County's costs for inmate medical treatment to increase
The two physician’s assistants that have made house calls to county inmates for the past year will quit after Jan. 31, which means more inmate trips to Prompt Care or health clinics – and more cost for Lincoln County.
“It’s going to be a time-consumer for us and expensive for the taxpayer,” sheriff Daryl Anderson said.
The county’s contract with Joe Chopyak and Tony Fantozzi, facilitated by St. John’s Lutheran Hospital, will be up at the end of February, but the county has been notified that they would be leaving Jan. 31.
Medical visits to the jail are a low-cost and convenient arrangement for the county, Anderson said. It avoids the expense of paying an officer to transport and guard the inmate at a facility, and it reduces instances of inmates feigning sickness to get out of jail.
“You take one guy (out to be treated) and it doesn’t take long before more go,” Anderson said. “It’s a domino effect.”
The county currently pays a $90 flat rate per visit, which can include treatment of more than one patient.
“If we take them to a clinic it will probably cost $150 or so just to walk in the door, besides the (cost of) care,” said Jerome Schad, detention center captain.
Schad also prefers house calls for safety purposes.
“The security issue alone is way better – for them to come over here so you don’t have to take them out of the facility,” Schad said.
In addition to working full-time at their practices, Chopyak and Fantozzi alternate treating patients at the jail. Inmates receive prescriptions they need, and the routine preventative care helps avoid costly trips to the emergency room.
What were supposed to be weekly house calls, however, have become almost daily visits, Schad said. The amount of medical attention the inmates need has been time-consuming and has increased liability for the practitioners.
“I don’t think they appreciated the amount of ongoing phone calls and support that the patients needed,” said Bill Patten, St. John’s chief executive officer.
No other health-care providers appeared interested in taking Chopyak and Fantozzi’s place, so Patten sent the county a letter earlier this month giving notice of their resignations.
Patten said that St. John’s would continue to treat inmates who are transported to the hospital, which includes visits to Prompt Care, a cheap alternative to the emergency room for minor illnesses and injuries.
Anderson said he intends to look into using the Northwest Community Health Center.
“We’re looking at other avenues,” Anderson said. “We’re going to go with what’s most reasonable for the taxpayer.”
An officer transports and guards an inmate when he or she must be taken in for medical attention. If a female inmate requires treatment and no female officer is available, the county must pay for an officer and a matron – usually a sheriff’s office secretary – to accompany the inmate.
Sharing a waiting room with someone in a jumpsuit and shackles won’t appeal to everyone.
“In the past we’ve had certain doors we would enter to stay away from the lobby area,” undersheriff Jerry Rust said. “We’ve had it go both ways. We’ve had them sitting in the waiting room with little kids running around.”
Even with backdoor entrances, Schad said, other patients usually notice an inmate exiting a patrol car outside the building.
Schad said he would like to see a nurse or PA be hired by the county, not contracted out, whose job duties would include treating inmates. Before the contract with Chopyak and Fantozzi, a doctor from Libby Clinic provided the service for a few years. Before that, Schad said, the job belonged to Lincoln County health officer Dr. Brad Black.