- The Washington Times - Saturday, January 14, 2006

Barry L. Stanton appears at ease in his spacious new office as he discusses key issues at the Prince George’s County Correctional Center in Upper Marlboro.

But Mr. Stanton, director of the county Department of Corrections for the past nine years, tenses as he bemoans the jail’s rising medical costs for inmates.

“People get better medical care in jail than I get at home,” he says from behind his desk in the jail’s new $8 million annex.

“If you pick up the phone and you say, ‘I am sick’ … they say, ‘If it is not an emergency, I will see you tomorrow,’” he says. “Here, [inmates] want to be on sick call right way.”

He has seen the Prince George’s detention center’s average cost per inmate rise from about $83 per day in 2003 to nearly $100 per day last year, while more and more inmates crowd the jail’s spaces.

Mr. Stanton is not alone in his concerns. Most detention centers in the metro area are dealing with increasing medical costs — which are covered by taxpayer funds — and overcrowding, reflecting a national trend.

At the D.C. Jail, inmates routinely are double-bunked in cells designed for one person in most of the 30-year-old facility’s housing units.

The jail — one of the oldest detention centers in the region — can adequately house 2,164 inmates a month, according to a consultant’s recommendation in 2004.

However, the jail usually houses more than 2,500 inmates a month and sometimes holds as many as 3,555 a month, according to D.C. corrections officials.

Most inmates are pretrial defendants awaiting hearings, and their numbers fluctuate as the courts handle their cases. Many inmates also are awaiting transfer to federal prisons, and the remainder are serving sentences.

According to statistics from the U.S. Justice Department and the American Correctional Association, the D.C. Jail’s average cost per inmate rose from about $65 per day in 2003 to about $78 per day in 2004. D.C. officials estimate the cost rose to about $86 last year.

“I would definitely agree that the cost has risen,” says S. Redwood York Jr., who has served as the interim director of the D.C. Department of Corrections since February. “And it is probably a factor of having higher support costs in medical, food service and other inmate needs, combined with the increased population.”

City officials attribute the rising costs in part to the jail’s exhaustive health screenings, which include voluntary testing for AIDS and tuberculosis.

City law requires that the screenings be provided to all inmates, regardless of whether they have been convicted or are being held for trial.

Repeat offenders and suspects must be provided with repeat treatments by the jail’s more than 140 medical staffers, who work alongside the facility’s 687 guards.

“We are hoping that someone will understand that we cannot go on doing what we are doing,” says Dr. Malek Malekghasemi, the D.C. Jail’s associate medical director. “You cannot tell people ‘no’ because … inmates have a constitutional right to health care.”

Alexandria

The D.C. Jail’s overcrowding is replicated at the Alexandria Detention Center, where two inmates frequently occupy one-person cells in several housing units. One inmate sleeps on a cot — which corrections officials refer to as a “sled” — while the other uses the metal-frame bed provided in each cell.

Opened in 1987, the facility usually holds more than 450 inmates a month, housing pretrial defendants and convicts in local, state and federal cases.

For example, the detention center recently held in an isolated cell former New York Times reporter Judith Miller, whom a federal judge had jailed for contempt of court for refusing to reveal her source in a grand jury investigation of a CIA leak.

Like the D.C. Jail, the Alexandria Detention Center has seen its inmate costs rise from an average of $101 per day in 2003 to about $109 per day in 2004.

However, corrections officials have sought to defray the facility’s rising health care costs by assessing the inmates fees for medical services, says Capt. John Griggs of the Alexandria Office of Sheriff, which runs the jail.

Capt. Griggs, who heads the support services division of the sheriff’s office, says the office charges inmates a $10 assessment fee for physician and dentist appointments, $5 to see a nurse, and $3 for prescriptions.

Montgomery County

Assessing inmates fees for medical services apparently has helped control costs at the Montgomery County Correctional Facility in Boyds, one of only two local jails that has recorded lower costs.

The three-year-old, $90 million facility, which charges inmates a $4 medical-assessment fee, has seen its average inmate costs drop from about $119 per day in 2003 to about $106 per day in 2004.

(The old Montgomery County Detention Center in Rockville now serves as the intake center, where pretrial defendants are processed.)

In addition, overcrowding is not an issue at the new correctional center, which officials say comfortably houses more than 800 inmates a month.

Dubbed “the Taj Mahal” by inmates, the county lockup features classrooms, computers, a library and a state-of-the-art medical facility.

Warden Robert Green of the county’s Department of Correction and Rehabilitation knows that his jail fills a unique space.

