N.D. lawmakers discuss inmate medical bills

BISMARCK�The increasing cost of medical care for jail inmates is of growing concern for North Dakota counties, and state lawmakers are trying to decide how to handle the issue.

The Senate Human Services Committee heard testimony Monday regarding Senate Bill 2024 relating to adequate medical care and payment of inmate medical costs.

�This bill isn�t the whole answer, but it does provide some answers to the questions that the counties are facing,� said Terry Traynor of the North Dakota Association of Counties. �This bill starts to put some brackets around that cost.�

In 2009, the state�s jails reported more than $1.5 million in inmate medical costs, he said. North Dakota�s 53 counties maintain 26 jails. A 2008 survey found the average daily population statewide was 1,063 inmates.

The bill makes �crystal clear� that it is not the responsibility of the jail to pay for medical costs for someone supervised under home detention, electronic monitoring or a similar program that doesn�t involve jail confinement, Traynor said.

The rest of the bill tries to clarify inmate medical responsibility, he said.

The bill states inmates are financially responsible for the costs of medical or health care, except for an intake health care assessment and related testing for an examination at the jail�s request.

The jail may seek reimbursement from the inmate up to the total amount of incurred medical or health care costs. If the inmate has health insurance, a medical or health care provider shall file a claim for reimbursement.

However, most inmates do not have medical insurance, Traynor said.

If the inmate doesn�t have insurance and the health care costs are the responsibility of the correctional facility, the bill would limit the jail�s responsibility to the rates paid under the federal Medicare program.

Cass County Sheriff Paul Laney said he�s glad to see the Legislature looking into the situation. The Cass County Jail has �been smacked twice� in recent years with inmates with significant medical costs, he said.

�We get charged full rate for each and every individual inmate that goes to the hospital,� he said.

Limiting the jails� responsibility would be a �huge� help, Laney said. Right now, counties struggle to predict budgets because they don�t know what medical conditions inmates may have and the associated costs, he said.

However, the bill brought up some questions. Sen. Tim Mathern, D-Fargo, said the full medical bills still need to be paid by somebody. What the counties don�t pay would get transferred to the providers and eventually be paid for by everybody with health insurance, he said.

Former inmate Donald Bender of Wilton, N.D., said he�s concerned about jails going after former inmates for medical reimbursement and what will happen to inmates who can�t pay.

Sen. Spencer Berry, R-Fargo, said inmates may not seek employment after their release if everything they work for is to pay their jail medical bill.

Mathern said the committee took no action on the bill Monday and will further discuss it and possible amendments in the future.