By Taylor Six
Lexington Herald-Leader
LEXINGTON, Ky. — The Kentucky Department of Corrections has outlined medical costs that the department will and will not pay for when state inmates at local jails have to be treated.
The agency had to better define what “routine care” was after an appellate court ruled its previous definition was too broad. The Department of Corrections has come under fire for not reimbursing local jails for medical costs incurred for state inmates — people who are in the custody of the state agency but are staying at a local jail.
During an interim judiciary committee Wednesday morning, lawyers for the state’s corrections department laid out a new regulation that further defines what medical services the department will reimburse, and which ones won’t be covered. The new definitions were part of an emergency regulation that went into effect Aug. 17 .
The new definition is a result of a 2023 lawsuit filed by the Kentucky Jailers’ Association and several counties who said the department was not reimbursing local county governments for medical care costs they were required to pay for convicted inmates.
Counties argued because of delays in classifying an inmate as a ward of the state, taxpayers bore the burden of tens of millions of dollars worth of housing, food and medical care.
But the department of corrections said the reimbursements which counties asked for sometimes exceeded the scope of “routine care” the department was required to pay.
The circuit court, and eventually the appellate court, ruled the department’s definition was overly broad and “saddled the counties and jailers with excessive costs.”
The types of treatment Kentucky will pay for at local jails
Previously, the department interpreted “routine care” to be every medical, dental or psychological procedure that did not require hospitalization or general anesthesia.
Ann Blaylock , general counsel for the Justice and Public Safety Cabinet, said the circuit court’s ruling did not provide any guidance on “what medical treatments are routine and which are not,” and the state corrections department was required to develop their own definition with members of the state justice cabinet.
The new regulation applies to 74 county and regional jails which house approximately 7,000 state inmates housed in their care, Blaylock said Wednesday.
Routine care is now defined as “necessary care that is customary, predictable and commonly provided within a correctional facility or local outpatient providers.” This includes:
- Evaluation and treatment for infections, injuries and common illnesses.
- Chronic care management for ongoing conditions such as hypertension, diabetes, asthma or mental health treatment that does not require “intensive or advanced intervention.”
- Basic diagnostics including laboratory testing and standard radiology such as X-rays.
Care that is “beyond routine” is defined by the department as:
- Emergency medical care that requires immediate transport and advanced intervention.
- Surgical procedures including outpatient surgery.
- Treatment from oncology, cardiology, neurology or specialists in similar fields.
- Dental treatment requiring extensive or restorative surgical or other treatment.
- CT scans, MRIs, or other non-routine imaging.
- High cost for specialty pharmaceuticals including biologics, chemotherapy agents or medications that require special administration or monitoring.
Representative: ‘Law clearly needs to change’
At least one lawmaker present at the hearing said he felt more changes in state law were necessary.
Rep. Scott Sharp, R- Ashland, represents Boyd County, one of the initial plaintiffs in the lawsuit against the state.
He said most of the problems he noticed was how long it takes inmates to be classified as a state inmate with delays caused by high attorney turnover rates, and other court factors. He noticed some inmates were housed for more than two years before trials, and felt that needed to be addressed.
“What is the Department of Corrections doing to address that?” Sharp asked.
Blaylock responded that the corrections department “follows the law as written,” and if the law was changed, the department would follow the law.
Sharp acknowledged the department is following the law, but said it “clearly needs to change.”
“So you are not looking towards the future to help make corrections?” Sharp pressed.
“We follow the law as written,” Blaylock repeated.
Jeff Mando, an attorney for the jailers’ association, was not immediately available for comment.
In June, Daviess County officials confirmed they were considering their own lawsuit against the Department of Corrections for not reimbursing nearly $400,000 for an inmate’s medical bills.
Jail officials say they sent a state-classified inmate in their care to have treatment, and that attempts to recoup the money have been thwarted by the DOC, which violates legal precedent, County Attorney John Burlew said in a letter to the governor.
The ordeal started in February 2022 , when the jail accepted a state inmate to participate in the jail’s substance abuse program, jail officials say. In Kentucky , local jails are legally bound to house inmates awaiting adjudication after an arrest in their area. However, they also will hold state inmates while they are awaiting specific classification from the DOC to be placed in prison and serve their sentence after a conviction.
Daviess County Jailer Art Maglinger was not immediately available for comment.
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