1. INMATE MEDICAL BILLS WHO PAYS April 21, 2009 Joseph R. Ross, Esq. RustyRoss@mmmlaw.com

2. So What is the Problem. Sheriff’s deputies escort new patient to your E.D. New patient is somewhat battered by the experience of being arrested/detained. Medical care is rendered and patient and Deputies leave (or worse-patient stays and Deputies leave and ask to be called when patient is ready). Bill not paid. Who is responsible.

3. So What is the Problem. I know he shot somebody and I shot him. Call me when he is ready to go. Just give him a once over and we will be off. Murder suspect-too far to drive. But he was released from jail on the way over. Milk Allergies.

4. SHERIFF– “WHY SHOULD WE PAY” O.C.G.A Section 42-5-2 “…it shall be the responsibility of the governmental unit, subdivision, or agency having the physical custody of an inmate to maintain the inmate, furnishing him food, clothing, and any needed medical and hospital attention;…”

5. SHERIFF– “WHY SHOULD WE PAY” Requirements under Statute. In Custody Dead give away---shackles Arrested Detained Protective Custody Released, but escorted.

6. SHERIFF– “WHY SHOULD WE PAY” Macon-Bib County Hospital Authority v. Reece 236 Ga. App. 669 (1998) “Thus, the fact that the three men had been handcuffed for transportation to the hospital is not determinative of their subsequent status, when the handcuffs were removed. “ Footnotes: 1 We express no opinion whether the three passengers met the statutory definition of "inmate" applied in Macon-Bibb County Hosp. Auth. v. Houston County, 207 Ga. App. 530, 531 (1) (428 SE2d 374). See also Macon-Bibb County Hosp. Auth. v. Reece, 228 Ga. App. 535 (2), supra.207 Ga. App. 530428 SE2d 374228 Ga. App. 535 2 Any question whether this procedure was a subterfuge designed to avoid the financial responsibility imposed by OCGA § 42-5-2 (a) also is for the trier of fact.

7. SHERIFF– “WHY SHOULD WE PAY” Inmate status Definition O.C.G.A. Section 42-4-70 (2): "Inmate" means a person who is detained in a detention facility by reason of being charged with or convicted of a felony, a misdemeanor, or a municipal offense.

8. SHERIFF– “WHY SHOULD WE PAY” Inmate Status (Cont.) Macon-Bibb County Hospital Authority v. Houston County, 207 Ga. App. 530 (1993) “Thus we conclude that the legislature, in using the term "inmate" in OCGA § 42-5-2, meant not only a person who has been convicted of an offense, but also a person who is detained by reason of being charged with a crime.” Self-inflicted wounds. Doesn’t matter why medical care is needed. Sovereign Immunity. “The county's immunity was waived by the legislature's enactment of OCGA § 42-5-2, and its responsibility to pay all medical and hospital expenses may not be avoided by the defense of sovereign immunity.”

9. SHERIFF– “WHY SHOULD WE PAY” Inmate Status (Cont.) Macon-Bibb County Hospital Authority v. Houston County, 207 Ga. App. 530 (1993) (Cont.) Early release program won’t work. “The county's attempt to reduce its liability by way of the court order that Camps be released from custody on January 5, 1990, when he was obviously not physically capable of being released, was an improper attempt to circumvent the county's statutorily imposed responsibility for Camps' care. “

10. SHERIFF– “WHY SHOULD WE PAY” Inmate Status (Cont.) Cherokee County v. North Cobb Surgical Associates, P.C., 221 Ga. App. 496 (1996) “But for Test” “In a like manner, we hold that Cherokee County is responsible for McFarland's medical care because he was injured while being taken into physical custody by the county sheriff's department and who, but for the seriousness of his injuries, would have been placed in the county's detention facility.” City v. County. City Police called County to investigate. County responds and “arrests”. No evidence of prosecution, although matter of shooting investigated.

11. Sheriff’s Liability O.C.G.A. Section 42-4-4 “(a) It shall be the duty of the sheriff: (2) To furnish persons confined in the jail with medical aid, heat, and blankets, to be reimbursed if necessary from the county treasury, for neglect of which he shall be liable to suffer the penalty prescribed in this Code section …” “(c) Any sheriff or deputy who fails to comply with this Code section shall be fined for contempt, as is the clerk of the superior court in similar cases. The sheriff or deputy shall also be subject to removal from office as prescribed in Code Section 15-6-82.”

12. PAYMENT SOURCES FOR SHERIFF Inmate insurance. O.C.G.A. Section 42-4-51 (a) and (b) Inmate Assets. O.C.G.A. Section 42-4-51 (d) County Funding. State Obligation (State Prisoners in County Jail). Third party liability.

13. LET’S NOT FORGET Safety and Security Police Restraint Protocol “Police Hold”

14. SOLUTIONS Be Proactive, be Political. Secure signed statement from Officer upon E.D. visit. No “Police Hold”. Documentation of Situation. Discharge Planner/E.D. Nurse Documentation. Open Records Act. Lawsuit.

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