In making sure the expenses at the Warren County Jail are appropriate, the Warren County Prison Board starts with health care and medicine.
Prescription drugs for inmates cost the county thousands of dollars each month. The county has saved money since it shopped its prescription service around.
"We've been very pleased," Commissioner John Bortz said at Tuesday morning's meeting of the Prison Board. "Costs are down."
Sometimes, however, there is nothing the board can do.
Fiscal Director Toby Rohlin said $4,000 is a baseline for the county's monthly pharmacy bill. In September, "two items bumped it up almost $4,000," he said. That monthly bill was $8,400.
Chris Darling of Darling Pharmacy said some medications are very expensive. An HIV medication is $3,000 a month. Another drug he did not name costs $30,000 and "there's no alternative."
For the most part, pharmaceutical spending at the jail is down.
"Things have been going very smoothly," Darling said. "We try, ultimately, to drive down cost."
"For us, it's been a win," Darling said. "If we can save the county money it ultimately saves all of us money."
Finding generic alternatives to name-brand drugs doesn't save as much as it used to, Darling said, adding, "A lot of brand-name drugs have gone off patent."
Pharmaceutical companies are "looking for revenue," he said. "Generics are back on the rise."
Nurse Mandy Smith of Seneca Home Health, which provides certain medical services at the jail, presented information to the board regarding physician coverage and the on-call doctor.
A doctor visits the facility twice in the usual week, she said. Family Medicine of Warren provides a doctor and a nurse practitioner who are able to be on site quickly on days when the in-house doctor is not available. Jail officers may call those professionals who will determine if a situation requires immediate attention or can wait for the doctor's next visit.
Smith said Seneca and Darling work together on providing some medications. "We work well with Chris," she said. "They help us find the lowest cost."