Medical services for inmates discussed at county meeting

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Socorro County Commissioners heard from Valencia Valley Healthcare about providing health care services for people in jail during the commission’s regular meeting Tuesday. The commission took no action.

Rebecca Granger, a nurse and one of five owners of VVH, said the company has provided health care services for Valencia County’s jail for two years.

Granger said she visited with county manager Delilah Walsh and jail administrator Evangelo Maldonado about plans to make health care services available to detainees at the jail. She said this is an opportunity for the county to look at what its needs are regarding health care for detainees.

During an interview Thursday, Maldonado said he wants medical services at the jail. He said jail inmates muster about five to 10 medical requests per day, mainly minor concerns like headaches and colds, and they all have to be taken to the emergency room at Socorro General Hospital because the jail has no on-site medical services.

“Anything minor we could take care of here if we had medical,” Maldonado said.

Maldonado said the emergency room has asked the detention center to limit visits to between 6 and 9 a.m. If a detainee has a medical issue at some other hour and the hospital is busy, then they have to wait for treatment, he said.

Granger told the commission Tuesday VVH’s philosophy is a nursing philosophy: “You don’t do more for your patients than they’re willing to do for themselves.” She said that philosophy will also help reduce liability for the county.

“We also promote being fair, being firm and being consistent,” Granger said. “So with that … we offer 24-hour on-call services.”

Granger said the biggest challenge of inmate health care is determining what’s legitimate, and what’s urgent or emergent care. She explained many inmates have spent a lifetime in self-neglect, and the jail is a detainment facility, not a hospital; jail nurses are there to provide urgent and emergent care, as well as continuity of services the inmate has already established.

Granger pointed to the risk of transporting inmates out of a facility, which Maldonado also acknowledged. Granger said VVH tries to contain that as much as possible. She said in Valencia County, they were able to contain off-site transports to five in the past year.

Commission Chairman Daniel Monette asked if VVH can work out of the county’s current tiny, old jail.

“Absolutely,” Granger said. “You know, it’s not a medical facility. Evangelo and I have talked about some ideas. … It’s really going to be piecemeal, no doubt about it.”

Granger said VVH screens inmates when they come into a facility for physical and mental health issues. She said if detainees demonstrate self-care, VVH tries to encourage that and help them. She said her company wants to focus on indigent and underserved populations, and make good health something the inmates can continue to pursue when they get out of jail. She noted many inmates of the Department of Corrections are given medications to manage mental problems, then when they get out they don’t have access to the medications so they go back to self-medicating with alcohol or illegal drugs.

“So we really want to promote that,” Granger said. “I think that is one of our greatest deficits in New Mexico, the lack of continuity from corrections to community.”

Monette asks if the Socorro County Detention Center screens detainees when they come in, and Maldonado said they just do booking.

Walsh said the jail relies on inmates to self-report medical issues. She added the county’s prescription costs are well over $100,000.

“We have good practitioners — it’s nothing against our local doctors, our doctors are here to serve the community and meet the needs of their patients,” Walsh said. “Whereas an inmate patient has a different set of needs and — ah — manipulation that they can use.”

Walsh told a story about an inmate who recently used “every trick in the book” to get medications. She asked Maldonado about his concerns.

“Our guards are passing out medications and we are not licensed to do so,” Maldonado said.

Walsh added the guards are not trained in the many methods drug addicts employ to get medications.

Walsh said the county needs to look at its liability, the prescription drug cost and urgent care cost. She said the VVH service is expensive, but the county is so open to liability right now it may be worthwhile. She expressed her concern that the jail has officers distributing medications to detainees.

Granger said VVH implements self-sustainable prescription services. VVH contracts with a local pharmacy for medications, and in Valencia County the prescription costs are from $2,000 to $4,000 a month for 150 to 200 inmates.

“That’s almost half of what you have and that’s almost double the population that you’ve got,” Granger said.

Granger said VVH also works with Department of Corrections inmates, including high risk and high profile inmates. She said VVH can contract with DOC to supply more acute care when it is needed.

“Rebecca, I’m sure you’ve heard from several other commissions, but our jail is a black hole — we keep dumping money down it,” Monette said. “I think we have to get with our manager and look at our budget. But as a liability issue, I know we’re going to have to do something.”

Monette said other jails have medical facilities, and Socorro County needs to put a medical facility in its new jail.

Granger said she would send the county more information about VVH and jail nursing for the commission to consider.

The other owners of VVH, according to materials in the county’s agenda packet, are Rolando Flores, Leona Herrell, Debra Stanger and Raul Ortiz, and the company is based out of Los Lunas. Granger said all of the business partners are nurse practitioners with emergency care experience, and she was director of nursing for 12 years at the Department of Corrections.