Every month, medical staff at the Placer County Jail dispenses an average of 35,000 medications to inmates.

When the bill is tallied for medications at the end of every three months, the cost is about $50,000.

Those figures don’t include the costs of other visits inmates make to the in-house infirmary. As incarcerated individuals, they’re provided dental care, undergo mental health evaluations and, if needed, are treated for other serious problems.

“We could walk into a clinic or hospital freely and collapse,” said Joanne Hendricks, registered nurse and medical program manager for Placer County correctional facility. “They’re incarcerated so they can’t go anywhere. We’re there to provide the care they need.”

Hendricks works for a medical company contracted by Placer County to provide medical care for inmates. She said medical staff is there to provide the best care possible for current inmates.

And while the problems that may sometimes lead an inmate to jail can be treated while they are incarcerated, the challenge is providing that treatment once an inmate is released.

The 24-hour infirmary logs about 1,200 inmate visits a month.

There are also inmates who have conditions that need outside attention.

“People live with broken bones and hips for weeks,” Hendricks said. “They come here, we intervene and have them have surgery.”

Hendricks explained that since inmates have no health insurance, “we’re the ones who pay for those surgeries.”

“It’s called deliberate indifference,” Hendricks said. “You must have access for these people.”

Repeat ‘offenders’

The people Hendricks and medical staff care for include a handful of inmates who seem to almost go through the jail’s heavy intake door as if it were revolving.

There is one man who, since early 2000, has been arrested 61 times and spent more than 200 days in jail.

There is a woman who has been booked into the jail 46 times and served 169 days since 1999.

These two inmates are some of the most-booked into the jail’s Auburn location – with mental health issues contiburting to their behavior that puts them behind bars.

Their arrests are overwhelming for drunk in public charges and their jail stays, save for a few extended sentences, are usually about one or two days at most.

They don’t represent a significant burden to the system, according to Correctional Sgt. Steve Couvrette.

They do represent some of the reasons why some people habitually end up in jail.

“At the end of the day, we are probably the biggest mental health service provider in the county,” Couvrette said.

Dr. John Baker evaluates each inmate when they are admitted and identifies any mental health issues.

“We see a full range of problems,” Baker said.

The problems include major mental illnesses such as schizophrenia, manic depression and severe depression as well as stress that comes from living in the jail. Those who are drug abusers also have problems surface.

Hendricks added that 60 percent of the jail’s $50,000 medication bill every three months is for the cost of psychotropic drugs. However, those drugs are the least administered.

Help on the outside

While access to needed medical care is relatively easy and immediate for inmates during incarceration, the challenge is continuing that care once they are released.

“We know we can provide anything (an inmate) needs while they’re in custody,” Hendricks said. “The challenge is where do people end up out of custody and can they afford to do it?”

Baker and Hendricks said jail medical staff do their best to direct released inmates to the services they need. Each one is provided with a list of general services and also an individual plan for that former inmate. Also, staff sets tentative appointments for inmates once released.

“We’re looking at who can continue their care,” Hendricks said.

That includes working closely with the Placer County Mental Health Department.

Maureen Bauman, client services director for Placer’s Adult System of Care, said county health department staff do not differentiate whether or not their clients were incarcerated or not.

She said along with other departments throughout the state, budget cuts have made the county look at the way it manages its resources and redesigns their system to provide the best care they can.

“We are serving those folks with the very highest needs,” Bauman said. “There are certain criteria to make sure we are the safety net for Placer County for folks with the most severe mental illnesses. Those are the folks that we want to catch in our system.”

Despite efforts from an inundated system, sometimes those with mental health problems can end up in legal trouble because of those issues.

“Unfortunately, sometimes people in the community have a lack of funding, incentive or they run out of medication,” Baker said. “That can contribute to them not thinking clearly about their behavior.”

The Journal's Jenifer Gee can be reached at jeniferg@goldcountrymedia.com or post a comment.

---------

Editor’s note: This is the second of a three-part series about the Placer County Jail.

Part 1: An overall look at the jail’s problems and life for an inmate

Part 2: How do inmate mental health issues impact the jail?

Part 3: Life on the outside. How past criminals rehabilitate

----------