Inmate medical care cost increasing

Blair County payout for prisoners going up $41,000 a month to $2.19M annually

HOLLIDAYSBURG -- Blair County's cost of medical care for inmates is increasing to $2.19 million annually -- about $41,000 more a month than the county has paid since February when it extended PrimeCare Medical's contract by six months.

"We knew this was coming," Commissioners Chairman Bruce Erb said Tuesday about the Harrisburg-based company's new rate that equates to about 6% of the county's annual revenue of $35 million in real estate taxes.

"It is sticker shock," Erb said.

Commissioners are slated Thursday to approve a three-year contract with PrimeCare, which assigns personnel to the prison for on-site medical, dental and some mental health services. The contract also includes a full-time licensed clinical social worker, a position added several months ago that will be retained in the new contract.

Commissioners said Tuesday that efforts were made to explore the availability of other providers. In February, they signed a six-month contract extension with PrimeCare, at $142,981 a month, providing time for that effort.

In a recent report to the prison board, Warden Abbie Tate said she identified two possibilities. One said it couldn't match PrimeCare's rates, she said, and the provider said it no longer serves Pennsylvania.

"There's just not a lot of options out there for inmate medical coverage right now," Tate told the prison board.

The commissioners, who sit on the prison board, had access to copies of the proposed three-year contract with PrimeCare.

Tuesday's meeting agenda listed the company's annual rate of $2.19 million -- $187,107 monthly -- based on 350 inmates. Small rate increases will be made when the population exceeds 350 inmates and slight decreases when it's less.

The cost of PrimeCare's contract also prompted discussion among Erb and fellow commissioners Laura Burke and Amy Webster about the need to advocate for a change in federal legislation so inmates can retain Medicaid coverage now halted upon incarceration.

While Medicaid is a taxpayer-supported program, Erb said it's also a program that drives down health care costs and would be considerably cheaper than what counties are collectively paying.

"Every county in Pennsylvania with a prison is facing this same issue," Erb said.

Webster added that the current practice makes it more difficult for a county to keep its real estate taxes low.

Erb also made the point that he thinks it's wrong for someone to lose Medicaid benefits while they're still considered to be innocent.

"This is before there's any guilt determined, before their sentence is set," he said.

Burke described that as "a fair point" and said she finds it unconscionable that Medicaid ends for an inmate who has yet to be sentenced or found guilty.

Erb also added that because a change in practice would require action by the federal government, the issue has been addressed with U.S. Sen. Bob Casey, D-Pa., and U.S. Rep. John Joyce, R-13th District.

Mirror records show PrimeCare has provided inmate medical care at the prison since 2005, when its first-year contract cost was $449,000.

In 2004 when the county employed health care personnel to work at the prison, medical care costs were reported to have added up to $817,000.

Mirror Staff Writer Kay Stephens is at 814-946-7456.