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| Jail Medical costs are rising exponentially due to a number of factors. The county should consider all models of provision of this care, including outsourcing, to curb costs and provide better care |
County staff have been discussing the outsourcing of Jail Medical for the last several years---as these costs have grown exponentially.
At our last regular meeting--we had over $5,000,000.00 worth of jail medical budgeting that was being requested of us. I pulled the item--as I knew we had been in talks with an outside provider to take the function over in order to achieve cost savings.
Several staffers received at least one proposal--however when asked about this at the meeting---there was a sudden sense of confusion and many staffers said that "no, they hadn't received the package and proposal."
So, I made a motion to pull the item, and the board voted to postpone the large medical expenditures--so we could all independently research what happened to the proposal from outside provider NaphCare.
(I never received the proposal either--although I was told it was sent to my office via FedEX. I never got it, and ultimately had to borrow Commissioner Bender's copy)
Meanwhile---Jim Little from the PNJ called me yesterday afternoon and we discussed the reasons I moved to drop the expenditure and also why I think outsourcing could save us money and provide better care for inmates. His column on this topic came out this morning and was a very good read.
The areas where it appears we can save the most money include:
--Reduced tranport to outside facilities--perhaps as much as 50% (saving guard staff time and vehicle wear and tear)
--Elimination of our costly Jail Med Malpractice insurance (Contractor would take on this cost)
--better overall care for inmates via proactive, initial assessments and flagging of inmates who are at risk
--staffing stabilization
--full utilization of our state of the art infirmary for more on site procedures (dialysis and other minor medical procedures for which we currently transport--costing us staff time and additional fees to dialysis providers)
--Savings via achieving a (much larger) economy of scale for pharmaceuticals
I plan on bringing the topic again at our October 14th meeting, at which point I will attempt to build support for the county developing an RFP for outsourcing jail medical. At least this will allow for multiple companies to present their best offers and creative solutions.
At the end of the day--I am certain the board will choose wisely and will find an option that saves money and provides the care our inmates need.
4 comments:
Thank you for your unrelenting effort to transparency against all odds.
It would seem simple enough, wouldn't it?
Probably be a good policy if someone happens to pass away the county's response isn't to fire employees.
If you know what I mean.
I think you do.
Keep up the good work.
Thank you for pursuing this, Commissioner Bergosh. Watching Chief Powell play dumb on that unsolicited bid, it was apparent that you're probably going to be in for a fight on this. But it makes good sense.
There are serious problems on both ends of the continuum. Yes, there are a whole lot of people making money on those unnecessary transports and in-hospital care. (BTW, my public record request for all the transport records during the first wave of covid--the non protected medical information, which is indeed public record--was ignored just as your request for the bid was.)
On the other end of the spectrum are the people who get refused medical care outright--and this is NOT a myth. I have spoken with many individuals with horrendous stories of being denied medical in Greyskull, the road camp and the work release program. One had skin cancer on his face that was allowed to spread during his time there, and his request for care for it was denied. He had large ulcerations on one side of his face. None of the people I spoke with were violent or hardened criminals. Most of them were in for substance abuse issues that should have been handled with a treatment program.
Outsourcing the medical care wouldn't just be a huge efficiency and cost saver. It would also put more eyes on the conditions in the facilities and maybe prisoners would have more access to care if the outrageous cost of the transports et al wasn't taking up such a huge part of the budget.
Well you better read between the fine print on the proposal. Jail medical was outsourced some years ago. It was too expensive, it didn't work and all of the staff stopped earning their FRS retirement. The medical care wasn't half as good as it is with inmates being under the county medical. You better be for CERTAIN that you read exactly what their contract entails. Outside medical care is a huge part of the bill. Cancer treatments, surgeries, emergencies, etc. and good luck getting dialysis back in the jail. It was there before the commission decided to take the jail back and the county let the contract lapse and it hasn't been back since although it was looked into on several occasions. This outsource company isn't going to be able to do it any better and definitely not cheaper than the county is doing it. When they are understaffed and can't keep up with the demands do you really think they are going to treat ANY issues in that jail that aren't minor when they know they don't foot the bill for outside services? What about your pregnant females? Are they going to provide an in house OB doctor or are they all going to be sent to outside appointments that the county still has to pay for? If it sounds too good to be true.....it generally is. They are a business in it to make a profit. There is NO WAY they can get services and/or pharmaceuticals that much cheaper than the county! I'm just saying....I would run through this with a fined tooth comb before I committed to anything. It might come back to bite the county. Are they going to provide dental, psychiatric services as well?
Morgan is on podcast here about this
https://ricksblog.biz/real-news-podcasts-thursday-sept-30/
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