Klamath County Sheriff Chris Kaber expressed support for a bill U.S. Sen. Jeff Merkley, D-Ore., introduced to the Senate last week that would allow pre-trial inmates to keep their health benefits while in jail.
Restoring Health Benefits for Justice-Involved Individuals Act of 2019 would ensure people in jail prior to conviction would still have access to their Medicare, Medicaid, Children’s Health Insurance Program and veteran’s benefits.
Kaber called the procedure of revoking inmate’s health benefits while they await trial “devastating” and said the change the bill calls for “really should be done.”
“It’s actually, I believe, in some cases, devastating to someone who is on a required regiment, and then that gets disrupted in any way,” Kaber said.
Merkley addressed Oregon media outlets Wednesday with Yamhill County Sheriff Tim Svenson, secretary of the Oregon State Sheriff’s Association, which Merkley said has backed his bill.
Svenson said the bill would ultimately save county jails money because it would no longer mean jails would foot the bill for providing health care services for inmates during that time before trial and possible conviction.
“When I first got elected five years ago, it didn’t make sense to me that on a Monday you could be covered through veteran’s benefits, CHIP or the Oregon Health Plan, but on a Tuesday you come into my facility for a minor disorderly conduct, criminal mischief charge, and those benefits get dropped. But then the moment you walk out of my facility three days later you’re immediately eligible again,” Svenson said.
Kaber said that KCSO budgets $100,000 a year for medical expenses for inmates in the Klamath County Jail. Although they might not spend it all each year and some of that might roll over to the next budget, it’s another expense the KCSO must budget for.
It’s not just medications, though, Kaber said, there are things like doctors’ visits and mental health care to consider.
Svenson also said an example of care the bill would ensure for inmates would be mental health care and access to things like counselors when they need it during the vulnerable time of being held in custody. Svenson said inmates often don’t have access to counselors while in jail because counselors have no one to bill for their services as jails
“This is an issue we’ve been struggling with for years, trying to provide a high level of medical service for individuals who come into our facility who are very vulnerable at that time, have high behavioral health, high medical needs, but their benefits immediately get cut off when they walk in the door.”
One of the most devastating parts of inmates losing access to their coverage, according to Kaber, is the interruptions they experience while the jail works to get medication or treatment and while they work to re-enroll once released.
“So then all of a sudden they leave custody with not very much of their medication, if any, and then they either have to get signed up again or figure out a way to get their medication so there’s delays in them returning to what I think we would all agree they probably need.”
The national average length of stay before a trial is 25 days, according to Svenson, and the Oregon average is 15 days.
Several groups and organizations across the state have endorsed Merkley’s bill, including Disability Rights Oregon, the Nation Sheriff’s Association, the Partnership for Safety and Justice, the National Council for Behavioral Health and the National Association of Counties.
Merkley introduced the bill to the Senate and after going through a committee it will make it to the Senate floor.
Although Kaber acknowledges that medical care for pre-trial inmates is paid for by taxpayer money either way, should Merkley’s bill pass, the money would come from the federal helth benefit programs instead of the county jails.
Merkley cited Kaiser Family Foundation research that says that 60% of people in jails across the country haven’t been convicted and that 50% of those in jail have a serious health condition.
The practice of denying health benefits for people in custody pre-trial has a greater effect on poorer inmates, according to Merkley.
“Think about it this way, if you’re affluent enough to post bail, your health care is not interrupted,” he said. “So in essence, the current structure has a poverty health penalty in which if you don’t have the money to post bail, not only to do lose your freedom in terms of detention, but you lose your health care.”
Kaber said, “And many times these are people who haven’t been convicted of anything and to me that’s the sad thing.”
Officers in the jail see every day, “how really devastating it is to the inmates themselves, plus then we have to pick up whatever medical expenses come in, and, you know, they’re expensive,” said Kaber.
“Without being convicted, that whole innocent until proven guilty thing needs to apply but it doesn’t apparently apply to people getting benefits from the government agencies that supply health care. They’re guilty until proven innocent, I guess—their medication gets interrupted,” he said.
Kaber said that although people might view anyone in jail as a criminal and feel they shouldn’t keep their access to health care while in custody, not everyone housed in jail gets convicted.
“There’s a difference between someone that’s convicted and serving their time in jail and someone that’s simply been accused of a crime and has yet to be convicted,” Kaber said. “And once we lose sight of that, we’re not fulfilling our constitutional position.”
Merkley acknowledged that the complexities and technicalities of providing health care for inmates doesn’t have an easy solution, but said he is looking to start the conversation toward change.
“This is sort of the bill that I think we’ll have to build a conversation around because it’s not something on kind of the top five list of things people are talking about in America, but I think it’s a very worthy effort to improve the continuity of care, an important part of our health care system that I hope I can produce a debate on and conversation about and then when health care legislation is moving, say this should be made a part of it,” he said.
“I think when senators and House members go to their local public safety providers, I think they’re going to hear a very strong yes, very strong support for this strategy,” Merkley said.