Community health concerns impact jail costs

Health care expenditures for those behind bars are a growing concern at the Ector County Law Enforcement Center.
Counties are obligated to provide appropriate medical, mental and dental services for people that are incarcerated due to state mandates, but budgeting for these expenses comes with challenges.
“Inmate medical care has just skyrocketed, and we have inmates over here that we are required to take to doctor visits, for wound care, dialysis and various other things,” Ector County Sheriff Mike Griffis said.
Estimated total operating costs for all 254 Texas counties increased by about 7 percent during the last fiscal year, from $1.5 billion to $1.6 billion, due to numerous contributing factors including health care, a Texas Association of Counties 2018 Unfunded Mandates Survey stated.
Forty-nine counties provided TAC with their expenditures for jail inmates’ trips to hospital emergency rooms, including Ector County, and the results showed a sharp increase in recent years.
TAC made estimations for the entire state based on data gathered from respondents and concluded about $40.5 million was spent last fiscal year for emergency room visits by jail inmates, up about 53 percent from 2017 and triple that of fiscal year 2011.
Adjusting county budgets to account for health care needed in jails can be difficult to predict.
Just this month, Ector County approved a budget amendment to cover further costs at ECLEC.
Ector County Auditor Randy Donner said the original budget for this year allocated $787,000 just for jail medical services, but an amendment for an additional $800,000 was passed last week to cover items like prescription drugs, medical supplies and doctor visits.
Griffis described the issue as an everyday battle with logistics.
The number of people in custody fluctuates on a daily basis because there are people coming in and being released from the facility 24 hours a day. The detention center is a facility with a housing capacity of 667 inmates and about 230 have been outsourced to other counties.
Interlocal agreements with other counties are used to house and care for the people that Ector County does not have the physical room for or does not have the number of employees to meet mandated jailer-to-inmate ratios set by the Texas Commission on Jail Standards.
Griffis said inmates that are sent to other counties are those that are minimum security risks and do not have any known behavioral, medical or mental issues, which leaves the population of incarcerated individuals identified as needing the most care concentrated in Ector County.
Some solutions being sought to control for rising operating costs include a jail expansion that is expected to be completed by October. The project will bring the total number of beds the jail will have up to 1,019 and reduce outsourcing cost.
The county spends about $45 a day for each inmate housed at another county jail.
Another avenue the county has taken involves partnering with local mental health authority, Permia Care, to use state grant money to provide continuity of care to people with mental illness who are involved in the criminal justice system.
A primary goal for Permia Care is decreasing recidivism of those who need treatment rather than incarceration. Todd Luzadder, the mental health director for Permia Care, said finding clinically appropriate solutions for patients before they are released is ultimately a cost savings for the community.
The people jailed at ECLEC come from a community where health care is already a widespread concern.
The Ector County Physical Activity Coalition identified the area as one of the unhealthiest counties in the entire state of Texas in 2015, and the next year a Medical Center Hospital community health needs assessment listed addressing high mortality rates, chronic diseases, preventable conditions and unhealthy lifestyles as a top priority for the following three years.
The MCH assessment stated as of 2015 Ector County had a significantly higher rate, 23 percent, of uninsured adults between the ages of 18 to 64 years old compared to the state, 16 percent, and nation, about 11 percent. Those without insurance are more likely to go without preventative care and may develop more serious conditions that require treatment that comes at a greater financial cost down the line.
An updated community health needs assessment will be released later this year.
Griffis said there will not be one fix for the problem occurring in the jail, but he hopes that the state will step up to ease the burden placed on local governments with limited funds.