Aaron Sanderford
LINCOLN — Nebraska’s prison system could save about $3.9 million by better controlling how it handles health care, health insurance and pharmacy services for prisoners, a state audit found.
And inmates and crime victims could get compensated sooner from jobs inmates do while in prison and on work release if the state did a better job of checking its own records, the audit reads.
“We take recommendations from this comprehensive audit report seriously,” said Rob Jeffreys, the department’s director. “During the audit period, the agency was in the process of implementing many of these changes, and we will continue to evaluate and alter processes to enhance efficiencies.”
State Auditor Mike Foley credited the Nebraska Department of Correctional Services for working to address the costliest concern, $3.5 million, forfeited because not all eligible inmates have applied for Medicaid.
Why Medicaid matters
That matters because both federal and state taxpayers share the cost of medical care for inmates who are eligible for Medicaid coverage. Foley said the corrective action could save “several million” dollars.
Since the audit, all eligible prisoners have been applying for Medicaid when processed into prison, the department said in its response to the audit. The state said it also is working to recover funds for those missed.
The audit identified issues with how the prison system verifies health insurance claims through Blue Cross Blue Shield, saying claims and payments need to be more stringently reviewed for accuracy.
In one case, the state paid for a $2,985 claim for health services received after an inmate had been released, the audit alleged. Department officials said they will do a better job checking the insurance claims and payments.
Inmate accounts off
Foley’s office found delays in crediting inmate accounts with about $530,000 in direct deposits for work while imprisoned. Prison officials said they are working on a new recordkeeping system to help.
Inmates earn about $0.53 to $1.55 an hour, the audit said, earning $1.26 to $8.69 a day. Correction officials said they are trying to cross-train more staff. They blamed shortages and technology for the troubles revealed by the audit.
Prisoners get to keep part of the money they earn and send some to their families. They also must contribute to the cost of being housed and fed by the state and contribute to a fund to help their victims.
A spot review of those so-called “maintenance fees” the department charges inmates also appear to have collected $310,000 too little from prisoners because of higher minimum wage payments, the audit found.
Department officials said they are working to update the fee rates and charges to match inflation, higher base pay and other factors and will more frequently review them to meet state law.
Pharmacy troubles and overtime
In the state-run prison pharmacy, the audit found too few formal explanations for inventory adjustments being recorded by hand, hinting that some medicines had gone missing and were unaccounted for.
Department officials said they would review and tighten up controls of who has access to pharmacy records and how the records are kept to make sure there are electronic records that are harder to alter without leaving a trace.
Once again, a Correctional Services audit highlighted the pressing need for the state to hire more prison staff, pointing to about $22 million in overtime pay and too many employees working too many hours.
Officials said they were working on trying to require fewer employees to work so much overtime but said the safety and security of inmates and other staff often dictate what they can do.
The auditor also found some continued problems with overpayments to employees, both current and former. One employee who left was overpaid nearly $18,000. The state said it’s working on better processes.
“Nobody could argue that running the Department of Corrections is anything but an enormously challenging … task,” Foley said in a statement. “Nevertheless, there is always room for improvement.”