Task Force in OK Aims to Solve Tension between Law Enforcement, Hospitals

Article excerpt

Caught in the act of committing a robbery, a man is shot during a gun battle with the police. He spends a month in the intensive care unit - racking up a considerable hospital bill - before he dies. Whose responsibility is it to pay the hospital bill?

The police force's position is it's the dead guy's responsibility to pay his own hospital bill. Obviously, the hospital has a problem with this approach.

Or another scenario: A person with a history of diabetes, heart disease, AIDS and methamphetamine abuse commits a crime. While in the temporary custody of the county jail, before he can be transferred to a state Department of Corrections facility, he has a heart attack. Who gets billed for his hospital stay and the treatment he may have received for any of his pre-existing ailments?

The Medical Responsibility and Jail Custody Task Force met Wednesday to try and piece together a solution to a problem that threatens the financial health of law enforcement and health care providers alike. The tension between hospitals and law enforcement appears to have worsened after a new state law was enacted last year.

Senate Bill 636 by state Sen. Charlie Laster, D-Shawnee, was approved by the lawmakers and sent to the governor on the last day of the 2005 legislative session. The new law states that if a person requires emergency medical care before they are received into custody by law enforcement - even if they were injured by law enforcement while resisting arrest - the medical bill is the responsibility of the individual, not the law enforcement agency.

Since many detainees do not have health insurance nor the means to pay the bill, the new law in effect dumps the cost of yet more uncompensated care onto local hospitals, say hospital administrators. Since the law went into effect, several hospitals have seen their bills to law enforcement rejected and have increasingly heard the phrase "pre-existing condition," said task force members. On the other hand, the hospitals are legally required to provide care to anyone who needs it, regardless of their ability to pay.

Charles Skillings of Unity Health Center in Shawnee said he heard of an incident wherein a detainee was "unarrested" solely for the length of time he spent in the hospital, which appears a blatant attempt by law enforcement to avoid the bill. Emergency rooms have already been turned into screening rooms for law enforcement, where patients are tested for drug and alcohol abuse, said Skillings. But the current situation creates other problems as well, as hospitals are given the responsibility for keeping an eye on someone who may be a dangerous criminal.

Often, law enforcement will ask hospital personnel to alert them when the patient is to be discharged, and the person will be taken into custody as soon as they leave the hospital. Hospitals have successfully coordinated such discharges with law enforcement, but in those cases where there is a scheduling glitch, the hospital lacks the ability and authority to detain prisoners, and some people who should have been arrested have instead walked out of the hospital free. …