COUNTY WANTS JAIL PAYMENT CLARIFICATION

Cape Girardeau County officials may attempt to clarify whether Missouri statutes require the state to reimburse counties for the medical expenses of some state prisoners held in county jails.

Prosecuting Attorney Morley Swingle said he believes statutes require the state to reimburse medical costs of prisoners charged with felonies. Swingle said he will research statutes and court cases and may recommend the county commission file a lawsuit seeking payment of medical costs.

Presiding Commissioner Gene Huckstep said if Swingle determines there are legal grounds for a challenge, the prosecutor would be "more than welcome" to pursue action against the state.

Cape Girardeau County Presiding Circuit Judge A.J. Seier said the state's nonpayment is based on a Missouri attorney general's opinion that jail costs do not include medical costs. "But that's an opinion, not law," he said. "The only way this can be resolved is for a county to file a lawsuit.

"Even when I was prosecuting attorney, I encouraged the county court to file a lawsuit against the state," he said. "We're losing thousands of dollars in taxpayers' money each year. I don't think local taxpayers should be completely responsible for medical costs incurred by these folks."

Seier served as Cape Girardeau County prosecuting attorney from 1969 to 1976.

County Auditor H. Weldon Macke explained the county began adding the medical costs to fee bills sent to the state after Seier, he, and the county commission agreed that the state should pay for the medical costs of state prisoners.

Even though Cape County has included medical costs on bills since about 1969 or 1970, Macke said the state has not paid such costs.

"They haven't paid them, but we still think they're part of (the bill)," said Macke. "That's probably stubbornness on our part for putting them on."

Macke said the state pays nothing toward the medical expenses. The tab is considerable, with this year reflecting a substantial increase over 1990.

Figures released last week by the Cape Girardeau County Sheriff's Department showed that so far this year medical costs for jail inmates have totaled over $34,100. The costs in 1990 ran just over $20,300.

On average, the annual cost for medical expenses over the past five years has been $26,000. The money goes for doctors, dentists, hospitals, medicine and ambulance calls. About 135 inmates received medical attention this year, either one or more times, said Leonard Hines, the department's chief deputy.

Macke and Huckstep said Gov. John Ashcroft has vetoed legislation that would have required the state to pick up the tab.

State Rep. David Schwab, R-Jackson, said bills requiring payment have been introduced at least for the last few years.

Schwab said he feels it is the state's responsibility to pay for state inmate medical costs, "and I've supported this in the past. One of the reasons (a bill) hasn't made it is the lack of money and the tight budget," he said.

Swingle said he hopes to clarify the situation soon.

"In January I plan to research any court cases that have interpreted those statutes to see where the state of Missouri is getting the idea that it is not responsible for reimbursing Cape Girardeau County," he said. If he finds no case that supports the state's action, Swingle said he will recommend that the county commission file suit against the state for payment of the medical expenses.

Swingle said a state statute says the medical expenses are to be treated and assessed like all other court costs in criminal cases. A second statute says that court costs in felony cases where the defendant is sent to prison are to be assessed to the state of Missouri.

"When you read those two statutes together it seems clear that the state should be responsible for the medical expenses of felony prisoners," he said.

Prisoners who have the money to pay their medical costs are required to do so. The statute would apply to indigent felony offenders, or those unable to pay, said Swingle.

Seier said though the nonpayment of the costs has always been a problem, skyrocketing medical costs have placed even more of a burden on counties. Once prisoners arrive at a state penitentiary, he said, the in-house medical facilities are used and the state takes over the costs.

Huckstep said Cape Girardeau County can deal with the state's nonpayment better than some other area counties.

"(But) only because Cape County is in good financial condition," he added. "Some of these other counties around here, just one bill could devastate their treasury."

Last year, a medical bill for an inmate at the Cape County jail came to about $22,000. The man, who developed a serious ailment and had to have major surgery, was not even a Cape Girardeau County prisoner, Huckstep said.

The man was a parole violator who was supposed to just be held at the county jail for a few days, "and bingo, the next trip was the hospital and we got stuck," he declared.

The state steadfastly refused to pay the bill, but the county discussed the situation with medical authorities and negotiated a lower bill. In the end the county wound up paying about $5,400.

Swingle said if the state is only basing the nonpayment on the attorney general's opinion, he will recommend that the county commission file suit.

"It's exciting," he said, "because if it turns out a court has never decided this issue, it will be an important decision statewide."

Some information for this story was provided by Managing Editor Joni Adams.