Budgetary pain from inmates' health issues

By Alex Bridges -- abridges@nvdaily.com

WINCHESTER -- The Northwestern Regional Adult Detention Center feels the chronic financial pain of keeping inmates healthy, and illnesses often come without warning.

Inmates at the regional jail have accrued 105 days of hospitalization this fiscal year, either at Winchester Medical Center or other facilities, Superintendent Bruce Conover told the jail authority Thursday. More than half that time -- 54 days -- proved the most costly at an estimated $286,546, though the superintendent noted a delay can occur with billing. By this time last fiscal year the jail had accumulated 62 hospital days, according to Conover.

"We certainly have had a rash of health-care issues," Conover said.

The superintendent noted as an example an inmate incarcerated for two months suffers from hemophilia, and his medications cost the jail $20,000 per month. The inmate's brother recently came into the jail, and also suffers from the blood-clotting disease, so the cost would double, Conover noted.

"Significant expenses, certainly. Expenses we couldn't see coming," Conover said.

Other costs have included $50,000 for HIV and Hepatitis C treatment, $39,000 for bowel obstruction surgery, $12,000 for a four-day stay at University of Virginia medical center for a high-risk infant delivery, and three days at $45,490 for a heart ailment.

The current budget includes only $416,000 for health care coverage through Anthem insurance. While too early to tell, Conover warned the jail may need to ask for additional funds from its reserves as costs increase beyond that amount.

The jail incurred $714,984 in health care costs for fiscal 2011. Conover advised the jail likely will spend more than that this fiscal year.

As the jail continues to deal with increasing costs, the authority voiced concerns about proposed reforms under the Affordable Care Act of 2010. The authority made comments in a letter to the Center for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.

The authority urges in the letter that the Center for Medicare and Medicaid Services issue regulations and/or guidance that bars states from terminating Medicaid eligibility solely on the grounds that individuals are inmates of a public institution, and that the agency amend the definition of "inmate of a public institution" to not exclude individuals awaiting disposition on charges.

Conover said it was his understanding Virginia can terminate an individual on Medicaid from receiving the benefit if the person becomes incarcerated.

The authority also seeks in the letter that any regulations would ensure application policies would allow incarcerated individuals to apply for any type of relevant health coverage.