An agreement to be considered Monday by the Limestone County Commission could save the county thousands of dollars each year on inmate health expenses.

During the 2017 legislative session, an act was passed to ensure Medicaid coverage for inmates and juveniles continues after they have been arrested. Prior to the act, counties were 100 percent on the hook for all medical expenses, even if the arrested party had health coverage through Medicaid.

The program and benefits were discussed at Wednesday’s commission work session.

If the Limestone commission votes to approve its participation in the program, Medicaid will cover medical expenses for those who are on Medicaid. The program would take effect beginning Jan. 1.

County Administrator Pam Ball said the county’s participation in the program should result in significant savings. Health care costs for county inmates has continued to grow each year, and not all inmate health issues can be treated by a steroid shot and antibiotics. If an inmate had heart trouble or some other issue that required him or her to be rushed to a hospital, the county incurred the expense but paid the Medicaid rate.

For fiscal year 2015, the county’s total inmate health care costs were $495,275.50, and $564,858.10 in 2016. In the 2017 fiscal year, health care costs were $566,981.83.

The county has an existing contract with Southern Health Partners, which operates a medical clinic at the Limestone County Jail seven days a week, 16 hours per day. In the previous fiscal year, the county paid $29,546.26 per month per the agreement, but that did not include outside health care costs, i.e. hospital visits.

Those costs were paid from the county’s general fund or a TVA-in-lieu-of-tax fund earmarked specifically for county health care costs. In some cases, inmate health care costs have been paid out of a combination of the two, according to county finance director Emily Ezzell.

A new contract with Southern Health Partners that took effect Oct. 1 will cost the county $49,268.48 per month and includes an outside cost pool of $150,000 to cover outside medical expenses. Southern Health Partners will reimburse the county 80 percent of the balance of any unused funds in the pool.

Road work

Elsewhere Wednesday, commissioners provided updates on road projects in their district. District 2 Commissioner Steve Turner expressed concern about chip-sealing efforts continuing into October. He explained the engineering department would prefer to take care of those projects earlier in the year.

“(The engineers) want us to get better organized,” Turner told his fellow road commissioners.

One of the issues with extending resurfacing, especially chip-sealing, is the temperature. The mixture sets better on the roads when nighttime temperatures stay at 70 degrees and above. Cooler nights may cause the surface to break down.

District 3 Commissioner Jason Black said he would prefer to have his roads resurfaced by the end of July. He explained there was more than enough work to do in the remaining summers months that had nothing to do with roads.

“If we’re still (paving) in June, July and August, that means something else isn’t getting done,” he said.

District 4 Commissioner Ben Harrison said paving on Baker Hill and Elk River Mill roads is nearing completion, though some shoulder and intersection improvements are incomplete. He added he was still getting the “occasional complaint” about the triple seal resurfacing but said others have been pleased by the final product.

District 1 Commissioner Stanley Hill said his crews are working on “normal maintenance.”