Dodge County has already surpassed its budget for medical costs for jail inmates, still months before the end of the fiscal year, according to Dodge County Board of Supervisors Finance Chair Rob George.
The ballooning costs this year were, what George calls, an “aberration,” with only a few inmates’ services accounting for an outsized portion of spending.
One inmate, for instance, who committed suicide in August, had medical bills that accounted for $114,000 of Dodge County’s $140,000 budget for correctional medical costs, George said.
“That’s the first big one we’ve had since (housing inmates at) Saunders County,” George said.
Dodge County Clerk Fred Mytty told the Tribune that inmate medical costs have risen to $286,148.80 through February.
The budget overflow won’t have any noticeable impact on inmate health services or on taxpayers’ wallets, officials assert. But it does highlight the difficulty of estimating the county’s correctional medical costs, which can vary significantly each year and have risen significantly since 2013.
“Over the years, the medical costs in the jail, it’s kind of like throwing a dart,” George said. “You have no idea.”
The August incident involved a 19-year-old man who attempted suicide in his cell at Saunders County Jail, which houses Dodge County inmates. He was found by guards alive but unresponsive and was taken by helicopter to Bryan Medical Center in Lincoln, where he received medical attention but ultimately died.
The inmate’s medical bills cost more than $81,000. The helicopter ambulance cost the county an additional $33,000.63, according to the County’s general ledger.
Dodge County Attorney Oliver Glass claims that the helicopter’s initial cost was even higher, but that he was able to negotiate a reduction, as he often tries to do with hospital expenses for inmates.
“We’ve also just had some inmates in jail with some very serious health problems,” Glass said.
Glass emphasized that the expensive year will have no bearing on the quality of medical services provided to Dodge County’s inmates.
“If somebody’s in jail with major medical issues, we’re not going to attempt to deny that person the help that he or she needs,” Glass said.
Additionally, the county has enough money in the reserves to counteract any budgetary issues, George said.
“In June, we’ll actually transfer some money out of one of our inheritance fund, our interest fund,” he said. “We’ll just move this money and, quite frankly, pray that we don’t have something like this that happens again next year.”
It’s difficult to predict the health needs of Dodge County’s inmates in any given year, the officials said. In this case, a handful of significant expenses were exacerbated by one dramatic incident, which threw the county off balance.
“It’s just a perfect storm right now,” George said.
The corrections department’s medical costs have varied significantly over the last 10 years, according to a Tribune survey of public records. The costs reached as high as $111,589.02 in the 2009-2010 fiscal year and as low as $29,732.28 in the 2013-2014 fiscal year. This year, medical costs will exceed the budget for the first time in the years surveyed.
The costs of correctional medical services do seem to be on the rise, however. Since the low point in the 2013-2014 fiscal year, the corrections department’s medical expenses have more than tripled, surging up to $101,456.75 last year.
The county budgeted $120,000 for correctional medical costs between 2013 and 2017. After last year’s surge into six-digit figures, the county raised the budget to $140,000 for the 2017-2018 fiscal year, George said.
“We increased our budget to $140,000, unbeknownst to us, we were going to have an $81,000 hospital bill,” George said. “It’s not anybody’s fault, it’s just the way it is.”
Glass suggested that an increase in drug-related arrests by the III CORPS Drug Task Force may be contributing to rising health issues.
“We get a fair amount of people in jail that have drug issues, and with drug issues come health issues,” Glass said. “When individuals, for lack of a better way to say it, are incarcerated, and they don’t have access to the street drugs, or whatever they were using to self medicate, these health issues come to the forefront.”
George agreed that it seemed that a large number of people were getting put in jail with drug-related illnesses.
“It’d be nice if we could get it through to some of those people that this is what it’s doing to you,” George said.
Medical needs for inmates are growing throughout the state of Nebraska and across the country, according to Dr. Gaylene Armstrong, the director of the University of Nebraska at Omaha’s School of Criminology and Criminal Justice. And that’s because there are often few options for individuals with mental health and, often, coexisting substance abuse issues who commit crimes other than jail.
