Officials tout jail medical center

EDITOR’S NOTE: This is the first installment of a two-part series on medical care at the new Garland County Detention Center. Part one provides an overview of the program. The series concludes next Sunday.

About one year into its operation, the medical center at the Garland County Detention Center, run by Southwest Correctional Medical Group, is proving to be a cost-effective way of dealing with inmates that ensures the safety of the community, the center’s medical director said Friday.

“You’re not having to pay transportation costs in either having a deputy leave his other duties to take them or the cost of transporting them by ambulance and you’re not having to pay emergency room fees,” Dr. Karl Wagenhauser said of the center’s increased ability to treat the majority of inmates on site.

Both Wagenhauser and Sheriff Mike McCormick acknowledge that the actual cost of operating the center, which offers roundthe-clock medical care with eight full-time employees, versus the previous method of transporting the majority of inmates to local hospitals, is not necessarily lower, but the decrease in liability and lawsuit costs, coupled with eliminating the risk of escape, makes it worth it.

The $888,000-a-year cost of the clinic is an expense “I am going to have to justify every year,” McCormick said, but noted, “This fits into my overall goal of trying to make Garland County a safer place for everyone.”

The center has three examination rooms, with the capability to take X-rays, perform lab work, provide IV fluids, and manage long-term conditions such as diabetes, HIV, hepatitis, and hypertension.

Wagenhauser also noted they are able to do many of the functions for a fraction of the cost of sending inmates to a hospital. Prescription medications are ordered through a contract with a pharmaceutical company at a lower price than what’s offered locally by “cutting out the middle man.”

He stressed that if there was an emergency they would contact a local pharmacist to get enough drugs for a day or two, but then would make arrangements to get the remainder of the medications from the company at reduced costs.

Since the center operates as a 24-hour facility, it is able to stockpile medications, and Wagenhauser noted it is equipped with same drugs as those found on an ambulance to deal immediately with any emergency situation, such as blood pressure control and allergic reactions.

Melissa Jarrett, the health services administrator for the clinic, noted that 70 percent of the inmates are using “some type of medication” although much of it is the over-the-counter type, and not long-term prescribed medication. She said the nurses have pill carts that they take around to the pods in the detention center twice a day distributing pills.

“A large part of the population that comes to the jail have problems. Out there they can self-medicate and they get in here and have to request it,” she said. “It’s an adjustment for them.”

Wagenhauser said they are equipped to deal with inmates that come in who are addicted to prescription medications and other drugs. “We can do detox at the facility now. We can take care of that.”

McCormick noted that the use of narcotics and other highly addictive medications has decreased by 80 percent within the detention center as a result.

“Having a full-time (on call) doctor dedicated to the medical program has allowed for alternative medications and treatment protocols to be utilized,” he said.

Jarrett said that about 90 percent of the medical problems the inmates have can be treated at the center. “They come in off the street and we evaluate them and check their vitals,” she said, noting that a patient complaining of chest pains can be checked on site, and much of the time remain at the center.

She said inmates who claim they are having a heart attack or other condition can now have their vital signs checked at the facility, saving the cost and risk of transporting them to a hospital.

Major examples, Wagenhauser noted, are people brought to the center for public intoxication with elevated blood-alcohol levels. He noted the previous procedure was to send anyone with 0.30 percent or higher to the hospital, but now “we can monitor them at the center until they sober up.”

Jarrett stressed that if their vital signs are “way down” or they show other signs of an emergent condition, they would immediately be transported to a hospital. Wagenhauser said that they would be able to stabilize the inmate there just like the ambulance personnel would before they are transported.

“We’re able to offer better care for the patients in a more timely manner,” Wagenhauser said, noting that a registered nurse or midlevel physician is always available for their needs.

Wagenhauser is on-site four hours a week to oversee the operation and examine the more complex cases as needed.

Even those who might have to be transported can be returned to the detention center faster with the new clinic, he said. “Instead of spending five days in the hospital with the county covering their bill, if we can get them out in two days and take care of the rest of their needs here you’re saving a lot of money right there.”

Jarrett said they are in the process of setting up a computerized referral system of local physicians so that when an inmate needs specialized treatment outside they can make the arrangements directly. Wagenhauser said that way, instead of sending them to the emergency room where they are then referred to a specialist, it would be handled by the center and again cut out the middle man.

In addition to medical care, the center also offers dental care. Jarrett said Dr. Wayne Scott from Hot Springs Village comes in for eight hours a month to treat the inmates’ dental needs. She noted if a condition arose they would be able to provide pain medication until they could see the dentist or if it was an emergency situation could make arrangements to get the patient to Scott’s clinic immediately.