Noting a serious problem with prescription drug use by inmates, Gammons stated that the widespread usage of "hydrocodone, sleeping medications and muscle relaxers (by inmates) is gonna stop."
"We have $100,000 in our budget for 'medical', and in the first two months of the (fiscal) year $80,000 has already been spent," stated Gammons. "This has to be got under control--at this rate we would spend half a million dollars on medical this year."
"I'm a taxpayer too---the county spent $240,000 on medical at the jail last year, and money that should have been used for officer training had to go toward this expense."
"I promise you we are going to clean it (the jail) out and run it in the most efficient, lowest cost way possible."
Sheriff Gammons told commissioners he had hired Dr. Charles David Stewart on a temporary basis "to get the medical cost situation under control" at the jail, and Dr. Stewart was introduced to the commissioners and asked by the new sheriff to address them as to what he intended to do to change the situation.
Stating that he had been "a board certified surgeon for thirty-two years," and had in recent years practiced general medicine in Lafayette for three years, Dr. Stewart noted he was now in practice with a Dr. Sanders in Sumner County, and that Sanders had the responsibility for medical care at the Sumner County Jail.
"Due to my association with Dr. Sanders, and having assumed his responsibilities (with the Sumner County Jail) during a period of time last year, I've learned a lot about the problems inherent in (providing medical care) for inmates."
"The prescribing of hydrocodone, muscle relaxers, Zanex, and other addictive drugs to people who are in jail in part because of their addictions to drugs or alcohol doesn't make any sense. As someone who cares a good deal about treatment for addictions, I can tell you this will change. You have a 'mess' at the jail and it is due to a lack of close supervision."
Stewart asserted he could save the county a lot of money by prescribing good generic drugs, when needed, instead of costly name brand drugs; that having an LPN under his supervision on staff and working in the jail five days a week would curtail unnecessary Emergency Room visits, and that he would prevent the ordering of unnecessary tests that have proved incredibly expensive to the county in the past year.
"I understand that one inmate ran up $26,000 in medical bills, due, I believe, to ER physicians ordering unnecessary and costly tests. Supervision is required, and good care can be provided without frequent ER visits by inmates.
"Every time I treat an inmate (at the jail) and avoid sending someone to the emergency room, it will save the county $1,000," asserted Dr. Stewart.
A discussion ensued as to the cost of Stewart's services, which will include staffing the jail's clinic five days a week with LPN April Heatherly. Stewart told commissioners his services would be $6,000 per month, plus malpractice premiums of $2,000. Insurance agent Bobby Carver pointed out that this malpractice insurance expense might be reduced, because as a county employee the physician would be partially covered under "tort limits" set under state law.
"This arrangement is for a three-month trial period," the physician pointed out. "My intention if to save the county a substantial amount on the cost of medical treatment of inmates. There is no excuse for the prescribing of expensive psychiatric drugs for inmates when good, inexpensive generics are available. Inmates may complain about being 'nervous' and needing medication, but no one ever died from being nervous," asserted Dr. Stewart.
"All we are trying to do here is save the county money," stated Sheriff's Chief Deputy Danny Fisher. "There's no reason in the world for the jail's medical costs to be what it has been."
Dr. Stewart said he and the sheriff had agreed on a three month trial period "to make sure what I'm doing works."
"My employees don't have insurance, and it's ridiculous for inmates to have better medical coverage than my employees," stated Sheriff Gammons. "I'm not going to sacrifice the training and safety of my deputies to pay for unnecessary medical (for inmates)."
Commissioner Melburn Cothron stated he believed that the sheriff didn't need the "court's approval" to hire Dr. Stewart. Nevertheless, on a motion by Anna Dean Carter, seconded by Tony Boles, the commissioners authorized the sheriff to hire Dr. David Stewart as the jail's supervising physician for a three-month trial period.
IN OTHER BUSINESS schools supervisor Mike Prock told commissioners that while he was not asking for an increase in the schools' share of the tax rate (constant at $1.07 for the past four years) he would like for them to consider letting the schools have the "growth money" that has been available to them in previous years.
"We have additional expenses, such as $54,000 to the Tri-County Vocational School because of an increase of Macon County students attending there."
Prock noted that the elementary schools were losing considerable revenue due to federal requirements that soft drink and snack machines be removed from elementary schools, and the revenue from this source had amounted to $40,000 in previous years.
Another expense which may well be incurred by schools is due to an increase in enrollment at RBS Elementary, which will require hiring of an additional teacher at the school.
On other school related subjects, Prock told commissioners that a new roof was needed on the Tony Woosley Fieldhouse, which is being used as an Alternative School classroom this year, and has a leaking, flat roof. He had a rough estimate of $15,000 for a replacement roof on the 42'X112' building.
Commissioner Phillip Snow asked how much an "A-type" pitched roof would cost for the building, and Mr. Prock stated he didn't know off hand. Commissioner Lindbergh Dennis stated that he'd gotten several complaint calls about Central School's roof leaking, noting the school was not even in his district.
Supervisor Prock reported that repair work had recently been done on the roof, but because of the deteriorating condition of the membrane more leaks seemed invertible.
On a motion by Gammons, seconded by Snow, the commission gave preliminary authorization for Prock to get an architect's estimate on metal, pitched roof systems for both Central School and the Woosley Fieldhouse.
ROAD SUPERVISOR Charles "Chop" Porter was asked if he had any business to bring before the body, and he replied "I don't see any need for me to ask for anything; it seems the Sheriff and the schools have pretty well 'cleaned the pot' already.
"I could talk for half a day about what I want, but I don't see as it would do any good," the road supervisor stated in good humor.
A NUMBER OF QUESTIONS ABOUT THE BUDGET followed, and after several exchanges about minor budget line issues, UT-CTAS adviser Ben Rogers offered the suggestion that the commissioners hold their regular "meeting of the Body as a Whole" on the third Monday (September 18), conduct whatever business necessary and then close the meeting with a recess adjournment, continuing the meeting until the following Monday, September 25, thus giving commissioners two weeks to "study" the mayor's proposed 2006-07 budget, which is published in summary on Page 4, Section C of this week's paper. The budget must be published and made available for examination by the general public ten days before it can be considered for a final vote of approval.
The commission agreed to meet next Monday night, select a Chairman and Chairman pro tem, go into recess adjournment and return again to session on Monday, September 25 to finalize the budget and set a certified tax rate. That rate is virtually guaranteed to be the same as last year at $2.70.
The county's budget must be filed with the state Comptroller by October 1 or the schools lose their BEP funding, and other even more unattractive consequences follow, according to UT-CTAS adviser Ben Rogers.
IN ORDER TO FUND the debt service on the $900,000 the commissioners voted to borrow earlier this year for a new roof on the Red Boiling Springs School, Commissioner Billy Bransford suggested a complicated series of fund transfers. The net result of these transfers would put 3-cents from the 2.70 certified tax rate into debt service for the RBS School roof, with the first payment of $122,000 due in 2007 on the nine-year note. The motion by Bransford, second by Dennis, passed with Commissioners Looper and Cothron voting "no".
The commissioners completed the long evening by passing three perfunctory resolutions on first reading; approved newly elected county officials bonds; approved a "letter of agreement" allowing Trustee Diane Cook to borrow sufficient funds to meet payroll until collection of fees can otherwise fund the payment of the Trustee's and her deputies salaries; and in response to a petition from residents on the Green Valley Road, directed the Road Supervisor to post 30 MPH speed limit signs on that section of county road.
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