“These folks have difficult histories and lives so they’re presenting with all kinds of other health conditions as well,” Armstrong said. “This population is an unhealthy, in-need population and that ends up falling on the public dollar while they’re in the jail, which is, some of the time anyway, not the best place for these individuals.”
She argued that medical services in jails, especially mental health services, are important because they benefit communities long-term.
“If they’re not receiving services at that point, eventually these individuals are going to be released back into the community where they’re still going to be unhealthy or left untreated,” she said.
Jails have also seen increases in their daily populations across the country, Armstrong added. Dodge County is no exception. Dodge County now deals with about 75 and 85 inmates daily compared to 55 to 60 years ago, George estimates. That can also drive up corrections costs.
In Dodge County, the overall budget for corrections has increased from $1,591,000 to $2,371,200 between 2014 and 2017, public records show. That’s largely because of increases in pricing for housing prisoners and the number of prisoners, according to George. The budget for boarding and transporting prisoners has indeed risen steadily over the last decade, from a little more than $300,000 in 2008 to $1,650,000 last year—the largest operating expense in the Corrections Department’s budget.
When it comes to medical expenses, Glass also tries to negotiate with judges over cases where someone who’s committed a crime might have particular health needs. Depending on the crime, Glass might argue that the individual is capable of being released on bond on his or her own recognizance, allowing them to be tried without taking up resources in jail. That might include somebody facing charges like driving under a suspended license, for instance, whose not an immediate flight risk or threat.
“People like this, you know they don’t necessarily need to be sitting in jail,” Glass said.
George, meanwhile, said that the County Board of Supervisors could increase the medical cost budget another $20,000 or so next year, but doesn’t anticipate raising it to anywhere near the costs incurred this year.
“This is not a typical year,” he said.
Terry Kitt was sitting near a large lake in Mozambique when a man from that country came by in a canoe cut from a log.
“I wish they wouldn’t make those canoes that low to the water,” said another man at the site.
Kitt wondered why.
“The crocodiles come out of the water and grab them out of the canoes,” the man said.
“How often?” Kitt wondered.
“So far 35 this year,” the man said. “It’s right on schedule with the 70 we lost last year.”
And it was only June.
Years later, the rugged skin of the 14-foot-long crocodile is spread out on a pool table in Kitt’s North Bend home. A black and white photo shows the enormity of the reptile — almost twice the size of Kitt, who stands nearby.
It wasn’t Kitt’s first big game hunt.
Kitt has been on big game hunts to Colorado, Alaska, South Africa and New Zealand. The comfortable home he shares with his wife, Vertie, houses the animals he’s harvested — a tahr from New Zealand, a brown bear from Alaska, a cape buffalo from Mozambique.
He’s hunted wildlife in Nebraska, too.
But Kitt and his family give back to the places where they’ve hunted.
“We’re conservationists,” he said. “We don’t just shoot to shoot.”
For five years, he’s raised more than 150 birds, including pheasant and quail to help the populations — and hasn’t harvested one. He spends money to plant plots for food for deer, quail and pheasants, also not harvested.
He’s set aside farm acres in the Conservation Reserve Program, which provides habitat for these birds and animals.
“We don’t shoot anything we don’t eat,” he said of these birds and animals.
Kitt has abided by limits on what can be harvested at home and abroad, adding that funds and meat from the trips have benefitted people in the overseas countries.
He gained an early appreciation for hunting.
Born and reared on a farm in southwest Nebraska, Kitt began hunting ducks, pheasant and quail with his dad.
“Dad was a very, very busy farmer,” Kitt said. “He was up at 4 in the morning every day and home at dark.”
So hunting provided father-son time for them.
Kitt didn’t get into big game hunting until he was a senior in high school. Those were his first deer hunts. He received a state certificate for the size of a mule deer he harvested.
He hunted elk in Colorado. And after his children graduated from college, he began going on big game travel hunts.
His first trip was to South Africa to harvest species including, kudu, blesblock and impala, duiker, mountain reedbuck, steenbok, warthog and black wildebeest.
Kitt made a second trip to Alaska for a Dahl sheep hunt.
“When you ask most people what the most difficult hunt they’ve ever done in their life is, it would be a (mountain) sheep hunt,” he said.
He twice hunted for seven days and didn’t see one legal sheep.
