Medical care for baby boomers is high at jail
By the numbers
2—The number of hours of psychiatric care available weekly at the jail.
20—The number of hours of mental health care available weekly.
192—The number of hours of medical care provided to inmates weekly.
440—The typical number of inmates in the jail on any given day. When the number is larger than that, the contracted medical services provider adds a fee to the jail's cost of care. When it's smaller, the jail is issued a credit.
$749,472—The amount of money county administration recommended in 2012 for medical expenses at the jail. That includes medicine and the cost of medical providers.
From July 2011 to June 2012
126—Number of inmates seen by a doctor.
11,523—Total number of nurse visits. That includes 2,880 sick calls and 5,817 intake calls. The rest would be follow-ups.
426—Inmates seen by a mental health professional.
6,067—Total number of inmates admitted to the jail. Some stay for hours while others stay for months.
—Source: Rock County Sheriff's Office data
Photo
New examination rooms at the Rock County Jail sit in an area that used to be the old booking center of the facility. The facility was expanded to meet increased complexity of inmates' medical needs.
JANESVILLE — When Rock County Sheriff Robert Spoden was a criminal justice student in the mid-1980's, he was told the baby boomer peak would come and go earlier in jails and prisons than in other facilities.
In his 25-year career in jail services, Spoden has since learned that prediction was wrong. The number of jailed baby boomers has gone up and not come down, he said.
In Spoden's experience, those boomers who are crime-prone aren't slowing down. They have become an expensive group to house at jails around the country, including the Rock County Jail.
"Unfortunately, they're not young any more, and their lifestyles are catching up with them," said Spoden who is 49 and was born at the tail end of America's baby boom.
The baby boomers are defined by the United States Department of Health and Human Services as those people born between 1946 and 1964. That makes them between 48 and 65 years old.
They aren't the only segment of the jail's population with complex health needs, but they are a big segment, Spoden said. The increasing complexity of inmates' health conditions was part of the reason the county in 2010 expanded the medical facility at the jail as part of a $5.7 million jail renovation.
The Rock County Jail's data system doesn't track the historical ages of inmates seen at the jail's medical facility, said Cmdr. Erik Chellevold, who is head of correctional services at the jail. He took a headcount for The Gazette on a recent day and found that of eight people in the jail's medical facility, five were baby boomers.
It's common that baby boomers who have lived lives prone to committing crimes have, "for years abused their bodies with alcohol or drugs," Spoden said.
"That abuse is taking a toll," he said.
Many inmates are diabetic and require insulin. Others need to be taken several days a week to local facilities for kidney dialysis. Some inmates need adaptive tools such as canes, oxygen tanks or sleep apnea machines.
Some go through drug or alcohol withdrawal when they are admitted to jail. Many have poor mental health, Spoden said.
"People are coming in with sensitive medical issues that we just didn't see in years past," he said.
They take a host of medications, Spoden said. The jail provides prescription medication for inmates who can't buy it from an outside pharmacy. The jail's coverage includes medication for depression or other mental illnesses if it is prescribed.
"Back when I was on patrol, if someone would have told me I would be dealing with these kinds of medical issues someday as sheriff, I never would have believed them," Spoden said.
"It's just expensive"
Medical expenses are the second-largest slice of the jail's annual budget, according to jail data.
The only thing more costly is staff salary and benefits, which take up about 90 percent of the jail's $10.946 million annual operating budget.
The county in 2011 budgeted $757,334 for physician services. The next biggest expense at the jail is boarding for inmates, budgeted at $531,929 last year.
The county's current contract for medical services is with Advanced Correctional Health Care and is good through 2013. Started in 2009, the contract cost was by far the lowest offered the county in that round of bidding, Chellevold said.
Advanced Correctional's bid at the time was in the ballpark of the $750,000 or so the county had been budgeting for the service.
That cost likely won't be around forever, Chellevold said. He suspects the next round of bids might be higher.
"There's a reason the others were around $1.2 million," Chellevold said of the previous bidding round. "It's just expensive."
"Like a small hospital"
For years, the county got by with using Rock County personnel to administer medical care to inmates. However, as the jail population kept climbing into the early part of the first decade, jail staff couldn't keep up.
