Article published March 7, 1993

Hospitalized prisoners cost county

Robert William Skelton of Inman crashed into John Bishop in a fatal accident earlier this month, and the S.C. Highway Patrol planned to charge him with felony drunken driving. But Skelton wasn't charged on Feb. 21, the day of the accident on S.C. Highway 292. Trooper Wayne Owens waited five days while Skelton recuperated in Spartanburg Regional Medical Center and then arrested him when he was released. If Skelton had been arrested the day of the accident, Spartanburg County would have been liable for his medical expenses and possibly the costs of putting a guard at his door. "Once you take away that freedom, you're responsible for medical care because they are no longer free citizens," county jail Warden Larry Powers said. "That's just a fact of life." Powers and others in law enforcement know how to avoid some of those costs, just as Trooper Owens did by not arresting Skelton until after he was out of the hospital. Powers worries as much about the cost of guarding prisoners once they've been sent to the hospital. He prefers short stays. "Somebody 24 hours a day, seven days a week, that's a lot of overtime," he said. Sometimes law enforcement agencies try to drop off injured suspects at the jail so they won't be responsible for guarding them. "Police try to slip these people in here," Powers said of injured prisoners. "They don't want to baby-sit someone at the hospital." Deputy Solicitor Trent Pruett said Powers occasionally will ask the Solicitor's Office to approve bond on a prisoner who has been in the jail because he needs medical care and the county doesn't want to pick up the tab. "I've had Powers come and say, `Can we get this guy out on bond so we don't have to pay for it?' " Pruett said, recalling one prisoner who was freed because he was facing major surgery. But Powers does not pay directly for the hospital care of prisoners who have not been sentenced. Under an agreement the county has with Spartanburg Regional Medical Center, the county's indigent care funds pick up many of the bills. Of the $250,000 the county paid that fund in 1992, $41,381 went toward medical costs for prisoners. The county also spends $21,000 a year for a doctor who visits the jail twice a week. Powers said 1992's costs were lower than previous years, and that the costs have been as high as $70,000 annually. Peggy Clary, supervisor of Spartanburg County Indigent Care Services, said her program handled 530 prisoner visits in 1992. Under the agreement, the hospital bills the fund for room and services, but uses in-house doctors instead of paying outside doctors' fees. The county must pay the medical expenses of someone who has been sentenced to time in the county jail. "We could have someone with a 30-day sentence on a public drunkenness charge, and if he had open-heart surgery, the county would be liable," Clary said. Typically the fund handles outpatient and emergency care, while a state program to which the county contributed $845,266 last year pays for hospital stays and services for the poor, including prisoners. "We try to get that pushed through, because naturally, the county doesn't want to pay that," Clary said of extended-stay hospital bills that are paid by the S.C. Medically Indigent Assistance Program for prisoners and other poor people. But Clary said extended stays are rare, and last year's costs were insignificant. "The county has as much a right to have a bill written off as an individual," she said. Powers also is budgeted $60,000 annually to take care of the medical needs of prisoners. He said much of that goes toward medical supplies and day-to-day treatment equipment. "There would be some major cost involved if the county had to pay for it," Powers said. Pruett and Powers pointed out that it is unlikely that the most dangerous defendants would get bond to go to the hospital just to save money.