Answer Man: You recently discussed what happens to the funds that Greene County Jail inmates use for commissary, etc. In that story, you mentioned that these funds can be used for certain medical care. What medical care costs are taken from an inmate’s personal funds? Do these medical costs include psychiatric visits and/or counseling? — Amy Chenoweth of Springfield
I asked your questions, Amy, and I received written responses from Melissa Howell, a captain at the Greene County Jail. In general, the county must provide any medical care if it’s needed, but it can try to reimburse those costs by seizing whatever assets inmates might have.
I’ll paraphrase what Howell wrote:
Inmates have access to inside medical services, dental services and mental health services.
They are charged $7 for a nurse sick call, an in-pod visit (inmates live in various pods within the jail) or lab work that is sent outside the jail — and they are charged $12 for a provider visit or dental visit.
Howell further wrote: Medical fees are not charged for admission health screening, follow-up care — at discretion of medical staff — emergency in-pod visits, prenatal care, in-house lab services, pharmacy medication, chronic care clinic or mental health therapy.
No inmate can be denied medical treatment because of inability to pay, she wrote. However, per state law, inmates must reimburse the jail facility for medical and dental services and medications. Payment for all medical treatment received outside the jail is the responsibility of the inmate, unless he or she is a federal inmate. In that case, the United States Marshals Service is responsible for payment.
(The Greene County Jail often houses prisoners charged with federal crimes.)
Inmate’s ‘assets’ can pay for care
I looked up the state law Howell cited in her response. It says:
“If any prisoner confined in the county jail is sick and in the judgment of the jailer, requires the attention of a physician, dental care, or medicine, the jailer shall procure the necessary medicine, dental care or medical attention necessary or proper to maintain the health of the prisoner.
“The costs of such medicine, dental care, or medical attention shall be paid by the prisoner through any health insurance policy as defined in subsection 3 of this section, from which the prisoner is eligible to receive benefits.
“If the prisoner is not eligible for such health insurance benefits, then the prisoner shall be liable for the payment of such medical attention, dental care, or medicine, and the assets of such prisoner may be subject to levy and execution under court order.
“The term ‘medical costs’ includes the actual costs of medicine, dental care or other medical attention and necessary costs associated with such medical care such as transportation, guards and inpatient care.”
In other words, if a patient needs to be taken to a hospital, the patient can be charged for the transportation and the deputy or guards who need to make the trip and, perhaps, stay overnight at the hospital.
Under state law, a patient’s “assets” include cash, Social Security, workers’ compensation, veterans’ compensation, pension benefits, previously earned salary or wages, bonuses, annuities, retirement benefits and compensation paid to the prisoner for work or services.
It also includes funds from any potential successful legal claim made against the state or any other agency.
Jail has a full-time doctor on staff
After receiving Howell’s first response, I followed up with a few questions about jail staffing.
The jail does not have a full-time dentist on staff. The facility has a contract with a dentist who provides services to inmates once a week.
The jail employs a full-time medical doctor, a part-time doctor and a part-time nurse practitioner.
This is Answer Man Column No. 26.