With a dozen basic prices -- ranging from $9,425 to $15,051 per month -- several Marshall County commissioners are considering the increasing and complicated premiums for jail inmate health insurance. More nursing supervision is needed when a jail's average daily population reaches 125 inmates, and according to County Budget Director Freda Terry, if the jail has an AIDS patient -- "which we have had" -- costs would also increase.
Thursday evening, the inmate count was 115, Jail Administrator Sabrina Paterson told the County Commission's Law Enforcement Committee; "But the (17th Judicial District Drug) Task Force could be out and bring more in, and the population was up last winter."
Chief Deputy Billy Lamb said the inmate count is higher on weekends.
Meanwhile, a change in rules on how to count inmates will increase costs.
"If someone wasn't in jail for 12 hours, then they wouldn't be counted" in a statistical analysis that affects what medical services must be available for inmates, explained Patrol Capt. Sam Bragg, a former jail administrator.
"Now, if they're in for four hours, they're counted," Bragg said. "So, if they're here after a domestic violence charge, their 12 hours is counted as if they were held for a day."
There's what's informally called a 12-hour "cooling off" period for suspects charged with domestic violence, he confirmed. It's like keeping someone charged with public drunkenness or driving under the influence until they're sober.
With a few questions from commissioners, including Billy Spivey, the captain verified their suspicions. If a man is booked in on a domestic violence charge at 6 p.m. on a Friday and released at 6 a.m. the next day, Saturday, that one man would be counted as staying two days.
"We've experienced some really bad years with health care," Terry said as she was handing out a comparison of costs on inmate health care services.
The company providing services now is Southern Health Partners of Chattanooga. Its contract expires June 30, so the committee asked Terry to find out if it would extend the contract to give the commissioners more time to study the bids. On Friday, a one-month extension was granted, according to Commissioner Scottie Poarch, chairman of the Law Enforcement Committee, said about a day after the Thursday session.
"They came in for three years plus one," Terry said of the contract that started nearly four years ago.
Southern Health Partners was one of three companies submitting bids last month. The others are Detention Health Care Associates of Georgetown, Ky., and Advanced Correctional Healthcare of Peoria, Ill.
Detention offered monthly prices based on an average daily inmate population of 90- and 125. Southern offered two price lines for each of those inmate populations. Advanced offered six prices; three each for the 90 and 125 daily inmate counts. Advanced also offered different additional costs for inmates with HIV/AIDS and hepatitis.
"This is a lot of information," Terry advised. "Every time I go over it again, I find something else" to consider.
"Do you want time to review it?" the budget director asked as the meeting began. "I need a recommendation to go to the Budget committee for contract renewal on June 8."
That led the Law Enforcement Committee chairman to consult a calendar and various other meeting schedules. After various other considerations -- including another subject on jail administration, the committee decided to meet again on June 18.