NEWS
March 29, 2010
Millions spent on Ohio's ailing, aging inmates
The Ohio State Penitentiary inmate was rushed to a Youngstown hospital. After nine days and thousands of dollars' worth of care, he was taken to Lucasville -- and executed.
You paid for the whole process, from his 24-hour surveillance when he took the pills to his hospital stay to his lethal injection.
While the circumstances were unique, the fact Reynolds received extensive health care behind bars was not.
Although universal health care for Americans is a hot topic for debate, it's a given for the 50,783 inmates in Ohio's state prison system.
Ohioans spent $212.5 million on inmate health care last year, according to data from the Ohio Department of Rehabilitation and Corrections. The state spent an additional $68.9 million for inmate mental health and $9.3 million for drug and alcohol recovery.
That amounts to $5,726 per inmate in 2009, up 37 percent from $4,175 per inmate in 2001.
Put another way, last year's bill equaled $25 in out-of-pocket costs from every Ohioan.
Without reforms, this financial obligation will keep growing as medical costs continue to rise and more felons are sentenced to longer terms without parole.
State officials are considering some solutions, including parole arrangements that would shift costs to the federal Medicare program. And nobody yet knows how the proposed changes in federal health care could affect state prison costs.
AGING INMATES
Ohio's prison population is getting larger -- and grayer. About 13 percent of the inmates were age 50 or older last year, compared with almost 10 percent in 2001.
At age 46, Kevin Klink, has had plenty of experience with prison health care, thanks to a cocaine addition that often lands him behind bars.
The Mansfield man moved from the Richland County Jail to the Lorain Correctional Institution after he was convicted of drug possession and identity theft in February.
For four months, Richland County taxpayers paid for the eight different medications Klink said he takes for diabetes, heart disease, high blood pressure, digestive problems and mood stabilization.
Now, the state will pay the bill until his release on Dec. 22.
In jail, Klink said he gets his medications twice a day and has blood sugar readings four times per day.
Klink is far from alone. More than 30 percent of Ohio's inmates have at least one chronic disease. In 2008, 7,584 had cardiac or hypertension diseases, and 2,124 had diabetes, according to data provided by the corrections department.
In addition, 18 percent of the prison's population has some kind of mental health problem, said Robert Hammond, chief of the Bureau of Mental Health for the prison.
Like other departments, Hammond said it is a challenge to meet these needs in a cost-effective way. The prison system has eight residential treatment units in the prison system that serve the mentally ill, as well as a psychiatric hospital.
Costs for inmates can vary depending on the severity of the illness, said Annette Chambers-Smith, head of medical services for the prison system.
When inmates like Klink arrive in the prison system, they are examined and their medical needs are assessed, Chambers-Smith said. Officials there will attempt to match drugs that fit the prison system's formulary, and the inmate will continue to get routine care.
There is no way to isolate how much a specific inmate costs the system, since drugs are ordered in bulk and staff works on salary.
Most minor problems are taken care of at each of Ohio's 30 prisons. Inmates there usually pay $3 to see a doctor or nurse, Chambers-Smith said, although nobody is turned away because of an inability to pay.
However, one facility is designed for more intensive care.
The Corrections Medical Center in Columbus has a double fence topped with razor wire and electronically controlled doors. Still, Warden Rod Francis wants the prison to be seen as a place of compassion. He jokes with staff and addresses inmates by name.
The center has two short-term wings for inmates with serious illnesses that eventually will heal or go into remission. Those inmates usually will go back to a regular prison.
For those who end up on the long-term wing, however, the center is the final stop before either death or release.
The center has 250 beds, including 80 for healthy inmates who work at the facility. With a budget of $39 million, it works out to $155,983 a bed.
The center has 148 full-time medical staff positions. Other prisons have between 20 and 30. This is still less than a comparably sized hospital. Clinton Memorial Hospital in Wilmington and East Ohio Regional Hospital in Martins Ferry have about 200 full time equivalent nurse positions each, although they provide a greater range of services.
Walking through the prison's facility, it's easy to see where the money goes. The facility has a full-service lab, which processes 3.5 million samples a year. It also has X-ray machines and a CT-scan machine.
The Department of Rehabilitation and Corrections contracts with Ohio State University to provide specialist care. In a busy hub on the first floor, inmates wait their turn to see a pain specialist -- OSU specialists rotate in and out and inmates are bused in from the various facilities to see them.
Down the hall, female inmates are seated on a bench waiting to see a dentist.
Dr. Ed Levine, director for prison care at Ohio State University Medical Center, said he feels pressure from the state to keep costs down -- but not any more than he gets from the general public.
"We always have that pressure," he said. "We do the best we can to give people the best care and get them out of the hospital."
WHY SHOULD WE PAY?
So why should convicted felons get health care for $3 or less, while their victims might not have coverage at all?
Ask any official about their thoughts on this and they'll give different answers. However, it all comes back to one concept: The U.S. Constitution requires them to under the Eighth Amendment, which bars cruel and unusual punishment.
Sometimes, judges elect to release prisoners so they can die at home. However, there is a population who has been in prison so long that if they were to be released due to illness there would be no place for them to go.
Corrections Medical Center Warden Rod Francis acknowledges that some of his long-term inmates are physically incapable of committing another crime. Still, he said, they are inmates being punished by society. Justice for their victims must still be served, Francis said.
Chambers-Smith said anger about the cost of medical care for prisoners often is misplaced.
Instead of asking why tax dollars go to providing health care a free person can't get, she said they should be asking why they don't have access to health care.
"We need to do what's right for human beings," Chambers-Smith said. Mark Caudill contributed to this report.
STAFFING LEVELS IN OHIO'S PRISON SYSTEM
# 440: Nurses
# 154: Licensed practical nurses
# 29: Physician administrators
# 33: Nursing supervisors
# 28: Pharmacy attendants
# 28: Schedulers
# 27: Phlebotomists
# 18: Quality assurance coordinators
# 9: X-ray technicians
INMATES WITH CHRONIC DISEASES, 2008
# 7,584: Cardiac or hypertension
# 5,390: Pulmonary
# 4,937: Hyperlipidemia
# 4,416: Liver
# 2,124: Diabetes
# 1,656: General medical
# 1,201: Seizure
# 752: Tuberculosis
# 411: HIV
# 147: Chronic pain
# 36: Pregnancy
# 33: Cancer
BY THE NUMBERS
# $212,542,636: Cost of medical care in prison
# 50,783: Inmates in the state prison system
# $5,726: Cost of medical, mental health and drug and alcohol recovery care per inmate
# $29,023,689: Cost of prescribing prescription drugs in 2009
# $571: Cost of prescription drugs per inmate
# 7,584: The number of inmates with cardiac problems or hypertension in 2008, the most common disease
# $3: Cost of an inmate co pay if they initiate care
# 36: Pregnant women in the prison system in 2008
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