Governor Dennis Daugaard's FY2015 budget proposal includes a boost to this fiscal year's corrections budget of $4 million. The Governor says we need to pump $4 million more into our prisons to fix a "correctional healthcare shortfall" arising from "significant inmate healthcare events." His budget proposes an immediate transfer of another $1.5 million to establish a reserve fund for correctional healthcare.
In next year's budget, Governor Daugaard is asking for $18,284,647 for correctional healthcare, an increase of $2,446,226 (19.6% over this year's budgeted amount), again due largely to "significant inmate healthcare events." That branch of our corrections budget will employ 87.0 full-time equivalents.
So that's nearly eight million more dollars of the common wealth that we need to lock up in lock-up. Is there any way to ease that budget burden on South Dakotans?
We could stop putting so many people in prison (and lowering the incarceration rate is one of Governor Daugaard's goals). But until we stop throwing the book at people who might get sick, we've got bills to pay.
Our friends in Minnesota have a suggestion: put inmates on Medicaid:
A Minnesota law set to take effect next month means the federal government will pick up the tab on hospital visits by some inmates of Minnesota jails and prisons, a move that could save the state millions.
It’s the first in-state change in decades to a long-standing rule that deems inmates ineligible for Medicaid, known in Minnesota as Medical Assistance [Abby Simons, "Next Year, Feds Will Pick up the Tab for Minnesota Inmate Hospitalizations," Minneapolis StarTribune, 2013.12.13].
Guess what law makes this budget crutch possible?
Backers say the long-desired law was made possible in part by the Affordable Care Act, which expanded Medical Assistance eligibility to single adults — a demographic that makes up a large portion of people behind bars. Cost savings could run as high as $6.1 million for the Minnesota Department of Corrections, which operates the state’s prisons, and $5.5 million for the state’s counties, which pay for the jails.
Counties and the state will continue to foot the bill for medical care provided inside the detention facilities, which makes up the majority of the health care budgets.
The potential $11 million savings is “only a sliver of the cost, but a few slivers add up to real money,” said Julie Ring, executive director of the Association of Minnesota Counties, which pushed for the change [Simons, 2013.12.13].
Get the feds to pick up state costs—sounds like a South Dakota solution to me! Unlike much of the South Dakota state budget, our correctional health budget includes no federal funds. Accepting federal assistance to treat some of the single adults we lock up would ease our tight budget. But since this budget boost would come from the ACA Medicaid expansion, Governor Daugaard is unlikely to entertain that solution.