Officials seek 24/7 medical coverage at jail

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Officials at the Tri-County Regional Jail are working to provide around the clock medical care for inmates.
Jail Executive Director Scott Springhetti said generally the jail has a nurse on duty 12 hours a day.
Union County Commissioner Gary Lee, who sits on the jail commission, said nurses try to share weekends and holidays, but said coverage during those times, “can be sporadic.”
“Over the last couple of years we have increasingly seen medical situations we don’t have nursing care for,” Lee said.
Springhetti said corrections officers are trained to deal with some medical issues and there is an on-call doctor that can be reached for consultations.
Lee said that if there is a medical issue beyond the capacity of the corrections officers, an ambulance is called and the inmate is taken to a local emergency department.
“I don’t have to tell you, the cost of that is significant,” Lee said.
Each of the three counties that share the jail — Union, Madison and Champaign — have each allocated an additional $110,000 to help pay for around the clock nursing coverage.
“It was a step that we felt was necessary,” Lee said.
He explained that the county incarcerating the inmate pays costs associated with a trip to the emergency room. Lee said the hospitals bill the county directly. He said the cost for medical bills comes from the county budget, not the jail budget. Lee said the commissioners create a line item in the budget to pay those bills.
“I think, as we start 2018, we are going to still budget that same number, but we will hopefully see a reduction in the need for that,” Lee said.
Jail officials estimate that as many as 85 percent of inmates are using drugs, primarily heroin, either on a daily or regular basis. Lee said inmates are generally at the jail long enough to begin withdraw but not long enough to be ready for help and treatment services. He said it is important to “help these folks get their withdraw under control.”
In addition to helping the inmates, the additional staff is a help to the others at the jail. He said that by providing around the clock medical attention, the jail administration is working to protect the inmates as well as staff.
“These people, as they go through that early withdraw, they are a threat to themselves and to the other inmates and the staff,” Lee said.
Springhetti said medical staff is required to give each inmate a medical assessment within 14 days. Springhetti said additional staff would allow those assessments to be done “more efficiently.”
He said new inmates are often not truthful with the corrections officers processing them. Springhetti said that because of fear, inmates will often not disclose medical, addiction or mental health issues to officers. He said those issues often come up in the medical assessment, noting the inmates will be more truthful with a nurse.
“As we look at staffing up, it is going to take a special person as a nurse, who has the right attitude for caring for these people,” Lee said. “They are going to be the lifeline for folks coming in. How they treat the new inmates is going to be critical to starting to get people on the right track.”
He said officials arte also looking at expanding both the mental health resources for inmates as well as the number of beds.
Springhetti said the jail was built for 160 inmates. He said there are now 212 physical beds in the jail, but anything over 160 is considered “overcrowded.”
He said the average daily population is 171 inmates.
“When the jail is over crowded, the more people you put in there, the likelihood of people getting along decreases, the opportunity for people, especially people with certain criminal histories, causing issues increases,” Springhetti said.
Lee said the jail was built with the potential for expansion.
“We do not have any numbers at this point, but we are starting to look at the cost of expansion to the jail,” Lee said.
Springhetti said Champaign and Madison County populations have “kind of stabilized” but Union County population is projected to steadily increase. He said the heroin epidemic also shows little sign of abating. He said he would anticipate increasing the jail size to about 300 beds. While the need for 300 beds is not there now, officials project it will get there.
“We think that would get us past this overcrowding situation and help with the expected population increase,” Springhetti said.
Obviously, Lee said, the concern is paying for the expansion. He said he would anticipate a minimum cost of $8-$10-million for the increase.
“It is hard to ask one of your partners to chip in for expansion they do not need,” Lee said.
Springhetti and Lee said there is a need for mental health resources. Lee said there has been talk of creating a halfway house or a step-down facility to help people transition from jail to the general population and to provide assistance as inmates get off drugs.
“Can we find a 20-bed facility that we can afford?” Lee asked. “That is something that, personally, I feel would be part of a solution, not the entire solution, but certainly a start”

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