Dallas County: More trips, higher rates cause rise; private service weighed
By Kevin Krause
The Dallas Morning News
Copyright 2006 The Dallas Morning News
The cost of transporting Dallas County jail inmates to Parkland Memorial Hospital has exploded in the past year as a result of increased trips and higher transport rates, according to county invoices and officials.
Darryl Thomas, chief financial officer for the Sheriff’s Department, said Parkland, which took over health care at the jails from a contractor in March, is authorizing more ambulance runs.
With adequate medical facilities at the jails at least a year away, county officials will also have to contend with higher overtime costs to help a private security company guard hospitalized inmates.
They also will face an increased risk of escapes from Parkland, as evidenced by the recent violent escape of a felony suspect.
Dallas Fire-Rescue provides the county with ambulance service to transport inmates from the various jails to Parkland for medical services. The county has no contract or any official agreement with the city for the service.
In the 2005 fiscal year, the city billed the county $76,216 for the service, according to invoices at the county auditor’s office. Last year, that number jumped to $207,519, according to the auditor’s office.
That represents a nearly 700 percent increase from 2003, when the city billed the county only $26,731 for ambulance service.
Mr. Thomas said the increased ambulance trips drained his budget. He said he ran out of money to pay the bills toward the end of last fiscal year. The county’s fiscal year runs from October to September.
Mr. Thomas said that his average bill used to be about $6,000 a month and that it’s now closer to $30,000.
Sharon Phillips, Parkland’s vice president in charge of jail health, said two factors are influencing the higher number of hospital trips. First, a lot of people with chronic illnesses and diseases are being arrested and need hospital care, she said. They include diabetics and people with HIV and cancer, some of whom are terminally ill, she said.
“If they’re too sick, we don’t want to bring them to jail, because it’s not a hospital,” she said.
Second, Parkland’s medical workers at the jails are doing a better job screening inmates who need to go to the hospital for emergency care, she said.
“We send them out when we see they are unstable in the jail environment,” she said. “We monitor them closely.”
Before Parkland took over in March, the University of Texas Medical Branch had a contract to provide medical service at the jails. UTMB, which had the contract since 2002, came under intense criticism for not providing adequate care and decided not to renew its contract.
Medical care at the jails has been under scrutiny for more than a year. The U.S. Justice Department has sent investigators to the jails, and the county has been hit with a flurry of civil rights lawsuits from inmates and their families who claim the lack of adequate care places inmates in jeopardy.
Parkland has a $28 million budget this fiscal year for jail health - double what was spent under the UTMB contract.
“What you see now is some catch-up or delay costs that we’re having to fund,” county Commissioner John Wiley Price said.
Ryan Brown, the county’s budget director, said the $125,000 currently budgeted for ambulance services for the jails will not be enough. He said it will hopefully get the department through midyear, and then he will have to dip into reserves.
“With Parkland taking over health care at the jail, they’re being very cautious in making sure people who need medical services have them,” he said.
Inmates with less urgent medical needs are taken to the hospital by police escort, he said.
Another factor in the higher costs is increased rates.
Dallas Fire-Rescue is charging an average of about $670 to transport an inmate about four miles to Parkland, according to a recent invoice. Before last year, the cost was about $450.
Jim Fawcett, assistant director of cash and investments for the city’s financial services group, said the Dallas City Council approved higher rates in October 2005. Base rates for service inside the city went from $320 to $600, and from $420 to $700 for service outside the city, Mr. Fawcett said.
Mr. Brown said the county had been under the impression that Dallas Fire-Rescue had to be used for taking inmates to the hospital. But the civil division of the district attorney’s office recently advised that the county could contract with a private ambulance company for the service, he said.
Shannon Brown, the county’s purchasing director, said she is meeting with the budget office this week to determine whether to seek bids for the service or to use some other procurement process.
The county currently pays $472 per ambulance run to provide service to unincorporated areas of Dallas County under its contract with Texas Lifeline Corp., a private ambulance company, she said.
That one-year contract, worth about $135,000, was recently renewed for another year. It’s based on an estimated 288 ambulance runs per year and includes a requirement that the company’s response time not exceed 12 minutes, Ms. Brown said.
Troy Mossburg, director of operations for Texas Lifeline Corp., said his company could definitely beat the city’s price for transporting inmates.
“It can be done cheaper ... for a lot less,” he said.
Ms. Phillips said Parkland is working with the county to add clinics and examination rooms to the various jails and eventually to build a jail infirmary, which would cut down on hospital trips.
Mr. Price said it will be about a year before the jails have adequate medical facilities for treating inmates.
The hospital trips also have cost the county more than $1 million a year to make sure the inmates - some of them dangerous felons - are guarded while they’re at the hospital.
A private security company, Greer’s Investigations and Security, was paid almost $900,000 last year to provide hospital guards. But the company hasn’t been able to provide enough guards to meet the demand, requiring the Sheriff’s Department to cover unfilled shifts with jail guards working overtime.
With jail inmates at the hospital, the county also has had to contend with escapes. At least 10 inmates have escaped from Parkland since October 2003, including one on Nov. 20.
Jason Shane Davis threatened a Greer guard with a pointed object he grabbed after being unchained to use the restroom, a spokesman said. Mr. Davis, 32, who is accused of robbery, was seen walking out the front hospital entrance.
He was arrested the next day in Oklahoma after police there found him speeding in a stolen cab. He will be charged with escape, robbery, resisting arrest and other offenses.