MAHONING COUNTY Cost going up for jail's medical services

By BOB JACKSON
VINDICATOR COURTHOUSE REPORTER
YOUNGSTOWN -- Mahoning County will pay more next year to provide medical services for county jail inmates.
A sharp rise in the inmate population over the past two years is largely to blame, officials say.
"As the inmate population goes up, the cost of medical services goes up with it," said Robert Knight, jail medical services director.
Knight said the average daily population has risen from 424 in 2000 to 551 this year.
Ohio law requires the county to provide medical care for jail inmates, Knight said. The county must pay for any care they receive while locked up.
"If a woman has a baby while she's in jail, we have to pay for that," said Commissioner Ed Reese.
The county has contracted with Prison Medical Services of Brentwood, Tenn., since the jail on Fifth Avenue opened in 1996. In December, commissioners increased the monthly payment to PMS by $13,000, for a total of $102,000.
The company had threatened to drop the county without the increase because it was losing too much money.
"It's not cheap, by any means," Knight said.
The county's contract with PMS expires next month, so commissioners sought bids earlier this year for a jail medical services provider.
Of the three companies who bid, PMS was the apparent low bidder, said James Fortunato, county purchasing director.
To help keep the cost down, commissioners will probably have to give up an indemnification clause that has shielded the county from incurring any costs for medical treatment required by inmates who are transferred to a hospital or special treatment facility outside the jail.
Background
Reese said Mahoning was the first county in Ohio to negotiate such a clause. It was included in the county's first contract with PMS in 1996.
Since then, medical costs have risen so much across the state and country that most companies will not even bid on such a deal.
Instead, most have switched to a plan in which the cost of off-site services is shared between the county and the provider. That's what Mahoning is looking at next year.
Fortunato and county Administrator Gary Kubic said they will most likely recommend that commissioners approve a contract in which the company would pay the first $150,000 for off-site inmate medical services required by inmates during the year.
If the cost rises above that mark, the additional amount would be split by the county and PMS.
Under those terms, the contract would cost the county $1,409,364 a year, which is an increase of $183,186 over what the county pays now.
"That's the worst-case scenario," Kubic said. "That's not going to happen very often."
Knight said this year is the first time that off-site cost has even risen above the $150,000 benchmark. He said it's largely because there have been four inmates who require kidney dialysis treatments, which can't be done in the jail.
If the county agrees to absorb only 25 percent of anything above the $150,000 benchmark, the overall cost would be $1,473,456. And if the county pays nothing for the cost-sharing, the cost would be $1,581,012.
"We tried to do the best we could with some type of risk-sharing that was manageable," Fortunato said.
He said the matter will probably go before commissioners for consideration at their Dec. 5 meeting. Commissioners won't meet next week because of Thanksgiving.
bjackson@vindy.com