A $50,000 medical bill from an inmate who was shot as he was taken into custody in March could have wiped out the Drew County jail's medical budget of about $40,000 annually, said Susan Potts, Drew County jail administrator.
The jail was able to apply on the inmate's behalf for Medicaid, which covered the inmate's medical treatment, Potts said. Medicaid was expanded in the state Jan. 1, 2014, under the federal Patient Protection and Affordable Care Act.
"County jails are strapped when it comes to medical," Potts said. "Without that help, at that particular time, it would have gone over my county budget."
The Medicaid expansion extended coverage to adults with incomes of up to 138 percent of the poverty level -- $16,105 for an individual or $32,913 for a family of four.
Medicaid does not cover inmates while they are held inside of a jail or prison, said Ronnie Baldwin, Arkansas Sheriff's Association executive director. It only covers hospital stays after an inmate has been treated for more than 24 hours.
"If that inmate is eligible, then that hospital stay is covered, and it results in a huge savings for the counties," Baldwin said.
It has taken time to train jail officials about the proper steps to take to apply for Medicaid coverage on behalf of inmates, Baldwin said.
"It is a very complex issue, and we have worked for a year to get this thing in place because nobody knew how it would work," Baldwin said. "That has been a huge problem."
Jail officials in several counties said in March that they were still researching how the Medicaid expansion would work. Washington County jail was one of those jails.
Randall Denzer, Washington County jail administrator, said he has since attended a training session held by the Arkansas Sheriff's Association. The session taught him how to properly file paperwork needed to apply for Medicaid on an inmate's behalf, he said.
The process is complicated and confusing, Denzer said.
"The paperwork looks like an income-tax form," Denzer said. "We start the process. Then we give it to the hospital and then they turn it in somewhere and then it goes through several steps before the money goes back to the hospital."
Washington County jail hasn't had an inmate stay in the hospital for more than 24 hours this year, Denzer said.
"Nobody has fallen in that category yet," Denzer said. "We have our forms if it does happen. We are ready."
Mark Whitmore, Association of Arkansas Counties' chief legal counsel, said his association is one of several groups in the state that have started helping county jails navigate the Medicaid system.
Potts said she relied on help from the association when filing for Medicaid for the inmate whose coverage she described.
"I had to fill out the paperwork," Potts said. "But the Arkansas Association of Counties was the one who got the ball rolling."
Drew County was the first jail in the state to apply for coverage from Medicaid, Potts said.
Whitmore said that by this summer, most jails had someone trained in how to fill out the paperwork.
"I think our jailers and sheriffs are well instructed on it, and they know about their options," Whitmore said. "The inmates are entitled to Medicaid. It is bad logic to think that a county jail, paid by local taxpayers, needs to step in when there is Medicaid available."
Baldwin said it took a few jails applying for Medicaid for the rest of the jail administrators to learn what to do.
"We are on the right path now," Baldwin said.
NW News on 01/04/2015