Councilman balks at medical bill

Sheriff said it, two others should have been paid last year

TELL CITY - "Why do we have to pay that bill?" Councilman Alan Cassidy asked of $2,748 additional appropriation on the agenda for the April 24 regular meeting of the Perry County Council. "Did we authorize or order all of those tests to be done for the sheriff's department?"

"The money is needed to pay a hospital bill from 2007 that we (were) not aware of," Sheriff Bob Glenn wrote in a letter to the council that accompanied the bill. He explained the delay in receiving it was due to Perry County Memorial Hospital being "misinformed as to who was responsible for this bill. We checked our records and this person was in our custody at the time (of the hospital visit)."

County Auditor Connie Berger provided Glenn's letter and a redacted copy of the bill to The News. The bill itemizes 22 procedures, medications or medical supplies contributing to the total.

"I don't think it's a matter of whether we order them or not," Council President Pete Franzman answered. "I think if they take them to the emergency room, I think that doctor has to do ... ."

"A pregnancy test?" Cassidy asked. "One day and they did all that in the emergency room?"

"I can't answer that," Franzman replied. "I think it's pretty much out of your hands once you put them into the emergency room, it's what the doctor thinks is medically necessary."

He said a moment later he wasn't sure the council could even talk about the issue, considering privacy laws.

"Now, if you have questions on it, I guess we can get an explanation from the sheriff," Franzman said. "I know that before they'll administer certain drugs to a female, they'll do a pregnancy test because if they give them that drug and they're pregnant, it can cause a problem.

"I think I saw that on TV," he added, eliciting laughter from the other council members. "Seriously, I think that may very well be why they have to do that."

Franzman offered to investigate the issue further before asking the council to act on it.

"I don't think we've got any choice," Councilman Merle Doogs said.

"I think it'd be a waste of time," agreed Councilman Ryan Daum.

"In the past, until we got the situation we have got now, if they took them to the emergency room, we paid the bill," Franzman said.

Glenn has taken steps over the last several years to reduce medical costs incurred by jail inmates. His first efforts had local doctors providing services such as telephone consultations, eliminating the need to transport prisoners to the emergency room for every complaint, which he said Tuesday "usually ended up being $1,500 per trip."

A contract with Drs. William Marcrum and Thomas Bailey brought "fairly good savings," Glenn explained. An initial fee of $750 per month covered 10 office calls. Extra fees were charged for more office visits, but Glenn said they numbered fewer than 10 monthly. Much of the medical care could be provided by faxing information to and from the doctors.

Marcrum told the commissioners when contract-renewal time came, however, the doctors were reluctant to continue their service due to liability concerns, but would for $1,000 per month.

The council was reluctant to absorb a $3,000 annual increase.

As The News reported in January, Glenn found an alternative in Peoria, Ill.-based Advanced Correctional Healthcare, a company working in 11 states at facilities ranging in size from 18 beds to more than 1,100.

Under a contract with them, a $53,837 fee for 2008 would provide physician services, prescription drugs and medical supplies needed by offenders, and a range of health-related management services, including training of jail employees, who now relay information to physicians and administer medication, tasks the sheriff said they already handle.

Of the contract amount, $20,000 was set aside for medical care provided outside of the jail, including emergency-room visits. Any money left over from the account at the end of the year will be returned to the county, less a 10-percent management fee.

Medical help is available around the clock, a doctor visits the jail one day each week and routine prescriptions are delivered by overnight mail, Glenn said.

If a medication is needed immediately, a local pharmacist provides it and the cost is paid from the escrowed money.

While it's too early to say how much Perry County will end up paying for inmate medical care this year, company representatives "say they have reduced medical costs by one-third, sometimes more, at the jails they serve," the sheriff said.

When people are taken into custody, "you become responsible for them," he noted. "This way, 24 hours a day, seven days a week, if something happens, they're covered."

The $2,748 bill was one of three discovered from last year, but the jail budget was able to cover two, Glenn said. If they'd all been found at the time, "we might have been able to cover it, because we had money to turn over at the end of the year," he explained Tuesday.

The council approved a motion to pay the 2007 bill, with Cassidy registering a nay vote.

In other business, the council approved appropriation of $25,833, with $8,611 of it pegged for each of three parts of the county's Drug Free Community Fund: prevention and education, treatment and intervention, and law-enforcement and justice. As The News reported April 17, the county commissioners approved the appropriation of the funds, which are collected as court fees by the county clerk's office and disbursed annually.

They also approved a temporary advance of $175,000 from the county's courthouse debt-service fund to the county-general fund. Franzman said the advance is necessary because taxes are being collected later than usual this year.

As The News reported Monday, county officials are working to meet new requirements and awaiting information from state officials before they can prepare tax statements for mailing.

First installments of the bills are normally due in May, but they won't be issued until sometime this summer, according to Berger.

The advance "is to get us by with cash until a settlement is made, whenever that might be," Franzman said.

In another action previously approved by the commissioners, the council also gave their OK to changes to the county-employees handbook extending unpaid-leave benefits for employees affected by the military service of certain family members.