TNC
07-09-2005, 03:19 AM
$6 million Ada jail hospital unit planned to reduce liability
Brad Hem
The Idaho Statesman | Edition Date: 07-09-2005
Clinical social worker Kate Pape meets with mentally ill inmates at the Ada County Jail and has to use the room where the visiting dentist does exams because the jail's medical unit is so small.
"And if the dentist is here, I see them (inmates) in the hallway," she said. It's not only inconvenient, said Pape, it compromises the patient's confidentiality and their willingness to open up to her while other inmates and guards walk past.
Generally, jails should have 5 percent of their beds in a medical unit, according to national standards. Ada County has 10 medical beds out of a total of 1,144 beds — that's fewer than 1 percent. With an average daily inmate population of 820, the beds are nearly always full, said Sharon Mauzy, the jail's medical services manager.
The jail has only one examination room. Wheelchairs and gurneys are pushed against a wall in the unit because of storage limitations. The hospital ward was built in 1994 when the jail had a capacity of about 400 inmates, Sheriff Gary Raney said.
The county is planning to spend just more than $6 million in its 2005-06 budget to expand the medical unit.
When hospital beds are full, that means inmates who are detoxing from drugs or alcohol, or are suffering from mental illness, are housed in the main jail with other inmates. That could make the county vulnerable to a lawsuit, the costs of which would be passed on to taxpayers. Earlier this year a national organization inspected the jail and criticized the lack of medical space.
"That is a liability issue," said County Commissioner Fred Tilman. "That's always looming for us."
The proposed county budget has been drafted and will be the subject of a public hearing Tuesday.
Exactly how many beds will be added won't be decided until planning and architecture work is completed, but Raney said he wants to add 50 to 60 medical beds. That would take care of the immediate demand and provide a small cushion for a couple years.
The increase in demand for medical treatment has grown with the inmate population, which has increased in size along with the county's population. But there are other factors involved as well, Raney said.
The general county's population is aging, as is the jail population. As the population has grown, the severity of crimes has increased, so the average length of stays at the jail has increased from 8.4 days in 1994 to 15.3 days in 2005. That means more time when an inmate could get sick and need treatment.
When the jail unit is full, the county sends inmates who need constant medical supervision to Saint Alphonsus Regional Medical Center at a cost of $900 per day. That happens with about two inmates a month, Mauzy said.
As methamphetamine use has increased, the number of people who are booked into the jail while they are still under the influence has gone up, Raney said. On Wednesday morning, three of the 10 beds were being used by detoxing inmates.
In April and May, 48 detox cases and 13 mental health cases were housed in the main jail because there wasn't room in the medical unit, Raney said. It's not an ideal situation. Ideally, inmates who are detoxing would spend their first two or three days in the jail in the medical unit.
"When we release them (into the main jail), we want them to be stable," Pape said. "We don't want to release someone who's unstable."
Those are situations where jails could open themselves to lawsuits, said Edward Harrison, president of the National Commission on Correctional Health Care. The Chicago-based agency criticized the jail for its lack of medical space in an inspection earlier this year.
If an inmate's heart stops while detoxing, and he isn't receiving necessary medical treatment, his family could sue the county, said Harrison. In 1976, the U.S. Supreme Court ruled correctional facilities must provide for basic needs, including meals and health care, he said.
"We have to provide them care," he said. "It's part of their civil rights according to the Supreme Court case. If they're diabetic and need insulin, we have to provide that."
Raney said substandard medical care and substandard food are the biggest reasons for lawsuits against jails in the country. It's only a matter of time until someone sues for inadequate medical care, Raney said.
"That's what's inevitable," he said.
Brad Hem
The Idaho Statesman | Edition Date: 07-09-2005
Clinical social worker Kate Pape meets with mentally ill inmates at the Ada County Jail and has to use the room where the visiting dentist does exams because the jail's medical unit is so small.
"And if the dentist is here, I see them (inmates) in the hallway," she said. It's not only inconvenient, said Pape, it compromises the patient's confidentiality and their willingness to open up to her while other inmates and guards walk past.
Generally, jails should have 5 percent of their beds in a medical unit, according to national standards. Ada County has 10 medical beds out of a total of 1,144 beds — that's fewer than 1 percent. With an average daily inmate population of 820, the beds are nearly always full, said Sharon Mauzy, the jail's medical services manager.
The jail has only one examination room. Wheelchairs and gurneys are pushed against a wall in the unit because of storage limitations. The hospital ward was built in 1994 when the jail had a capacity of about 400 inmates, Sheriff Gary Raney said.
The county is planning to spend just more than $6 million in its 2005-06 budget to expand the medical unit.
When hospital beds are full, that means inmates who are detoxing from drugs or alcohol, or are suffering from mental illness, are housed in the main jail with other inmates. That could make the county vulnerable to a lawsuit, the costs of which would be passed on to taxpayers. Earlier this year a national organization inspected the jail and criticized the lack of medical space.
"That is a liability issue," said County Commissioner Fred Tilman. "That's always looming for us."
The proposed county budget has been drafted and will be the subject of a public hearing Tuesday.
Exactly how many beds will be added won't be decided until planning and architecture work is completed, but Raney said he wants to add 50 to 60 medical beds. That would take care of the immediate demand and provide a small cushion for a couple years.
The increase in demand for medical treatment has grown with the inmate population, which has increased in size along with the county's population. But there are other factors involved as well, Raney said.
The general county's population is aging, as is the jail population. As the population has grown, the severity of crimes has increased, so the average length of stays at the jail has increased from 8.4 days in 1994 to 15.3 days in 2005. That means more time when an inmate could get sick and need treatment.
When the jail unit is full, the county sends inmates who need constant medical supervision to Saint Alphonsus Regional Medical Center at a cost of $900 per day. That happens with about two inmates a month, Mauzy said.
As methamphetamine use has increased, the number of people who are booked into the jail while they are still under the influence has gone up, Raney said. On Wednesday morning, three of the 10 beds were being used by detoxing inmates.
In April and May, 48 detox cases and 13 mental health cases were housed in the main jail because there wasn't room in the medical unit, Raney said. It's not an ideal situation. Ideally, inmates who are detoxing would spend their first two or three days in the jail in the medical unit.
"When we release them (into the main jail), we want them to be stable," Pape said. "We don't want to release someone who's unstable."
Those are situations where jails could open themselves to lawsuits, said Edward Harrison, president of the National Commission on Correctional Health Care. The Chicago-based agency criticized the jail for its lack of medical space in an inspection earlier this year.
If an inmate's heart stops while detoxing, and he isn't receiving necessary medical treatment, his family could sue the county, said Harrison. In 1976, the U.S. Supreme Court ruled correctional facilities must provide for basic needs, including meals and health care, he said.
"We have to provide them care," he said. "It's part of their civil rights according to the Supreme Court case. If they're diabetic and need insulin, we have to provide that."
Raney said substandard medical care and substandard food are the biggest reasons for lawsuits against jails in the country. It's only a matter of time until someone sues for inadequate medical care, Raney said.
"That's what's inevitable," he said.