“Therefore, I didn’t get my sheep,” he said.
On the second hunt, he did harvest a grizzly bear and a couple of caribou.
His next hunt was in Mozambique, where he got a leopard, cape buffalo, baboon and that crocodile.
The huge crocodile was sunning itself on a small island at the time. Kitt got the animal on the first shot. His guide had him shoot it twice more. All three shots were within an inch of each other.
Kitt wondered why the guide had him shoot more than once.
The guide did so, because the previous week a crocodile, tied to the side of a 16-foot wooden boat, was resurrected so to speak.
Kitt’s next trip was to New Zealand, where he harvested a tahr, chamois, red stag, wild boar and paradise ducks.
He returned to Alaska to harvest a brown bear in Alaska.
Kitt said he’s had the animals taxidermied, because of his admiration of their species.
“They’re all magnificent in their own way,” he said.
He has respect for them.
“How do you describe a leopard or a cape buffalo?” he asks.
With the exception of the hippopotamus, the cape buffalo has killed more hunters in Africa. The leopard is silent and evasive, a real predator.
To Kitt, the animals and birds aren’t just something on a wall.
“I honor the species that I’ve harvested,” he said.
Kitt said when harvesting the wildlife, he takes a humane shot to minimize any suffering.
All his trophies are males.
“That’s conservation,” he said. “For instance, one pheasant rooster can support 20 hens. So you keep the 20 hens around and you shoot the rooster. When they’re born, you get 50 percent males and 50 percent females.”
He pointed out that foreign countries have limits of what can be shot.
“There’s a conservation officer there that follows you around and collects a fee for every trophy, which goes to support the locals,” he said.
He remembers when money and food went to an impoverished village in Mozambique, which had been in a civil war for about two decades.
Besides conservation, Kitt talks about the camaraderie.
Kitt has enjoyed hunting with his family. He and his sons, Dusty (Neil) and Cody and son-in-law Jason go to a deer camp at Verdigre. They try to grow the population and might not even come home with a deer.
He enjoys a weekend of turkey hunting, which includes daughter Traci and grandchildren. He teaches his grandchildren about conservation and gun safety.
Kitt plans to make an annual elk hunt with his best friend from high school. His bucket list includes a moose.
So does he ever go fishing?
He does, but doesn’t catch many.
But he eats what he catches.
The YMCA will be hosting a free self-defense class for women next week.
“SAFE,” a program developed by Jim Rosenbach, owner of Rosenbach Warrior Training, stands for “Surviving a Fighting Encounter.” It aims to teach women how to defend themselves in unwelcome or violent encounters, Rosenbach said.
It also stands for “Scream, Avoid, Fight and Escape,” Rosenbach said.
“It’s a very practical self-defense program that we’ve put together over the years to empower women in a situation so they don’t become a deer in the headlights, and to realize that they can be empowered, and that they can defend themselves to get out of a bad situation,” Rosenbach said.
Rosenbach believes that the event is especially relevant now, in the midst of the #MeToo movement, which has stressed women empowerment and worked to combat sexual assault.
“This is a pretty relevant thing,” he said. “If it saves one lady from being accosted, then it’s worth it.”
The event will take place on March 13 from 5:30 p.m. to 7 p.m. and is free to attend. Rosenbach is a martial arts expert with more than 40 years of training and teaching under his belt. He received his Ph.D. in Martial Arts Philosophy at the University of Asian Martial Arts Studies and has been inducted into the U.S.A. Martial Arts Hall of Fame.
He encourages women of all ages to attend.
Rosenbach says that the first rule of self-defense is avoidance, and that the class will go over basic tips to avoid a dangerous encounter, from staying in brightly lit areas to avoiding traveling alone.
But the class also delves deeper into defense, teaching striking techniques, how to escape being grabbed and how to avoid ending up in vulnerable positions, like on the ground.
Last time Rosenbach held the class at the YMCA, more than 80 women attended, he said.
The message that Rosenbach tries to convey to the women who participate is clear: “You have a right to not have anybody put their hands on you in any way shape or form without your permission.”
Put in simpler terms: “Fighting is just like Christmas: it’s much better to give than to receive,” Rosenbach said.