The Duval County jail’s inefficient health care system — one that can appear at times more like a taxi service to UF Health — comes at a cost to inmates and taxpayers alike.
The Pre-Trial Detention Facility, which primarily houses those accused but not convicted of crimes, has a basic medical clinic with four exam rooms, but it lacks a full infirmary. That means some medical care, including basic care like the insertion of an IV, requires inmates to be taken to UF Health Jacksonville.
The Jacksonville City Council auditor found that the inefficient system comes at a significant cost. The city paid $6.1 million to pay for transportation and security at the hospital. And then the city is billed for the inmates’ care at the hospital — a cost of $13.9 million last year, the auditor found.
That cost comes on top of the $20 million allocated this year toward a private contract with the jail’s medical providers.
City Council Auditor Kim Taylor examined the cost of health care for inmates as part of a wider look at the city’s rising obligations to UF Health. Medical care for defendants makes up a third of the $40 million the city paid UF Health last year.
PREVIOUS REPORTING: MOUNTING DEBT, INMATE CARE, COST OF TREATING POOR PEOPLE PUTS UF HEALTH IN FIRE FINANCIAL STATUS
Everyone involved — the Jacksonville Sheriff’s Office, the City Council, the auditor, the private medical provider, experts — agrees: if the city is to build a new jail as the sheriff has requested, it must ensure the jail can provide better care for its residents.
The city has been comparing its system to Hillsborough County’s jail, which houses a similar number of inmates. There, the jail holds 40 exam rooms, 10 times as many as Duval’s, and it has a full infirmary, where inmates can get a higher level of care such as dialysis and IV medications.
Partly because of the Jacksonville jail’s lack of medical facilities, UF Health cared for 4,429 inmates in 2023, compared to 2,842 the year prior, according to records obtained by The Tributary. The cost of inmate care in Jacksonville rose by $3.2 million last year, according to the auditor’s report.
Adding to the city’s financial burden is Florida’s refusal to expand Medicaid, which means inmate health care funding isn’t covered by federal dollars.
The majority of inmates taken to the hospital need dialysis, said T.J. Meneely, the director of operations for NaphCare Florida. But some are transferred because they are dehydrated or going through withdrawal and need IVs.
Despite the amount of money spent on inmate care – between private medical care in the jail and intervention at the hospital – in-custody deaths have tripled since 2017, with 15 reported last year. That was the fourth year in a row JSO saw double-digit deaths at the jail under a private medical provider.
For some inmates, the lack of a full infirmary and IV access can be deadly. In 2018, Lina Odom, 28, died after her extreme alcohol withdrawal symptoms were ignored, according to her family’s settled lawsuit. At the time, Armor handled care at the John E. Goode Pre-Trial Detention Facility. Medical staff never put Odom under special observation, and despite asking repeatedly for help, court documents show the staff kept Odom at the jail, where her condition deteriorated.
The city didn’t admit fault in Odom’s death even as it settled the case.
At a meeting earlier this month to announce the audit’s findings, JSO Corrections Director Kevin Goff said he hopes “the next jail will have an infirmary in it so we can provide some of these services on site and can decrease manpower.”
After the meeting, City Council President Ron Salem said he was surprised by how much of the city’s funding intended to care for the uninsured was going to inmates.
“Clearly, as we envision a new jail, we need to ensure that it contains an infirmary similar to the one in Hillsborough County that can manage the vast majority of these situations in the jail itself,” he told The Tributary.
A special committee started by the council in August has explored options for moving the jail and upgrading the current facilities. The audit will help the groups navigate how to move forward when considering the future jail’s size and physical layout, Salem said.
A full infirmary will come with additional costs upfront, Meneely said, because of additional staff requirements and equipment such as X-ray and dialysis machines.
But Salem found Meneely’s presentation to be impressive and said he was happy to hear Meneely talk about the possible addition of X-ray machines, which Meneely said get used often for respiratory issues or internal injuries.
“If we can do that within the jail, it’s a win-win for everybody,” Salem said.
Meneely compared Jacksonville’s facilities to the jail in Hillsborough County, where NaphCare also handles medical care. Because the jail has a robust infirmary, inmates who need around-the-clock medical attention can be watched more closely and their ailments can be treated quickly. In Jacksonville, some inmates have to be sent back to the general population during their treatment and aren’t monitored by medical staff full-time, he said.
Having an infirmary, Meneely said, would stop at least 20% of transfers to the hospital. But many questions about the logistics of a full infirmary and the costs surrounding it are still unanswered.
Since the city hired NaphCare in September, Meneely said the company’s staff has been “playing catch up” from where Armor left off.
“We’re trying to figure out what the true cost of inmate care looks like,” he said, adding that during the transition, NaphCare had to purchase additional medical carts and a 25% increase in medications kept on site.
Nichole Manna is The Tributary’s criminal justice reporter. You can reach her at nichole.manna@floridatrib.org or on Twitter at @NicholeManna.
