Request By:
Ms. Karen S. Moore
Administrative Assistant
Kentucky County Executive Association
231 Leawood Drive
Frankfort, Kentucky 40601
Opinion
Opinion By: David L. Armstrong, Attorney General; By: Charles W. Runyan, Assistant Deputy Attorney General
The county jail problem is the topic of your letter of inquiry and request for an opinion. It reads in part:
"The Kentucky County Judge/Executive Association met in Frankfort on June 20-22 to discuss various topics of interest. As in the past, it seems that county jails are still creating many problems for local officials.
"During our program with Secretary Wilson of the Corrections Cabinet, one very important question has surfaced that we need your official opinion on. It appears that there is no clear answer until we have direction from the Attorney General. We would greatly appreciate your opinion as quickly as possible since this problem is happening on a daily basis across the state.
"If an indigent prisoner is brought to a county jail and refused because of medical need and is taken to a hospital for treatment, who is responsible for those medical payments? The counties feel that they are under no obligation since the prisoner has not been accepted into the county jail and booked."
KRS 441.025, as enacted in 1984 (see Ch. 141, 1984 - eff. 7-13-84), reads in part:
"(1) The fiscal court of each county shall provide for the incarceration of prisoners arrested in the county or sentenced or held by order of the courts in the county.
"(2) The fiscal court shall provide for the incarceration of prisoners by: (a) providing and maintaining a jail in the county; or (b) contracting with another county or a city for the incarceration and care of its prisoners; . . ."
KRS 441.045, enacted in 1984 (see Chapter 415, 1984 - eff. 7-13-84), reads in part:
"(3) Except as provided in subsection (4) and (5) of this section, the cost of providing necessary medical, dental and psychological care for prisoners in the county jail shall be paid from the county jail budget. "
Subsection (4) of KRS 441.045 provides that the cost of providing necessary medical, dental or psychological care for prisoners of the United States government shall be paid as provided by contract between the United States government and the county, or as may otherwise be provided by federal law. Subsection (5) of KRS 441.045 provides that the cost of providing necessary medical, dental or psychological care, heyond routine care and diagnostic services, for prisoners held pursuant to a contractual agreement with the state shall be paid as provided by contract between the state and county. The costs of necessary medical, dental or psychological care, beyond routine care and diagnostic services, of prisoners held in the county jail for which the county receives a per diem payment shall be paid by the state.
KRS 441.045(7) provides that the determination of whether a prisoner is indigent shall be made pursuant to KRS 31.120. Under KRS 441.045(9), the term "necessary care" means care of a nonelective nature that cannot be postponed until after the period of confinement without hazard to the life or health of the prisoner. The physician attending the prisoner shall certify, under oath, that the care was necessary.
Where an indigent prisoner is brought to a county jail, and assuming that the particular county has the responsibility under KRS 441.025 to incarcerate the prisoner, the fiscal court of that county, through its jail budget, has to bear the cost of providing necessary medical, dental or psychological care for such prisoner, subject to the applicable exceptions under KRS 441.045(4) and (5). Under KRS 441.045(7), prisoners who are later determined not to have been indigent, or who at a time following treatment are no longer indigent, shall be required to repay the costs of payments made pursuant to this section to the unit of government which made the payment. Under KRS 441.045(6), when the cost of necessary medical, dental or psychological care for a prisoner exceeds twenty-five hundred dollars ($2500), as calculated by using the maximum allowable costs to similar persons or facilities for the same or similar services under the Kentucky Medical Assistance program, the state shall reimburse the county for that portion of the costs that exceed twenty-five hundred dollars ($2500), subject to the conditions that the care is necessary and that the prisoner is indigent, and subject to the condition stated in KRS 441.045(6)(c).
The fact that the jailer refused to incarcerate the prisoner when first brought in on the ground that medical attention was deemed necessary in no way militates against the responsibility of the particular county in this factual situation. Sick or not, the prisoner, under the facts, was the responsibility of that particular county and jail for purposes of incarceration. The cost of the medical care logically ensued from that premise. See OAG 83-324 and OAG 83-381, published, Banks-Baldwin, of related interest.
Our opinion is based upon the plain meaning of the above cited statutes. See