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PLN editor Paul Wright quoted in atricle re FL jail medical care

Star-Banner, Jan. 1, 2008. http://www.ocala.com/article/20080427/NEWS/8042...
PLN editor Paul Wright quoted in atricle re FL jail medical care - Star-Banner 2008

Inmates will keep verified meds under new jail program

BY NASEEM S. MILLER

STAR-BANNER

Published: Sunday, April 27, 2008 at 6:30 a.m.

Last Modified: Sunday, April 27, 2008 at 6:31 a.m.

OCALA — The Marion County Jail is implementing a new procedure which will make use of legitimate medications inmates bring in with them at the time of arrest.

The jail will dispense the inmates' medications, after they're verified by the nursing staff, instead of setting them aside with the inmates' personal property and ordering a new batch from its own pharmacy.

The process has never been tried here and is uncommon among jails around the nation, mainly because of security concerns.

But according to jail officials, it will improve continuity of treatment, decrease waste of legitimate medications and could lead to small savings, especially on the more expensive psychotropic or HIV medications. They believe the security concern is minimal.

"It makes a lot of sense clinically, operationally and financially to do it this way," said Phil Hoelscher, executive director of Ocala Community Care, a local nonprofit organization that oversees Marion County Jail medical care. OCC replaced the national private company Prison Health Services earlier this year.

So far, if inmates have medication on them at time of booking, the nursing staff takes the drugs and verifies them by calling the pharmacy or doctor's office. After verification, and after the jail's doctor deems it necessary to continue the medication, the nurses order the medication from the jail pharmacy. The entire process can take a day or more. The inmates' medications are not used and are instead added to their personal property.

"What a waste to not be able to continue to use just that medication," Hoelscher said. Duplication of a valid prescription, he said, is paid for by taxpayers.

Through the new system, the nurses go through the same detailed verification process, which includes examining the pills one-by-one. Medication must be in the original pharmacy container, marked as current, and be name-specific for that inmate, according to the jail's policy.

Then, instead of adding the medication to the inmates' personal property, they'll start dispensing it to the inmate until the medication runs out. The doctor then decides whether the prescription needs to continue. If so, the jail pharmacy will continue to fill that prescription.

Time will show whether the program will benefit the inmates and the jail. To those who are not familiar with the program the jury is out.

Paul Wright, editor of Prison Legal News, an independent national monthly magazine that provides review and analysis of prison issues, said the new procedure is fairly unusual and "has a good side and a bad side."

On one hand, he said, there are reported cases of people who have mental illnesses or infectious diseases like HIV and are temporarily taken off of their medication after they're arrested.

"And they suffer some type of horrible problem as a result," he said.

So the new procedure could actually help with the continuity of their treatment.

The Star-Banner last year reported on the case of former Marion County Jail inmate James Johnson, who was taken off of his psychotropic medications and tried to commit suicide.

Johnson could not be reached for comment, but his son, Jordan Johnson, said, "he'd be excited about the change. People with mental illness, you can't just pull them off."

Johnson had turned himself in to the jail and his son, who was accompanying him, took all of his legitimately prescribed medications to the booking desk. Johnson received none of those medications and was suicidal within the first 48 hours of his arrest.

Yet, not all inmates walk in with legitimate medications.

The nursing staff, Wright said, "are not pharmacists. .Ê.Ê. We don't know what [the inmates] are bringing in. Why take the chance?"

Hoelscher said there will always be a minimum risk to using the medications inmates bring in.

"We've been aware of the possibility of this, and security programs have said that there's a chance that the meds may not be what they are. The risk does exist, but it's minimal."

In addition, aside from those who are taken into custody at home pursuant to the state Baker Act, what are the odds of a person carrying their bottled medications at the time of arrest, wondered Karen Gievers, an attorney in Tallahassee who has represented inmates allegedly suffering from inadequate medical treatment at the jail.

Otherwise, "it sounds like there's some common sense to [the procedure]," she said.

In addition to rigorous checks, there are several restrictions to the program.

Hoelscher said there are no plans to allow inmates' families to bring in their medications after arrest or continue renewing their prescription from outside the jail.

Also, OCC has requested the opinion of state and federal government to find out whether they allow inmates to continue using medications paid for by Medicare and Medicaid. Until the opinion is issued, the jail will not allow inmates to continue those medications while incarcerated. Instead, the jail will prescribe the medication for them from its own pharmacy.

Hoelscher said the process will improve the jail's medical system and its "benefits far outweigh the potential downside risk."

Naseem Miller may be reached at naseem.miller@starbanner.com or 867-4140.