Although he's seen the change as it happened, it still surprises Spoden to see the variety of medical needs that come through the door.
"It's amazing from my perspective, to see the day-to-day services we provide," Spoden said.
When Spoden started working as a corrections officer at the jail, one nurse, who would have been a county employee, took care of a small number of minor concerns. Often, the nurse dealt with cuts and bruises inmates got from fighting just prior to or during arrest, he said.
"To go from that to where we are today …" Spoden said. "It's like a small hospital we have here within the confines of the sheriff's office."
Ups and downs
On one hand, giving up the mountain of paperwork involved with providing medical services has been a good reduction in labor and hassle for jail administration, Chellevold said.
One downfall of having an outside contractor provide medical services is that it has limited the county's involvement in purchases. The current contract includes a tool to motivate the provider to keep costs at a minimum, Chellevold said.
The contract includes a pool of $50,000 for outside services such as hospitalization or dialysis. By statute, the county is allowed to pay hospitals and other providers the same rate a Medicaid client would pay, Chellevold said.
If money is left in the pool, 90 percent of it goes back to the county. The contractor can keep 10 percent as a bonus.
Inmates pay a $7 copay to see a nurse. If the nurse refers the inmate to a doctor, that visit is free.
The county was paid $5,649 for inmate copays in 2011, according to county data.
Managing costs
Since Spoden took office in 2007, he has focused on developing alternative programs that give inmates the opportunity to do community service instead of jail time. He also has increased the number of inmates ordered to stay at home on GPS monitoring bracelets.
Those programs, along with the Huber work-release program, do more than reduce the housing costs at the jail. They reduce medical costs, too, Spoden said.
People who are on the bracelet and serving their time at home are expected to cover their own medical expenses, Chellevold said. They therefore reduce the pressure on the busy medical facility, Chellevold said.
"If all the people that were out there on the bracelet right now were in here, we'd be busting at the seams," he said.
Aug 21, 2012 at 3:33 p.m.
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gonfo5,
Nah, to easy. Let's stone them to death for battery crimes, cut off limbs for stealing, etc...
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The struggle is balancing punishment for the crime and rehab for their return to society. Maxium security prisons already produce some of the most violent criminals in our society.
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If you treat inmates like caged animals they will act like animals, that should be caged, when released.
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So, do we go on the cheap, save money short-term and deal with the violence when their sentence is done, or do we invest in criminals hoping the investment results in less repeat offenders - less victims?
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It isn't black and white. I worked in a prison and witnessed on man released and returned 12 hours later. What a waste. I also know of at least one man who now successfully lives in Janesville. I have seen him volunteering on multiple occassions. What a great story!
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This is similar to alternative programs and charter schools. Do we invest in kids that don't "get it" and provide an alternative or do "stone them" with expulsion, F's and no alternatives?
Aug 21, 2012 at 2 p.m.
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Tent cities at the base of rock quarries! If they want to eat three times a day and sleep at night, they get to make large rocks into small rocks and so on! The materials they make can be sold to help cover their costs. May not be much but since they are overhead anyways, any money that is gained from their work will help. No fancy prisons to maintain and they get to work out without weight benches. Chances are they will never want to come back, but I'm sure some do-gooder group would hate this idea!
Aug 21, 2012 at 8:50 a.m.
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I understand jail and prison is overcrowded BUT if I want to beat up somebody what deturs me?? I have no fear of going to jail and getting free room and board, playing in the garden and still being able to go to work. Doesn't seem like punishment to me for some of these crimes.
One guy recently killed somebody drunk driving and got 10 years or so.
Aug 21, 2012 at 7:07 a.m.
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poo...so it's up to the hospital lobby to want more lenient sentences? You gotta be kidding with that thought. That's like saying the fast food industry should lobby to support Blomberg's proposal to shrink soda sizes to be sold. That's not their role! And it's not the prison's role to lobby for verdict or sentencing. It's congress role to set laws and the punishments for breaking the laws.
Aug 20, 2012 at 9:07 p.m.
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BTW- I would hate to be a nurse who has to work at the jail. The amount of work that they do is mind boggling. Yes, it scared me with my situation with my medication administration, but I also thought of just how many inmates take medications on a daily basis. Just thinking about the amount of work the nurses are doing with all of their patients and their limited resources, and I just have to say, Thank you.
