Jail administrator: Some people get arrested for free medical care

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LYNCHBURG (WSLS 10) - Millions in tax dollars are being spent to cover medical bills for people who break the law.

The administrator of the Blue Ridge Regional Jail Authority tells WSLS 10 the jail can easily spend $100,000 a month on prescription drugs alone. Lawmakers had a chance to alleviate the jail's financial pain, but at a potential cost to health care providers.

Under the current interpretation of Virginia code, jails pay for every penny of an inmate's care, even if the inmate was already hurt or sick when he or she entered the jail. The code says jails must "provide" the medical care. Does "provide" mean a jail must simply get the inmate to the doctor or must the jail also pay the inmate's medical bill?

"I call it the wildcard in my budget," said Tim Trent, Blue Ridge Regional Jail Authority Administrator. "I really can't determine who's going to have a heart attack, who's going to get arrested with a serious illness, who is going to have a pre-existing condition such as needing dialysis."

The Blue Ridge Regional Jail Authority operates five detention centers in Lynchburg and surrounding counties.

"The code of Virginia says we shall provide these services even if it's pre-existing," said Trent.

Services are provided regardless of how much money is in the jail's existing budget. The authority budgeted just more than $2.4 million for medical costs this fiscal year. That's up nearly $232,000 from the previous year, due to a sicker inmate population.

Trent said more inmates are coming into his jails with HIV, hand in hand with the heroin epidemic.

"It doesn't take but one individual or two individuals with a rare type of cancer maybe, or perhaps HIV-positive and your costs start spiraling out of control," said Trent.

Trent said free medical care has even become an incentive for some to get arrested.

"I have seen people come in here in the past, individuals that are incarcerated that would get arrested if they had a medical issue," said Trent. "Or they had to be something wrong with their teeth. They would do something to get incarcerated and we have to either pull their teeth at no charge to them or provide medical care or provide medications. It's no charge to them."

"People would just get arrested for minor things to get whatever treatment they needed," said Senator Bill DeSteph, a Republican who represents part of Virginia Beach. "Some of these were $60,000."

That's like getting $2,000 a day in free medical care, along with your 30-day sentence. Virginia Beach's Sheriff brought it to DeSteph's attention.

"It is truly impossible to budget for," said DeSteph.

So the Republican introduced SB 1146 this session. It says medical treatment shall not be withheld due to an inmate's inability to pay; but that no sheriff, jail superintendent, or locality shall be required to pay for the treatment if it's for an illness, injury or condition the inmate had prior to his incarceration.

"We did not get a chance to speak with Senator DeSteph before he filed the bill," said Ralston King, Assistant Vice President of Government Affairs for the Medical Society of Virginia.

The Medical Society of Virginia has plenty to say about the legislation on behalf of the 11,000 medical professionals the organization represents.

The society joined in a lobbying effort with insurance carriers and hospitals to amend or defeat the legislation.

"If you allow for those inmates to get care with no form of payment, whether it's from sheriffs or localities, that puts a huge burden on providers." said King.

"They see the Blue Ridge Regional Jail as having what we call deep pockets," said Trent. "We're going to pay our bill and they don't see that with individuals on the street."

The bill didn't make it past the Senate Committee on Rehabilitation and Social Services this session.

DeSteph said he'll get a working group together this summer to include hospitals, insurers, sheriffs and jail administrators. He wants input before reintroducing the legislation next January.

Until then, jails are in for more medical bills.

"I want to be perfectly clear that we provide adequate medical care," said Trent. "We will continue to provide regardless of your ability to pay. However, I don't feel it's our responsibility to pay for it financially. It's your responsibility."

Most inmate medical care is provided in-house at Western Virginia Regional Jail. This year's budget for that contracted care is $2.6 million, second only to personnel costs in the overall jail budget.

The jail has seen a 2 to 5-percent increase in medical costs each of the last seven years. That doesn't even include the additional $200,000 the jail sets aside to cover any medical services provided in doctors' offices or hospitals.

There's been an increase in pregnant inmates with opioid addiction at Western Virginia Regional Jail in Roanoke County. The jail is responsible for a mother's medical care, including drug treatment, but not a baby's after delivery.

The jail superintendent said when a particular condition becomes acute, when they're seeing more and more of something, like pregnancy, or HIV, they may need to hire additional medical staff or buy more medication.