New medical provider begins work at Sevier County Jail

Firm specializes in corrections; 'This is an underserved population'
Aug. 02, 2014 @ 11:38 PM

Medical care at the Sevier County Jail is being reshaped as a Birmingham-based company that specializes in correctional medical services is taking charge of it.

The county and the previous contractor, First Med Clinics in Gatlinburg, faced a number of lawsuits over medical care at the jail.

Inmates and their families complained that medical staff failed to diagnose or treat serious and sometimes life-threatening conditions, including an incident in which an inmate was reportedly left paralyzed, but medical staff initially said he was faking his injury.

Jail Administrator Larry McMahan said he hopes the experience and expertise of the new contractor, Quality Correctional Health Care, will help in quickly diagnosing inmates and providing appropriate care.

“That’s all they do is correctional health care, so hopefully it will provide a more comprehensive service,” McMahan said.

The county didn’t break its contract with First Med. That four-year agreement came to an end, and the county issued a request for proposals of services for the new contract period, which started in July.

The county received several proposals, including one from First Med, but QCHC was the low bidder and also offered the most options.

Dr. Johnny Bates, CEO of the company, comes in twice a week. A registered nurse is on site 40 hours a week to see inmates, as well as a dentist.

Bates has training in mental health care, and officials are looking to add a social worker or another mental health professional to help with mental health issues.

QCHC also provides the prescription drugs for inmates. They’re only handed out by medical staff, McMahan said.

Jail staff has been working with the new contractors on updating protocols, and McMahan said the transition been going well.

Bates said he got into correctional medicine after working as a physician at a prison shortly after he started practicing medicine about 30 years ago. He saw a need for a specialized practice.

“This is an underserved population,” he said. “They deserve appropriate care.”

Just determining what care is appropriate is a challenge.

Many inmates come in claiming they have medical issues they really don’t, trying to convince staff to give them prescription drugs they’ve been abusing. Sometimes inmates have convinced a doctor to give them a prescription that a simple physical indicates they don’t really need.

Others haven’t been to see a doctor for real conditions and are unaware of serious heatlh problems.

“I’ve discovered patients with cancer they didn’t know about, with hepatitis, with HIV ...many of them don’t have insurance (and therefore haven’t been to see doctors),” he said.

Abusing narcotics and prescription drugs can mask a lot of symptoms as well, he noted.

A new chronic care program is being started for inmates diagnosed with diabetes and other long-term ailments that require continual monitoring and care, he said. The goal is to see to it that the inmates can get the care they need without having to leave the jail.

“If they need to go out, they’ll go, but we want to keep them here,” he said.

Medical professionals try to diagnose when inmates have overdosed before coming in —another issue the jail has faced. But, Bates said,  that’s not easy to do.

If, for an example, an inmate took a bottle of pills just before officers apprehended him and they didn’t see him do it, they might not see symptoms, depending on how quickly he’s brought back for the medical screening process.

Overall, Bates said, the experience for doctors is more like being in an emergency room than being a typical internist or general practitioner.

“You get people in here who have abused a substance, you get people who have just been in a fight, and you get people that have a long-term condition that hasn’t been diagnosed or treated,” he said.