County health staff say Medicaid absorbed more than $6.3 million in jail inpatient charges in FY2024

Wayne County health department staff reported that Medicaid absorbed substantial inpatient hospital charges for Wayne County jail inmates across recent fiscal years, and commissioners asked staff to produce category-level reasons and trend analysis to inform policy and budgeting.

Ebony McCann, transition services division director in Health, Human and Veteran Services, said the report was prepared under ordinance 2024-664. For fiscal year 2024 (Oct. 1, 2023–Sept. 30, 2024), the department identified 71 inmates whose care required escalation to a hospital; charges redirected to Medicaid totaled $6,313,851.06. For fiscal year 2025 (Oct. 1, 2024–Aug. 2025), staff reported 28 overnight hospitalizations with $4,064,342.02 redirected to Medicaid. McCann said these redirected charges were "absorbed" by Medicaid and therefore not charged to the county.

Commissioners asked why the FY2025 totals fell relative to FY2024 and whether staff track reasons for hospitalization (for example, diabetes, overdose, or other causes). McCann said the jail’s medical provider compiles patient care records and the county team reviews those records; she noted HIPAA constraints but offered to provide anonymized summary categories and to consult the medical director about trends. Mary Carr, deputy director, and McCann cited earlier figures from budget materials showing FY2022 had 29 hospitalizations ($2,317,617 redirected) and FY2023 had 45 hospitalizations ($3,323,737 redirected), demonstrating the rise into FY2024 and a decline in the partial FY2025 reporting period.

Commissioners requested that staff return with a longer-term (multi-year) comparison and an anonymized breakdown of hospitalization reasons so the county can identify potential in-jail interventions to reduce community hospital transfers. The report was received by voice vote.