Medical Fees for Jail Inmates

Constitutionally and statutorily, the sheriff is responsible for the well-being of the jail inmates committed to his or her custody. “It is but just,” the supreme court once wrote, “that the public be required to care for the prisoner, who cannot, by reason of the deprivation of his liberty, care for himself.” Spicer v. Williamson, 191 N.C. 487 (1926). Still, a jail can charge certain fees. When it comes to emergency medical services for jail inmates, the county is generally responsible for the cost. G.S. 153A-224(b). In the relatively rare case where an inmate has third-party insurance, the provider can bill the insurer first, leaving the county liable for whatever costs are not covered by the insurance. The statute then says the county may seek recovery from the insured inmate for any non-reimbursed medical services. No statute specifically authorizes a recovery for the costs of emergency medical care from an uninsured inmate. For nonemergency medical care, the jail may establish a fee of not more than $20 per incident. The fee must be established as part of the jail medical plan required under G.S. 153A-225—developed in consultation with appropriate local officials, approved by the local health director, and adopted by the board of county commissioners. The jail may also charge a fee of not more than $10 for a 30-day supply or less of a prescription drug. (I read the 30-day limit to refer to the medically necessary length of the prescription, not an arbitrary unit of measurement set by the jail. [...]