will decide if future visits are necessary. Barrick and a corrections specialist plan to complete his visits later today.
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Plan to cut inmate health care costs