On Dec. 10, Inyo County Health and Human Services Director Jean Turner presented the Inyo County Board of Supervisors with a sobering workshop on what she called “the biggest single concern for my department.” That concern: the rapidly escalating cost of jail inmate medical service.

Turner reported that the cost of jail medical service for the first quarter of Fiscal Year 13/14, from July to the present date, is at $98,266.  Given what Turner described as “an alarming spike in medical costs to our inmate population,” staff projected out the trend and came up with an estimated total cost of $523,937 for FY 13/14.

By comparison, the total cost for jail medical service in FY 12/13 was $263,430.

Jail medical service costs include a contract with Southern Inyo Hospital, a pharmaceutical contract, jail nurse, physician, dentist, ambulance, and other miscellaneous costs.

The spike in medical service expenses is the direct result of Assembly Bill 109  (AB109), Turner explained. Governor Brown signed AB109 into legislation in 2011 with the intent to reduce crowding in state prisons by transferring low-risk inmates to local county jails to serve out the remainder of their sentences. Where before, inmates could only serve up to a year in County jail, “we’re now starting to see people with long-term sentences in County jail,” Turner said. She added that this year, “we have the highest year of inmates with medical issues so far.”

Because these inmates suffer chronic diseases typical of the greater population, from diabetes to kidney stones to heart disease, and because some of these diseases require intensive daily management or even hospital visits to Southern Inyo Hospital, the need for jail medical service is growing. While the AB109 inmate population hasn’t grown, Turner said, the increased, long-term demand for medical service from the population is taking its toll.

In her presentation to the Board, Turner separated the increase in service costs directly attributable to AB109 inmates from the overall annual cost of jail medical service. That cost for AB109 inmates has risen from 9.2 percent of all jail medical service expense in FY 11/12 to a projected 45.6 percent of all jail medical service expense in FY 13/14.

Turner also noted that the County does not receive state funds specifically designated for inmate healthcare costs, but rather a broader fund for both inmates and the general population. “It’s a finite amount of money,” she said, adding that to apply more of that pool to inmate services would reduce funding for services for the general population.

Turner did offer a note of hope that Medical will soon begin covering inmate inpatient care, for inmates on Medical. Inpatient care “can certainly be a big chunk of a healthcare cost,” she said. However, she added, “what we’re seeing here is a majority of outpatient care.”

Health and Human Services has tracked trends in jail medical service since 2004, Turner said. The trend toward a rising jail medical service cost could change, she said; “We’ll be coming in [to the Board] monthly with updates on what we’re seeing in the inmate population.”