Dwyer said the pharmacy bill in 2017 was $218,343, and it shot up to $310,136 in 2018 and $383,925 in 2019.
“I would believe the fluctuation between ‘17 and ‘18 was caused by one inmate to be honest,” Dwyer said of the impact a single person can have on the costs.
He said the jail is responsible for getting people to dialysis, and a prevalent health problem is diabetes, but the pharmacy bill does not include medications for drug addictions.
The Butler County Mental Health and Addiction Recovery Services Board (MHARS) has a $3o,000 contract with Community Behavioral Health to treat 75 to 100 inmates per year with Vivitrol for addiction to drugs, according to executive director Scott Rasmus.
Dwyer said detoxifying drug addicts however is not the biggest problem the jail has.
“The most acute detox problem we have isn’t heroin, meth, cocaine or any of that, it’s alcohol,” Dwyer said. “The potential for fatal alcohol withdrawal is higher than most others here. If you have a really, really bad alcoholic that comes in, those are the ones that cause a little more attention from the medical staff. When they go down, they go down bad.”
Rasmus said the difference is with a drug addiction the person will feel sick for a time but then recover. An alcoholic in withdrawal can go into seizures and die, so strict attention by medical staff is essential, and sometimes that requires a hospital visit.
“It’s a longer process and more costly and then you typically need medical support staff to watch those folks,” Rasmus said. “Where folks that are withdrawing from opiates, even though they may feel terrible and they may vomit and things like that, they are not at risk for seizures or death, due to the withdrawal process.”
There are about 1,000 inmates in the county jails at any given time. The only other county facility that houses people is the Care Facility with 109 beds and a current daily census of 79. Care Facility Administrator Chamika Poole said the pharmacy budget there is around $200,000
She said almost all of the drug bills at the Care Facility are reimbursed through Medicaid, Medicare and private insurance. Not so at the jail. Dwyer said some prisoners have private insurance, others have Medicaid or Medicare but coverage runs out eventually when someone is incarcerated.
“Our job is to seek out all the reimbursements we can to protect county dollars as much as we can,” Dwyer said. “It’s just not a lot we’re able to save.”