“I think our focus on rehabilitation is one of the absolute keys to our success,” Warden Green says. “You will find very few facilities that maintain the term [rehabilitation] in the title of their department, but it is clear that this facility is built on that premise.”

Fairfax County

Like the Montgomery County Correctional Facility, the Fairfax County Adult Detention Center — the region’s oldest and largest jail — has implemented inmate fees to help reduce its operating costs.

Correction officials require co-payments from inmates for medical expenses — $5 for prescriptions, $10 for doctor appointments and $20 for dental visits.

“We also take a dollar a day [from inmates] to help with the cost of the their upkeep,” says 2nd Lt. Tony Shobe, spokesman for the Fairfax County Sheriff’s Office.

The county detention center’s average inmates costs fell from about $125 per day in 2003 to about $120 per day in 2004.

Lt. Shobe says the cost-cutting measures, which were initiated after 2001, may seem harsh, but have helped cut down on unnecessary medical examinations.

“Amazingly, once we instituted the $10 [co-payment] charges, it amazingly cut down on who wanted to see the medics,” Lt. Shobe says.

The county jail regularly houses more than 1,300 inmates and opened a 750-bed expansion in 2000. It boasts that it is the only facility in the country that uses three forms of inmate monitoring:

• Linear supervision, in which deputies patrol the hallways of cell blocks that can house up to 10 inmates.

• Podular remote supervision, in which deputies in control booths oversee cells that are set up in “pods” around a common area, or dayroom.

• Direct supervision, in which inmates who have committed less serious offenses are managed by deputies working alongside them in the cellblock.

Some overcrowding occurs among the pod cells, where inmates can be found double-bunked.

“It increases the tension for us and increases the tension for them,” Lt. Shobe says of overcrowding.

Prince George’s County

Tension about overcrowding runs high at the Prince George’s County Correctional Center in Upper Marlboro, where inmates in bunk beds fill some of the jail’s common areas.

The detention center’s intake housing unit, where new inmates are admitted and processed, and its medium-security unit house rows of bunk beds in open-air rooms where inmates usually gather to talk, play cards or write letters.

Mr. Stanton, the jail’s director, says the facility — built in 1987 — desperately needs more cells, even though a $16 million expansion provided more space about four years ago.

“There is no capacity, as far as people go. We have to take everyone that is arrested,” he says. “It is not as if we can shut down the facility.”

The rising population at the county jail, which averages about 1,200 inmates a day, is driving up the facility’s medical costs, he adds.

“We have more inmates now that require hospitalization,” Mr. Stanton says. “A lot of inmates are going to the hospital getting specialized treatment, getting specialized health care in the area of heart disease, HIV, serious breathing problems and pregnancy.”

Vicki Duncan, spokeswoman for the county Department of Corrections, says officials have found that the best way to control the escalating costs of health care and check abuse of medical services by inmates is to charge them a $4 assessment fee.

“The reason for it was we used to have a ton of people that wanted to see the doctor or a nurse just to get out of their cell,” Miss Duncan says.

Although the assessment fee is not as high as the average co-pay at some other regional detention centers, county inmates still receive medical treatment that is just as good or better than they would outside the jail, she says.

“Nobody is refused medical treatment because we deduct the fee from their account after they have had the assessment,” Miss Duncan says.

The county began charging the fee more than a decade ago, but still has seen its inmate costs rise from about $83 per day in 2003 to about $99 per day last year.

Arlington County

The Arlington County Detention Facility — a high-rise jail with a population of more than 600 — charges inmates $5 for doctor appointments but, like other detention centers, has seen its costs rise.

The average inmate cost rose from about $103 per day in 2003 to about $107 per day in 2004.

Margo B. Ray, spokeswoman for the county sheriff’s office, which operates the jail, says officials are waiting for an independent review of its medical services to be completed.

“The medical report will be completed by Jan. 19, then be presented to the County Board for review,” she says.

Jail populations are rising across the country. According to the U.S. Justice Department’s Bureau of Justice Statistics, the country’s local detention centers held 713,990 inmates at midyear 2004, compared with 691,301 inmates the previous year.

And the increasing population has brought on a rise in costs for localities. For example, New York City saw its inmate costs rise from $161.27 per day in 2003 to $164.57 per day in 2004.

Keith B. Ashdown, vice president of the nonpartisan watchdog group Taxpayers for Common Sense, says correction officials nationwide should rethink their priorities in dealing with the rising inmate costs, especially those driven by health care.

“The best medical care in the U.S. shouldn’t be in the big house,” Mr. Ashdown says. “I would be very outraged if we are seeing the same type of health programs that we see for average Americans.”

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