County may face additional costs for inmate care

Published 5:00 am Wednesday, July 14, 2004

Lincoln County officials say an upcoming change affectingpayments for state inmates’ medical expenses could have someimpact, but they do not know yet how much of a financial hit thecounty might see.

Some counties have received letters notifying them that theMississippi Department of Correction would only pay the Medicaidreimbursement rate for medical care of state inmates housed incounty jails. The change means counties could be picking up more ofthe tab for inmate medical care.

Lincoln County Sheriff Wiley Calcote said Tuesday he had notreceived the letter from the state.

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“We’ll just have to work with it the best we can,” Calcote saidabout any possible changes in reimbursements. “We’re going tosurvive.”

County Administrator David Fields said it was not known how muchimpact reimbursement changes could have.

“That’s hard to say right now,” he said.

Fields said the county would want to work with the hospital anddoctors about being charged the Medicaid reimbursement rate. Heindicated it’s possible the county already is getting thatrate.

“It’s never been an issue before,” said Fields, adding he wasawaiting more details on the expected change.

Dean Snider, chief financial officer for King’s DaughtersMedical Center, said inmate visits to the hospital have beeninfrequent in the past. He said there has been no firm agreementwith the county regarding treatment of inmate patients.

“We work with them on a case by case basis,” said Snider, addingthat the Medicaid reimbursement rate would be acceptable if thechange comes about.

Currently, Calcote said, the state has been paying whateverbills that are submitted for reimbursement. One change that hasbeen in effect about 30 days, though, is prior authorization forinmate trips to the doctor or hospital.

“They want to know before,” said Calcote about getting approvalunless there is an extreme emergency.

One service that could be helping to keep trips to the hospitaldown is a local doctor’s monthly visits to the jail. Calcote saidinmates with medical concerns speak with Dr. Lee Neal when he comesabout every 30 days, although Neal has responded when needed atother times.

“It’s been working out real well,” Calcote said.

Fields mentioned some other cost-saving efforts by the countyregarding medical costs.

Fields said the sheriff’s department went through the bidprocess for medications and pharmaceuticals. Also, the court systemhas been working to get cases to trial quickly so that those whoare found guilty become the state’s responsibility instead of thecounty having to absorb the full costs.

While a potential cost-cutting measure for the state, the changein health care reimbursement represents “an unfunded mandate” thatis being passed on to the counties, Fields said.

“Health care has got to be provided,” Fields said. “Taxpayersare paying for it one way or the other.”

Calcote said the reimbursement change would be a “smallobstacle” compared to other tasks involved with running a jail.

“It’s going to hurt, but we’ll have to manage it and make itwork the best we can,” Calcote said.