Aug 20, 2012 at 9 p.m.
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RECAP is a wonderful program that allows inmates with addictions to become educated and to help them from relapsing. They also do a variety of community services in the Janesville area. Not everyone who goes to jail is a lost cause. We are all human and all of us have made mistakes. I had alot of time to reflect on my own mistakes. I certainly did not enjoy being an inmate, but I met people who touched my heart. Some of their life experiences made me cry and I understand why they went to jail.
One thing that really surprised me was how many people that were there who were addicted to heroin. It is becoming an epidemic in this area and that terrifies me. I hope that RECAP continues working with individuals who are addicted to drugs and have gone to jail because of it. It is my hope that people will realize that it is very easy to overdose on heroin and die. Is death really worth the high?
Aug 20, 2012 at 3:34 p.m.
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Chain gangs are rapidly becoming more prevalent and are, in part, responsible for civilian unemployment and wage stagnation. As politicians continue to privatize prisons and hand them over to private prison corporations to run, the trend will continue to worsen. New laws and longer sentences will continue to increase the rolls of cheap chain gang labor for private prison corporations.
And then the "law and order" tough guys can complain that prisoners are taking their jobs and/or preventing them from earning a living wage. Go figure. [ http://www.salon.com/2012/04/19/21st_cen... ]
Aug 20, 2012 at 1:36 p.m.
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Everyone knows, if you want free health care, free room and board, rob a bank and turn yourself in. Want something a little more cushier, plead insanity.Frankly, I like the way they operate in Arizona...chain gangs !
Aug 20, 2012 at 11:05 a.m.
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donnaw said, "poo...I thought the courts and judges determined if the charged defendant was guilty or not and the length of the sentence, not the prison."
This has nothing to do with who finds the person guilty. Laws are frequently being modified to lengthen sentences and judges increasingly have less discretion in sentencing -- having to follow strict sentencing guidelines. New laws are being added that criminalize behaviors that were not previously criminal and result in more people spending more time in prison. As previously stated, America now has 5% of the world's population and 25% of the world's prison population. I've not yet heard of any private prison corporation lobbying for more lenient sentencing guidelines and a reduction in the number of laws so their profit potential was decreased.
Aug 20, 2012 at 9:41 a.m.
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omg they lock you up for anything in rock county lol,half the people in jail,dont belong there,and thats why they are over crowded,they have nothing else to do,so lets mess with people,i actually moved out of rock county,hell i moved out of the state.ive never seen such crap,pull you over for anything,the prisons are loaded with people who couldve been punished other ways lol,oh but its ok,its only our tax dollars paying for it.
Aug 20, 2012 at 9:27 a.m.
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The only injustice here is that taxpayers are forced to bear the burden of cost for a groundswell of ne're-do-wells - many of whom are perpetual adolescents operating in a life-long state of arrested development. Most have likely seldom if ever taken responsibility for their behavior or for their health or for their families and offspring. Those choices should have consequences, and not be society's burden for wasting a life. Jail is not a cure-all comfort zone.
A comparatively disproportionate jail population in N American in relation to "the rest" of the world, hmmm? Why not? N Americans are likely the most selfish, self-absorbed, spoiled, over-medicated, unhealthy population the world has ever seen. Self-indulgent illegal behaviors go hand-in-hand, and we shouldn't wonder why our jails are burgeoning! Many of the incarcerated would never have made it in other countries or other times - here they are merely warehoused for lack of better options! Well...there's always RECAP!
So really, is it any wonder at all why jail health care is the second "Higest" cost!
Aug 20, 2012 at 8:39 a.m.
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The story fails to mention the dirty little secret of how penal institutions across the country keep medical costs under control. It's a little game where they "release" the inmate temporarily so they can obtain treatment at the hospital, pick up the inmate upon discharge & then leave the hospital holding the bag because the inmate most likely is uninsured with no means to pay. I've seen this done over & over including with inmates serving time as registered sex offenders. Frightening & disgraceful practice.
Aug 20, 2012 at 6:38 a.m.
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poo...I thought the courts and judges determined if the charged defendant was guilty or not and the length of the sentence, not the prison.
