County health staff report Medicaid is covering much inpatient care for jail inmates, easing county costs

Wayne County health officials presented a report showing that inpatient hospital charges for people registered as Wayne County Jail inmates were redirected to Medicaid for fiscal years 2022–23 and 2023–24, reducing costs for the county general fund.

Kenil Johnson, director of the Department of Health, Human and Veteran Services, said the report had been submitted in advance and that staff would summarize data showing inpatient charges billed to Medicaid rather than charged to the county. Keith Dugokenski, who identified himself as part of Jail Health and Transition Services, told commissioners that Medicaid began allowing inpatient benefits for inmates about 15 years ago and that Wayne County has taken advantage of that benefit to have hospitals bill Medicaid directly for inpatient services.

Dugokenski said the county has been diligent about ensuring eligible individuals are enrolled in Medicaid, and that Medicaid expansion further reduced the cohort without coverage so a higher proportion of inpatient costs can be billed to Medicaid. Commissioners asked about historical outlays and how much the county previously paid; Dugokenski said there were large prior costs before the inpatient benefit and noted that the county’s current approach redirects hospitals to bill Medicaid, thereby avoiding charges to the county general fund.

Commissioners did not call for immediate policy changes; they asked clarifying questions about when the county began its enrollment push and how the shift in Medicaid eligibility affected county expenditures. Staff indicated they have long used the benefit and will continue the practice.