Con man
Suspicious medical maladies put criminal suspects in the hospital, not jail - and you"re footing the bill
By Steph Greegor, The Other Paper, Columbus
March 24, 2008
Over the past decade, Columbus police Sgt. Rich Weiner has dealt with a slew of newly arrested suspects who complain that they require hospitalization, often for diabetes or chest pain. But he’s come to realize that, more often than not, they’re faking it.
“If we arrest a guy, he might say he’s short of breath or his blood pressure is high and he needs to go to the hospital,” said Weiner. “But this is after he’s just smoked a crack pipe and been chased down two blocks by police. Now, wouldn’t your blood pressure be elevated? Of course it would.”
The maladies arrestees typically complain of are cardiovascular and insulin troubles, said Weiner, who has learned a trick or two on how to unravel a bout of convenient hypochondria.
“When I was on the street, if I sensed they weren’t being truthful, I’d look at my clock and tell the prisoner, ‘I’ll take you to the hospital, no problem, but I just want to let you know that you’re gonna miss dinner,’” said Weiner. “And then all of a sudden he was fine, and it was like, ‘No, no. I don’t need to go to the hospital.’”
Weiner said letting a prisoner know he may have an extra day in jail if his trip to the hospital postpones court action also can provide mystical healing powers.
But if a prisoner sticks to his story, Weiner said, the police can’t take any chances.
“We’re not medical professionals; we’re law-enforcement officials,” he said. “We don’t want to get into the business of making health assessments. That’s not our job.”
Mark Barrett, chief deputy in charge of corrections for the Franklin County Sheriff’s Office, is aware that arrestees feign illness to avoid jail, but he said it’s the exception and not the rule.
“For the most part, everyone is accepted into jail,” said Barrett. “Medical care is just a necessary evil that all policing agencies are required to deal with. Columbus police, as well as the county — we have liability issues we have to deal with. So we have to provide medical care, whether it’s real or not.”
Franklin County provides prisoner health care to the tune of $10 million annually, Barrett said. Once a prisoner becomes a ward of the county, municipalities no longer pick up the tab unless the person requires medical attention that the county’s medical facilities can’t provide.
But municipalities are put in the position of picking up the medical tab at two critical moments: if the arrestee needs medical attention at the time of arrest and if the county jail turns the arrestee away. Barrett said the jail can refuse to accept a new prisoner for anything from an open wound to elevated blood pressure.
If an arrestee is turned away for medical reasons, the city might be stuck with the medical bills. That often depends on the seriousness of the criminal charge the prisoner faces.
“If it’s a misdemeanor, which is not an offense of violence, then the officer has the discretion of taking that individual to the clerk of courts and giving them a summons. We then take that person to the hospital, but the bill is on them,” said Weiner.
“On felonies, though, it’s a different story. You can’t just let a felon go. That’s when we’re guarding them until we can get medical clearance to take them to jail.”
Hospitals, Weiner said, will bill private insurance first. But if there is none, that’s when the bill comes to the police ?division.
“It’s frustrating to let someone go on a misdemeanor,” said Weiner. “It’s equally frustrating to have to guard someone in the hospital and know they’re racking up bills for a condition that doesn’t exist.”
Prisoners complaining of medical maladies are taken to hospitals all over Columbus. A small sample of bills from one of those hospitals, Ohio State University Hospital East, is enlightening.
Columbus paid bills for 26 prisoners taken to OSU East in February and March of 2007.
Eleven prisoners required a minimum of two major medical procedures each. Most of those 11 also received IV therapy or extensive pharmaceutical and lab testing. Only one was admitted to the hospital and received room and board.
Ten other prisoners received one procedure each. Then came five who required no medical procedures whatsoever and were released either with or without self-administered meds.
And while most of the 26 were indicted, there was one criminal who got double his money’s worth — he ran up a $900 bill he didn’t have to pay and later had all charges against him dismissed.
“It’s frustrating for street officers and street level supervisors to watch criminals exploiting the system,” said Weiner. “It’s them adapting to a system we have established.”
Barrett agrees: “It’s where the courts are on this. They have set the standards, and we’re legally obligated to comply with them.”
It generally sticks in Weiner’s craw that taxpayers end up footing medical bills incurred by criminals — sometimes even a result of the crime itself.
“If you’re in the commission of a felony, you should foot the bill for your actions,” said Weiner. “You’ve made the choice to commit the crime, and you should be held responsible.”
But that argument doesn’t necessarily hold legal water, said Columbus City Attorney Rick Pfeiffer.
“If you’re going to arrest people, there’s a cost for incarceration,” said Pfeiffer. “And that’s the reality of it.”
He said whether an arrestee is actually sick is irrelevant.
“When you arrest someone, you have deprived a private citizen of his or her liberty,” said Pfeiffer. “And since you have decided that that person has broken the law, you have to take care of that person. You have to give them a bed to sleep on, a pot to use, food to feed them. And if they’re sick, you have to provide health care.”
It’s a tradeoff, he said, that Columbus citizens have to live with.
“Whether they’re in the hospital or they’re in the jail, what Columbus citizens are paying for is to have criminals off the streets,” he said.
The good news is that the city does get some relief on the bills it pays. Most area hospitals have a voluntary agreement with police to charge Medicaid reimbursement rates instead of the maximum amount for procedures.
For example, those 26 arrestees from February and March racked up bills totaling $51,918.40, but the actual billed amount from OSU East paid by Columbus was $9,740.34 — a discount of 81.2 percent.
But, Columbus police legislative liaison Mike Weinman said not every health-care provider is so willing to discount prices.
“There are outfits that won’t do it voluntarily and continue to charge us the maximum rate,” he said, “primarily emergency room physicians at OSU.”
Ohio State spokesman David Crawford was unable to provide a definitive answer as to the billing procedures of the university’s ERs and their physicians.
But it’s safe to say that the issue is such a point of contention that state Rep. Kevin Bacon, a Columbus Republican, introduced House Bill 453, which requires all health-care providers to charge municipalities and townships the Medicaid reimbursement rate.
“It comes down to predictability: Townships and municipalities need to have an idea of what costs they’re going to incur when they take someone to the emergency room,” said Bacon.
Weinman doesn’t want to shirk the duty of paying for health care.
“We just want to pay the same rate that county and state agencies are already paying — and that’s the Medicaid rate.”
Pfeiffer agreed, saying Bacon’s bill is a necessary measure. “Anything to control the cost for local government is helpful,” he said.
Still, everyone agrees on one thing: There really is no good solution for catching a criminal who’s feigning illness.
“How do we really know they’re faking it?” Pfeiffer said. “We don’t. So police must err on the side of caution.”
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jackscrow commented, on March 27, 2008 at 10:25 a.m.:
Maybe we should have this guy investigate the Athens City Schools BOE.
