That’s according to a recent discussion of medical issues inside the jail by Sullivan County commissioners and Christy Frazier, health director for the Sullivan County Jail.
Frazier spoke with members of the Sullivan County Commission’s Executive Committee earlier this month as commissioners debated her request to increase the fees inmates pay for medical services.
The full Sullivan County Commission later approved those increases. It was the first time the fees have been increased in years, and the increases raised prices to be comparable with what neighboring counties charge. New (and old) rates include: sick call $8 (up from $4); doctor visit $10 (up from $8); dentist visit $15 (up from $8); per med $5 (up from $2); and monthly meds $5 (up from $0).
Frazier told the committee one goal of the increases is to lessen the workload of the jail’s medical staff by reducing the number of sick calls inmates request — because often their complaints are resolved with over-the-counter medication the inmates could simply order from the commissary. And Frazier said most inmates have the ability to pay for such medications through their commissary accounts.
Inmates are allowed to spend up to $75 per week through the commissary and can have up to $375 in their commissary accounts. That money does not come from tax dollars. It is deposited into the inmates’ accounts, usually by family or friends. The commissary is operated by a third-party contractor and offers food, personal hygiene items and clothing. The sheriff’s office receives a commission on the sales.
“In the last six months of this fiscal year, inmates spent almost half a million dollars ($500,000) on Pop-Tarts, basically, on their commissary,” Frazier said. “So they have funds.”
Frazier said about 30 percent of the inmates qualify as indigent and are exempt from the medical fees, and compared to other counties in the region, the Sullivan County Jail’s fees were significantly lower prior to these increases. Asked if the increases needed to be even more, Frazier said she tried to maintain a balance and took into consideration that higher fees could result in stronger inmates pressuring weaker ones to do the sick call and bring them the medicine.
Frazier said one of her staff, as required by the state, is available to cover sick calls and chronic care, and her time is completely taken up, 40 hours a week plus some, on jail sick calls.
“We’re at an enormous amount,” Frazier said. “Basically an inmate ... uses a sick call, which requires a staff reaction, rather than just ordering over-the-counter medications through the commissary. It requires an officer to go get them and bring them to medical, duh, duh, duh.”
Last year the jail spent $121,000 on medication for inmates, Frazier said, and inmates pay nothing. The jail contracts for medicines with a Georgia-based pharmacy, Frazier said.
Sometimes inmates are transferred to Sullivan County from another county, Frazier said, and once in Sullivan County they will ask for their medication. Frazier said she will point out their record shows they were not taking it in the other county. Their answer is they would have had to pay for it elsewhere, but now that they’re in Sullivan County and it’s free, they want the medication.
“To me, they have a lot of money to spend and they are spending it on Pop-Tarts,” Frazier said. “I’d like to see us get that back.”
Sullivan County Commissioner Michael Cole, an officer with the Sullivan County Sheriff’s Office, said Pop-Tarts are a commodity inside the jail.
“And this leads to gambling with the Pop-Tarts and assaults happening, and then they have to take them to the hospital,” Cole said.
At that point in the discussion, another commissioner said she saw a man who’d had his arm broken in the jail because of a Pop-Tart.
County Commissioner David Akard apologized for not knowing Frazier and asked her to introduce herself.
“And you have to deal with this?” Akard asked after she did so.
“Unfortunately,” Frazier said.
Frazier said she tries to bill private insurance first, and it can provide coverage the first 30 days or so an inmate is jailed. But it is difficult to achieve success.
“The hospitals don’t want to help us there,” Frazier said. “They want to bill the sheriff’s office automatically.”
The jail recently had a female inmate whose shots cost $3,000 per month, paid by the jail, Frazier said — and that inmate was in on a “simple” charge, theft under $500, and had been in the jail “quite some time.”
“It would be cheaper to pay her bond and get her out,” Commissioner Joyce Crosswhite said.
Frazier said there is a misconception that the county has a responsibility to pay for inmates’ medical care, but the responsibility is to get the inmate medical care.
“I always say if we’re giving better care to our inmates in there than we do our law-abiding, taxpaying citizens, I’m not doing my job,” Frazier said. “I try really hard to make if fiscally responsible.”
Frazier said pre-trial inmates account for a majority of inmates at the jail (550 of over 900) and one thing that aggravates her is new inmates who come in with a medical problem.
As an example, she said one male inmate recently came in for driving on revoked and failure to appear and once in, “for absolutely nothing,” complained about a lesion that would require being sent out as an outpatient for a biopsy. Frazier said she had four inmates needing biopsies the night she spoke to the committee.
“I’m going to automatically, when she hands me that, I’m going to look at your charges and figure out your court date and try to see ... oh, we’re not doing crap on this,” Frazier said. “That gives me two to three months. I’m still making an appointment, for after that. I’m still dealing with it.”
Frazier said there were 944 inmates in the county’s jail facilities the day she spoke, and “only 100 were sentenced to the state.”
“They want to blame the state,” Frazier said. “But with 550 that are pretrial, it’s not hard to see your problem.”