THE COST OF PRISONER HEALTH CARE0

JACKSON -- The state of Missouri's position on paying prisoner medical costs remains a mystery to Cape Girardeau County Sheriff John Jordan.

The county holds hundreds of state prisoners, or those charged under the state penal code, over the course of a year. The state pays a daily fee for housing those prisoners. The state pays costs of extraditing prisoners from other states. The state pays for food and transportation and even the costs of trials.

But the state doesn't pay the cost of medical care for those prisoners.

Case in point: Roberta Burrell, 42, who is charged in the stabbing death of her mother, Opal Baugus, in October.

Burrell has racked up prescription drug charges of more than $2,300 since her arrest.

"Those are drugs prescribed by a doctor, so she has additional medical bills that aren't in that total," Jordan said.

Last year, Cape Girardeau County spent over $62,000 to keep prisoners healthy. The sheriff thinks some of that should have been paid by the state.

The issue dates back at least a decade. But the state remains steadfast in its decision not to pay.

"When we house county prisoners at another county, we pay their medical bills. When the feds house prisoners with us, they pay the medical bills," Jordan said.

This legislative session, Jordan said, members of the Missouri Sheriff's Association, the Missouri Association of Counties and other statewide organizations will renew their request to get medical bills covered.

In the meantime, the sheriff explained, the county has taken steps to bring medical costs in check. Specifically, three years ago the department began requiring prisoners to pay a $10 co-payment for medical treatment. The money is deducted from prisoners' commissary accounts.

If prisoners have no money, the county keeps track of the medical visits in case a prisoner returns to the jail on another charge at another time.

"Before we instituted this policy," Jordan said, "we used to have a lot of `sunny day-itis.'"

Prisoners would complain of a malady or illness just for a change of scenery and a trip to the doctor's office.

Now that the trip has a cost to the prisoner, Jordan said, the 'sunny-day' trips have stopped.

"Their commissary money is precious to them," he said. "When they request medical care, they are really sick."

And with an average daily jail population hovering between 90 and 100, the cost for sick inmates mount up.

In the two months of Dec. 1998 and Jan. 1999, the county spent $6,348 for some 60 prisoners housed at Cape County jail. Those bills include doctor's office visits, prescription drugs and emergency room visits.

In addition, during the same two months the county paid another $6,826 for some 30 prisoners housed at other facilities. Burrell, for example, is being housed in Madison County.

For several years, the county has been housing prisoners at jails in surrounding counties because the jail in Jackson is full.

"When prisoners are at other counties, we don't have control over the costs," Jordan said.

The difference in medical costs for prisoners housed in Jackson and half as many housed in other jails points out the need for a scheduled jail expansion, Jordan said.

"We've got to do something. It's not just the costs of medical care," Jordan said.