The new year is bringing one more woe to inmates in the Baltimore County Detention Center in Towson.
Starting today, they will be the first inmates in the Baltimore metropolitan area to be charged a $4 fee when they seek medical attention.
The General Assembly approved the program, intended to discourage unnecessary medical visits, last year.
Several jurisdictions, such as Prince George's, Frederick and Wicomico counties, have begun imposing medical fees on inmates, and a state corrections spokeswoman said a $2 fee is under consideration for state and Baltimore City inmates. Carroll County charges no fee, but bills inmates for jail medical services when they are released.
Vicki Duncan, a spokeswoman for the Prince George's County Correctional Center, said the $4 fee began there July 1 and has reduced sick-call visits by more than half.
Medical visits have dropped from 1,250 a month to 300 to 500 a month, she said.
"It has really worked," she said.
Several other counties, including Anne Arundel, Howard and Montgomery, are considering a fee, officials said.
James Dean, administrator of the Baltimore County Detention center, said the goal of the fee is not to make money but to discourage prisoners who aren't really sick from abusing sick-call privileges.
Everyone seeking medical attention will get it, he said.
The money will be deducted from inmates' private jail accounts later, and repeat visits requested by medical authorities will be free. Inmates with no private funds will be treated without charge, Mr. Dean said.
Inmates who aren't sick and seek treatment because they want a diversion "take away the service that somebody else who really needs it should be getting," he said.
Having inmates walking the halls on medical call is a security risk that Mr. Dean said he wants to limit. With renovations under way in half of the crowded main building, the administrator said he is concerned about potential lapses in security.
County jail medical officials said they average 34 appointments a day at the main detention center on Kenilworth Drive and the old county jail complex nearby on Towsontown Boulevard.
The goal is to cut those visits by 20 percent.
Many inmates are not happy about the plan.
Dayton Walters, a trusty serving six months, said the charge should be applied only if a doctor determines that an inmate is faking.
"You got some people who abuse it, but not everybody," Walters said. "You got homeless people here with no money."
Elmer Roberts, 57, a trusty due for release in February after serving a year for drunken driving, said jail officials should make clear to inmates that they can get treatment even if they have no money.
"They only say it will cost $4," Roberts said. "They should explain."
The inmates interviewed said that with the new procedure some might not ask for medical help when they need it because they have no money.
In another move, the county and the district Public Defender's office have teamed up to place Renee Battle-Brooks, an assistant public defender, at the detention center full time. The purpose is help inmates with legal problems and free jail beds faster.
District Public Defender Thelma J. Thompson said the new arrangement, begun Nov. 16, is expected to get District Court cases to trial in two to four weeks instead of four to six weeks, and eventually may help speed Circuit Court cases to trial.
The presence of Ms. Battle-Brooks at the jail saves time for inmates with complicated legal problems, she and Mrs. Thompson said.
"We want to get our clients to court," Mrs. Thompson said.