State Probes Sheriff’s Billings for Ill Inmates

Alarmed at a high error rate in record-keeping by the Los Angeles County Sheriff’s Department, state auditors are seeking to determine whether sheriff’s officials overcharged the state millions of dollars for medical care provided to jailed parole violators--including billings of $755 a day for some inmates who may not have been sick.

The state’s concerns, initially voiced more than a year ago, have touched off a bureaucratic standoff in which the Sheriff’s Department is desperately seeking to defend itself and free up $12 million withheld by the state.

Facing a burgeoning budget crisis that is forcing the department to cut short the training of new recruits and sharply reduce overtime for deputies, sheriff’s budget managers will meet with state Department of Corrections officials today to plead for at least a portion of the money withheld amid the allegations of inaccurate medical bills.

Sheriff’s officials say they believe the billings are accurate.

“It is time for them to assist us in getting repaid,” said department budget director Fred Ramirez. “As a bean counter, I feel that our process is we have correctly identified parolees [as medical patients].”

Sheriff Sherman Block could not be reached for comment.

The concerns stem from a routine state controller’s office audit released in 1996 in which auditors said they discovered flaws in the sheriff’s medical billing practices. They found that the sheriff charged the $755-a-day medical rate in some cases where there was not adequate information to show that they should have been billed at other than the regular $52.66-a-day rate per inmate.

“The review of medical records identified serious concerns regarding the quality of documentation and the use of a single medical cost rate in all instances where medical service is provided, regardless of the level of service,” auditors wrote in their report to state corrections officials.

In a sample of medical records, auditors found 40 in which the billings were correct and 13 in which “records were missing or inconsistent.”

“With such a high error rate, 32.5%, the auditors have serious concerns about the reliability of the medical records maintained by the Sheriff’s Department,” the audit concluded.

Auditors are trying to determine whether state prisoners in jail awaiting parole hearings in Superior Court were placed in jail medical wards, at the $755-a-day rate, even though they weren’t sick.

Sheriff’s budget director Ramirez acknowledged that in the new review of records, the first state inmate whose medical records were studied turned out not to have been ill.

Said legislative analyst Dan Carson: “It certainly raises a serious issue when you get billed for folks who are not sick.”

Auditors also specifically noted two instances in which the $755-a-day rate was charged despite inmates receiving minimal care. The auditors suggested that in these instances, a lower interim rate should be established.

“In these cases, [the Corrections Department] was charged $31,993 for state parolees in the orthopedic ward,” the audit said. “Based on notations made in the medical records, both inmates received minimal care after being admitted into the orthopedic ward.”

State corrections officials are now conducting an extensive review of the sheriff’s medical billing practices, combing through records of 200 state parole violators to determine what level of medical care was provided to the inmates while they were in county jails. (There are 800 state parole violators in the jails awaiting court hearings or transfer to state prison).

State analyst Carson said that since the state raised the medical reimbursement issue, the Sheriff’s Department billings have significantly dropped.

For example, for March 1996, the state was billed $1.2 million for medical bed costs, based on 1,776 bed days for the month. For September 1996, the billing dropped to $617,000, or 877 bed days.

“What this tells me is I’m glad we’ve been raising these questions,” Carson said. The missing and inconsistent records found by the auditors appear to be an additional example of the flawed tracking system in Los Angeles County jails.

The outdated, paper-basedsystem has led to a series of snafus in recent years, including the erroneous release of dozens of inmates--including five homicide defendants--who were let go because of clerical errors in the jail’s document control room. Sheriff’s officials are pushing for an updated computer system to solve the paperwork problems.

Glenn Yee, a Department of Corrections official who is working on the audit, said it is too early to tell how much of the $12 million, which stretches over two years, would be ultimately withheld to make up for the alleged billing discrepancies.

“It could be $10 million or it could be nothing,” Yee said. “I basically won’t know that until the final report comes out in June.”

Sheriff’s officials, however, said they cannot afford to wait that long for the state to sort out the matter. Ramirez said he would admit to a 5% error in the medical billings just to get the issue quickly resolved because of the department’s dire budget crisis.

“We’re going to camp on their doorstep until they pay us the money,” Ramirez said.

Two weeks ago, sheriff’s officials sent out a departmentwide letter warning of a possible $18-million budget shortfall by the end of the fiscal year, including the $12 million being withheld by the state.

Scrambling to offset the deficit, the department is cutting short its deputy training classes and instead sending about 100 new recruits to the county jail system, where they will work as jailers.

The recruits are to be sworn in at a ceremony today, even though they completed only 16 weeks of their 23-week training. After the budget crisis is over, officials say, the new recruits will return to complete their courses.

The department is also considering severely scaling back operations at its inmate bakery at Pitchess Detention Center and closing its popular firearms training center called Laser Village, according to an internal memo sent out to department personnel.

The department is also sharply reducing its overtime, which is expected to soar to $36 million this year, compared to $18 million in previous years.

To make up for the overtime reductions, homicide detectives and sworn personnel assigned to media relations and other administrative departments will be sent to work at jails as backup officers.

Depicting the situation as dire, officials sent out the recent letter telling officials that “the department is anticipating a number of emergency personnel actions to accommodate that deficit.”

“We’ve got to solve this before the end of the year,” Ramirez said. “We’ve got to come within our budget.”