It is a problem that is still desperate for a solution; while awaiting trial, release, or transfer to the prison system, the inmates of Colorado's county jails sit in a poorly funded and widening gap in our health care safety net.
You can sit in a county jail for over half a year on certain misdemeanor charges such as DUI, but after one month on the inside, Medicaid coverage disappears and prisoners can suddenly find themselves without medication in one of the worst environments imaginable for a health crisis.
Colorado's jails and prisons have, by default, become the front line of mental-health treatment in the state. Nearly one fifth of prison inmates, and one quarter of those in county jails, are diagnosed with moderate to severe mental illness.
"Jails were never designed to be long-term treatment and care. They were designed to be placement for pretrial offenders," said Maketa, who as sheriff runs the largest mental-health facility in El Paso County -- its jail. "But history has certainly shown to us it's a responsibility we're going to have to assume."
This year, it is becoming the central issue for a group of area County Commissioners.
In 2003, the Metro-Area County Commissioner group (MACC) formed to address issues of what they believe are 'unfunded mandates' pressed upon them from other divisions of government. Recently they have chosen to focus on the problem of providing mental health care to their inmate population.
It is what Adam's County Commissioner Larry Pace calls 'low hanging fruit' because of its 'relatively low fiscal note' of $45,000,000.
Even if you just look at the most directly effected, the impact is very wide. Denver Post 6/24
Nearly 17 percent of inmates... have serious mental health problems, ranging from schizophrenia to manic depression...
"And there are others with less serious mental illnesses who are able to function in the jail and receive treatment, but in all cases, once they're released from the jail, they hit this cliff," said Bill Lovingier, Denver's director of corrections.
Commissioner Pace offered no remedy, and would not say if it was Federal, State or local help that the counties sought, but he said MACC will be discussing the problem at an August meeting. It will be open to the public, but only for observation and not for comment. (For details contact the Adam's County Commissioner's office.)
In his comments at a recent Progress Now event, Gov. Ritter spoke repeatedly about investing in Colorado. In examples ranging from education to health care, the Governor spoke about the returns the State can expect from sensible action to prevent future problems. There may be no other issue where small outlays can save the State so many costs.
Between the Governor's interest in investment, and the First Lady's focus on health issues, his office should not be a bottleneck to finding a solution.
An average annual cost to keep a person in a Colorado jail bed is over four times what it costs for that same person in a community based treatment program, and the mentally ill in our jails are at vastly greater risk of homelessness, recidivism, and suicide.
One of the challenges of Colorado's 208 Commission will face is crafting a new health policy that will provide proper coverage to the many underserved populations in our community. Commissioner Pace hopes that MACC's efforts will keep the needs of the county jail inmates in fore-front of the legislatures awareness.
Despite describing himself as a 'fiscal conservative', Pace doesn't see this one as just an issue of being a better steward of county funds.
This is about people, not about how much we are spending. I want these people to get the right care.
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