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Archive for Monday, September 21, 2009

Prisons struggle with increased medical costs

September 21, 2009

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— Prison health care costs are soaring in Kansas as once-experimental drugs and procedures are becoming standard treatments.

The Kansas Department of Corrections spent $46.5 million in the most recent fiscal year on inmate health care, up 116 percent from 2000, the Hutchinson News reported in its Sunday editions.

“The primary factor is what everybody is experiencing — health care costs are just going up,” Secretary of Corrections Roger Werholtz said.

Health care now totals 17 percent of the department’s total operating costs as inmates with conditions once considered terminal and in need of treatment that was once experimental — such as HIV infection and hepatitis C — are living longer.

“People are being managed with those illnesses for very extended periods of time,” Werholtz said. “And we are obligated to extend that care when medically indicated.”

Even a shrinking prison population — down about 7 percent since 2004 — hasn’t been able to stem the increasing costs. The cost per prisoner has jumped from $2,772 a year in 2001 to an estimated $5,407 in 2009-10.

Much of the care is provided at prison clinics. One such clinic, at the Hutchinson Correctional Facility, sees more than 1,000 prisoners a month for everything from minor illnesses to end-of-life care. The Corrections Department also has designated centers of excellence at various facilities providing cost-effective specialized care such as cancer treatment, dialysis and cardiac care.

Inmates who are too sick to receive care at prison facilities are taken to community hospitals, where they are accompanied by guards who maintain a 24-hour-a-day watch.

Viola Riggin, the department’s director of health care services, said inmates are less healthy on average because many of them used illegal drugs that took a toll on their bodies or were too poor to see doctors.

“We get inmates coming to us very worn down and ill,” Riggin said.

She said more than 4,000 inmates in the system have chronic illnesses, such as asthma, cardiac problems, hypertension, congestive heart failure, seizures, diabetes, renal failure, hepatitis and HIV infection.

And the number of inmates with such conditions could rise in coming years because the prison population is aging.

“I wouldn’t say I’m alarmed (about health care’s growing share of the budget),” Werholtz said. “But we are always concerned about things that are harder to control. It’s no different than utility costs. ... You have to have electricity, you have to have water, you have to have heat, and there’s very little you can do to control the costs other than some conservation.

“It’s the same with health care. ... We just have to make sure health care is provided as effectively as possible. But we can’t control the costs of a heart catheterization or dialysis or an HIV drug regimen.”

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