Aug 20, 2012 at 12:01 a.m.
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It's high at Mercy as well....peace
Aug 19, 2012 at 10:16 p.m.
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Also. RCJ offers many alternatives to jail or prison. They have the workender program for people to do community service to work off their fines they had warrants for. They have the RECAP program to help educate and find resources to get jobs and provide education to individuals to help them from relapsing and using drugs. If they complete the RECAP program, they do not have to go to prison. Rock County also provides Veterans of War with alternative solutions to jail if they suffer from PTSD from the military. They have drug court, which monitors individuals with frequent drug testing and counseling as an alternative to jail, and they do have the bracelet for home confinement for individuals such as myself (I am currently on the bracelet to finish the rest of my 30 day sentence, can NOT wait for Friday my last day whoot whoo!) But seriously, many counties in Wisconsin do not offer these alternatives to jail. I think RCJ is very serious about helping individuals who are serious about rehabilitation. The staff generally care, no matter what you might think. I know it opened my eyes and I am grateful to be out at home instead of in jail.
Aug 19, 2012 at 9:54 p.m.
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woodsmen-they do NOT ignore the contraband. I know for a fact that a female inmate in Huber for seven days brought in seroquel, klonopin, tobacco, rolling papers, and matches (in her vaginal area). She was caught and given an additional twenty days added on, without huber privileges. I think she personally should have had more charges added on, but at least the guards were vigilant about monitoring and searching inmates for potential contraband being brought into the jail.
Aug 19, 2012 at 9:47 p.m.
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Apparently, the nursing staff at the jail is severely understaffed. I had the pleasure of being an inmate for two weeks at the Rock County Jail. I was almost given the wrong medication, prozac instead of my night dose of gabapentin. If I had not been a nurse and been educated about my medications, I may not have caught that mistake. Another medication that was prescribed to be given to me once daily, the staff attempted to administer it to me twice daily on numerous occasions. I would then have to tell the nursing staff to check the label of my medication. Another issue that scared me was an inmate in there had a severe asthma attack in the middle of the night and was not treated for at least an hour. We were locked in the cells and there was not any way I could have given her medical assistance. I could hear her wheezing and frankly, I thought she might die. It was very scary. I understand that there are numerous inmates in there and the the ratio of nurses to prisoners is insanely NOT safe. However, what happened to every nurse checking medications for the Right med, Right dose, right patient, right time, & the right route & checked three times before giving the medication every time?
Yes, I made a poor choice and had to serve time for misdemeanor bail jumping, but while being there I expect to be kept safe. I was very concerned. I had also learned that the jail was prohibited from giving me certain medications that were prescribed by my doctor for my chronic health issues if they were on a certain list. This included medications that can cause severe adverse effects if stopped abruptly. However, they would give methadone to people who were addicted to heroin. I am just lucky I was released without anything serious happening. I hope to make better choices & NEVER go back there.
Aug 19, 2012 at 9:38 p.m.
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I would like to know why the RCJ just ignores the fact that the inmates are bringing in drugs,tobacco,roll paper & what ever else in there butts??
I know people that have just been in there,said they "DO NOT" check the rear cavity,well dah,that's where the stuff is!!
Aug 19, 2012 at 9:32 p.m.
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TroubleMaker, I agree with you and one cause of the high number of inmates in America is the privatization of prisons -- turning them into for-profit businesses. This provides incentives for private prison corporations and their shareholders to imprison more people and to incarcerate them for longer periods of time.
America has 5% of the world's population and almost 25% of the world's prisoners. This has got to be addressed.
Aug 19, 2012 at 8:50 p.m.
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Trouble- They must get some kind of state/federal funding per inmate for doing stupid stuff like that...There is really no other reason not to use home confinement for those cases...They could make home confinement for a longer period if they want that factor also.
Taxpayers get whacked in one way or another when they pull stuff like that.
Aug 19, 2012 at 5:22 p.m.
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Oops, someone didn't proofread the headline on the front page today: http://media.gazettextra.com/img/photos/...
Aug 19, 2012 at 5:07 p.m.
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There are just too many people in jail and prison in the US. It's shameful! I know several people quite well who are are not a threat to society or anyone else who are locked up for a long time. The criminal justice system is badly broken.
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