San Juan County Commission vetoes inmate co-pay policy at jail

Steve Garrison The Daily Times
The Daily Times

AZTEC — San Juan County commissioners voted unanimously Tuesday evening to discontinue charging inmates at the county's Adult Detention Center a fee for using medical services.

Jail Administrator Tom Havel provided the commissioners information that supported his belief that the policy of charging co-pays was not cost effective and created an undue burden on staff at the jail.

Havel told the commission it had good intentions when it passed the policy in 1997, "but it's ending up being more trouble than it's worth."

Commissioner Jack Fortner made the motion to discontinue charging the fees.

He said he was concerned that the policy was not cost-effective, but also that it may lead to more lawsuits being brought against the county and its jail.

"We don't want to discourage inmates who have legitimate medical concerns," Fortner said.

The Daily Times first raised questions about the policy in May after three inmates at the detention center died in the first three months of this year.

As previously reported, two of those three inmates filed formal grievances with the jail regarding the medical fees in the months before their deaths.

The family of all three inmates have filed wrongful death lawsuits against the jail and its health care providers, San Juan Regional Medical Center and Presbyterian Medical Services.

The National Commission on Correctional Health Care, created by the American Medical Association in 1983, has stated it does not support the charging of medical fees, arguing the fees discourage inmates from seeking treatment for minor illnesses, which may lead to more costly medical emergencies.

However, experts interviewed by The Daily Times have said the fees are common at detention facilities at the state and county levels because they discourage frivolous medical complaints.

The current fees range from $5 to $20 at the San Juan County jail and are collected from the inmate's commissary account whenever he or she visits a physician or dentist, or when the inmate refills a medication prescription.

A medical review by an in-house clinician will also result in a fee.

However, Havel told the commission Tuesday that more than half of billable fees, about 56 percent, were not collected in the past fiscal year due to inmate's having insufficient funds in their commissary accounts.

He said, historically, the jail has collected an average of $18,000 per year from inmates, which is less than 1 percent of the jail's total medical and mental health expenditures in fiscal year 2016.

Commissioner Scott Eckstein said he was concerned about inmates filing false medical claims.

"I cannot tell you that will not occur," Havel said. "But the triage ability of the hospital is incredible and I think they can catch that."

Eckstein said he would "reluctantly" second Fortner's motion discontinuing the fee policy, but said the situation at the jail would need to be monitored.

"I don't want us to be sued, but I don't want us to waste money on inmates either," he said.

Steve Garrison covers crime and courts for The Daily Times. He can be reached at 505-564-4644 and Follow him on Twitter @SteveGarrisonDT on Twitter.