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Counties hoping to recoup inmates' health expenses

Saturday, June 28, 2008
Chicago Tribune
by Joel Hood

Chicago-area county leaders are hoping to funnel millions of tax dollars into local projects by recouping money they now spend on health care for inmates in county jails.

Counties such as Cook and Will spend millions on Medicaid and Medicare for prisoners awaiting trial because the federal government strips health-care funding when an individual is arrested. The costs shift to the state, which passes them on to the counties.

But some of largest counties in Illinois are throwing their support behind a bill in the U.S. House that would force the federal government to reimburse counties for providing health care to prisoners. If enacted, the new law could redirect money to county officials to pay for roads, more police officers or any number of local programs.

"The law as it currently stands creates huge inequities," Cook County Board President Todd Stroger said in an e-mail. "Any individual that enters our system, including those who are not yet and may never be convicted of a crime, still lose their Medicaid benefits as soon as they are incarcerated in county jail facilities."

Exactly how much money they would receive if the bill becomes law is unclear. Cook County budgets $37 million annually to provide health care to 10,400 adult and juvenile inmates in its crowded correctional system. But it's unknown how many of those prisoners are eligible for Medicare and Medicaid. Stroger said the county could recoup between $3 million and $6 million a year, but other estimates put that number much higher.

Will County officials said they spend as much as $3 million a year. Lake County has a $1.7 million contract this year with its jail medical services, and DuPage County budgeted $1.2 million for inmate care, officials said. But the process of determining how much money they could receive is complicated by federal eligibility requirements and the transient nature of the county jail population, they said.

"It's simply outrageous that counties have had to pick up the bill for so long," said Will County Board member Jim Bilotta.

Discussion of the issue comes at a crucial time for counties, which were flush with cash during the recent real estate boom but are looking to cut costs in the sour economy.

"I think it's fair to say this issue just was off our radar for a while," said Bruce Friefeld, chief of staff for the Will County Board. "Now that we have less coming in, we have to look at how we're spending it."

The Illinois General Assembly last month took steps to recover the health-care costs. The state Senate and House approved bills that would force the state to pay for inmate care at the county level and open the door for Illinois to seek partial reimbursement from the federal government. The governor has yet to sign the legislation.

"The problem is festering and festering because of the increased cost of medical care and because of tighter budgets," said State Rep. Tom Holbrook (D-Belleville), the bill's sponsor in the House. "This issue has been a huge burden to counties for years."

This month Will County Board members joined representatives from some of the largest counties in the nation to meet with lawmakers in Washington and rally support for the bill in Congress.



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