The term ‘medical OR’ has been mentioned in several recent conversations about the Oklahoma County Detention Center (OCDC). Interim CEO of the jail, Maj. Brandi Garner, has started reporting the number of medical ORs requested and granted in her reports to the Oklahoma County Criminal Justice Authority, known as the jail trust, and the Citizens Advisory Board (CAB). She also talked about the role a medical OR plays in getting vulnerable individuals out of the jail in a recent interview with The Frontier (https://www.readfrontier.org/stories/listen-frontier-new-oklahoma-county-jail-ceo-talks-about-her-plan-to-turn-around-troubled-facility/). So, what is a medical OR and why are they important?

So, what is a medical OR? 

An OR bond is a type of bond where a judge releases an individual from jail on their ‘own recognizance’ without requiring a cash bail on the promise that they will return to court for their court date. Sometimes OR bonds have additional conditions, like engaging in a pretrial release program or with a community partner like the Diversion Hub or TEEM, and these are sometimes called conditional bonds.  

Medical Own Recognizance, or a medical OR, is like an OR bond but a judge determines that a detainee’s medical needs or requirements for treatment are extensive enough to serve as the basis for release.

The jail takes detainees to the hospital how is this different?

When a detainee is taken offsite to a hospital or medical provider, they are still considered to be in custody and must be accompanied by a corrections officer from OCDC the entire time that they are receiving care. For care like dialysis or chemotherapy, this could mean that a corrections officer is away from the jail for several hours. When a detainee requires an extended hospital stay or end of life care, they must be supervised by an OCDC officer around the clock, leaving one less detention officer at the jail for days or weeks on end. 

Not only does this increase staffing issues at the jail but keeping these individuals in custody also means that they aren’t permitted to have family or friends visit them or be at their bedside when they are most vulnerable. 

In addition to being more compassionate and alleviating staffing requirements, medical ORs may also help a detainee qualify for programs to help with their medical bills. 

Individuals booked into the jail are personally responsible for medical costs incurred due to a pre-existing condition while they are incarcerated, but the jail must pay the medical provider and wait to be reimbursed by the individual. Former detainees are billed, but this is often just another overwhelming debt on top of the fines, fees, and restitution that an individual may owe after being incarcerated.  

Often, detainees are unable to repay the detention facility, even though they may have qualified for Medicare or other kinds of assistance to pay for their medical bills if they had not been incarcerated at the time that they needed medical care. Once booked into jail, these programs will not pay or provide any benefits, until the individual is released and eligible to re-enroll.

What about public safety? 

ORs require an order from a judge. OCDC refers every detainee who is considered to have a chronic health problem which requires a high level of care for a Medical OR. The District Attorney can sign off and agree with the referral or disagree, but it is ultimately up to the judge who decides whether to grant the OR based on their own set of factors to help ensure public safety. 

Detainees may be released to a specific facility to receive care and returned to the jail once they recover. They may be released with an electronic ankle monitor or released without additional conditions. Any conditions or requirements of the release are up to the judge to set in place when they issue the order.  

This process helps ensure that any concerns are addressed and that all factors are considered.

Why are medical ORs an important part of making the jail safer?

OCDC is known for being understaffed and over-populated in addition to a long list of other issues that have made it not only unsafe but deadly. Addressing this list of needs, means exploring every option available. 

Medical ORs are a compassionate option for release for individuals who have complex medical conditions and who the courts have deemed are not a threat to public safety. Detainees who are released under a medical OR also are being held pretrial and have not been found guilty of a crime.  

Detainees with complex medical needs are at an elevated risk of having a medical emergency in the jail which may only have limited capabilities and treatment options available. The jail has some medical facilities onsite, but they are not a hospital. TurnKey, the medical provider at OCDC, has a well-qualified staff, but they do not have the space or equipment to care for detainees with medical conditions which require long-term and/or intensive care.  

When a detainee poses no threat to public safety and their medical needs exceed that which can be safely provided by the detention facility, a medical OR can help them get released so that they can receive the care they need.