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New inmate healthcare service already paying off, provider tells board

RICHARD RAINES says that his staff has prevented 30 unnecessary emergency room visits by jail inmates since Jan. 1.

According to the inmate health care service provider at the Grady County Detention Center, the county has already saved a projected $175,000 to $200,000 for unnecessary hospital visits.
Richard Raines of Innovative Healthcare Solutions appeared before the board of commissioners Tuesday to give an overview of the new inmate healthcare service that began Jan. 1 of this year.
“I’ve got good news. From Jan. 1 until April 1, we have prevented 30 unnecessary emergency room visits and seven hospital admissions,” Raines told county commissioners.
According to Raines, Innovative Healthcare Solutions’ nurse at the jail evaluates patients, takes electrocardiogram tests, transmits them to a physician and dispenses medicine, plus more in an effort to provide quality healthcare to inmates while, at the same time, reducing the county’s liability and healthcare costs.
The county is under contract with Innovative Healthcare Solutions at an annual rate of $129,804.
Raines said that even if you took half of the projected savings during the first three months of the year, the county has saved the cost of his services.
During the first quarter, Raines said that 350 inmates were treated and over 500 prescriptions were filled and are dispensed according to doctors’ orders by the jail nurse.
A nurse is at the jail 20 hours per week but, according to Raines, the average for the first quarter has been 26 hours a week. He said the county would best be served with the nurse on-site from 7 a.m. until 7 p.m. to eliminate jailers from having to distribute medicine at night.
However, he said he would continue to maintain the county’s cost based on 20 hours per week and he would cover the 26 hours of service as long as he can and achieve a profit.
He reported that his nurse has received an average of 15 calls after hours and makes, on average, two trips to the jail after hours per week.
Raines told commissioners as inmates begin to learn the firm’s practices, those numbers will decrease. At another south Georgia facility, Raines said the nurse receives only an average of two calls after hours and makes about one trip per month to the jail after hours.
“Inmates don’t want to be in jail and they will use any excuse as a ticket to go to the hospital and get out of jail,” Raines said.
However, he admitted that many of the county’s inmates are unhealthy people. During the first quarter, he said that three inmates had to be sent to the hospital. One was with a case of gall stones and a third was a pregnancy, which is not covered by the contract.
“Overall, we have exceeded my expectations of what we could save the county. As inmates learn how we do things, they will think less about calling the nurse when they see it doesn’t give the ticket to get out of jail,” Raines said.
The Innovative Healthcare Solutions official, who is based in Valdosta, said he and his staff have developed a good rapport with Sheriff Harry Young and Jail Administrator Captain Tim Gainous.
Sheriff Young agreed and noted, “I am very satisfied with Richard and his staff. This is something we needed to do for a long time. You will get sued when you operate a jail, it is just part of the business, but this will greatly cut down on our liability and the cost of inmate healthcare.”
Commission Chairman Billy Poitevint questioned Raines on charges for medical supplies billed to the county and asked if the company would reimburse county for those charges.
Raines said the county should not be billed directly for any medical supplies and agreed to meet with the sheriff and jail administrator to go over the bills in question.
Both Sheriff Young and Jail Administrator Gainous said the sheriff’s office has to buy some medical supplies to have on hand including surgical gloves used when booking or frisking inmates, as well as first aid supplies for jail personnel and the county work detail that cleans county offices and does roadside garbage pick up.
County Commissioner Charles Norton questioned Raines on his projected cost savings.
According to Commissioner Norton, the county spent a total of $132,000 for inmate health care in 2010; $148,904 in 2011; and $116,096 in 2012.
“The numbers just don’t show the savings you are talking about,” Norton said.
Raines explained that before his firm took over inmate healthcare if an inmate complained of chest pains the jailers would have the inmate transported to the emergency room for evaluation. Under his projections, each of those visits has a cost associated with it and every unnecessary emergency room visit the county does not have to pay for is a savings realized by the county.
“Regardless of what you have paid in the past, this is what we are seeing now,” Raines said.
Chairman Poitevint also questioned the value of the EKG testing.
“Unless he is having a heart attack right then or you have another test to compare it to, it doesn’t tell you anything,” Chairman Poitevint said.
Raines disagreed and said it would alert the nurse if the inmate was suffering a cardiac pain or not.
“It will not determine long term cardiac injury or muscle damage to the heart, but if it is not emergent, then you don’t need to send the inmate to the emergency room,” Raines said.
Commissioner T.D. David asked if there were any issues with providing healthcare to jail inmates who happened to be city prisoners, which prompted Commissioner Norton to note the contract was based on a certain number of inmates in the jail and there was no reference to the inmates being county, city or state prisoners.
Raines said he had made a proposal to the city of Cairo to help reduce their cost of healthcare for their inmates, but the city did not respond. He then suggested a fee per inmate, which the city rejected.
Raines said  the city and sheriff have an agreement and he has instructed his nurse to provide care for all inmates regardless of if they are city inmates or county inmates.
“I’m the one that asked that you come and give us a quarterly report to make sure there are no fires to put out. If you are satisfied and the sheriff and (Captain) Tim (Gainous) are satisfied, then we don’t have any problems,” Commissioner David said.

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