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FARMINGTON — An official at San Juan Regional Medical Center alleged in a letter sent to the county's chief operations officer in January that a former healthcare provider at the San Juan County Adult Detention Center had staff members unlawfully perform tasks they were not qualified to perform.

And the hospital is asking county commissioners today to approve an increase of more than $600,000 in it's contract so it can hire qualified individuals, including a registered nurse to work nights at the jail.

According to budget documents included with the letter, the hospital still expects a $55,508 deficit in the next fiscal year.

Tom Dean, the hospital's chief administrative officer, claimed in the Jan. 18 letter sent to San Juan County Operations Officer Mike Stark that the hospital discovered in February 2014 that "uncertified medical assistants" and emergency medical technicians were performing duties at the jail that, by state law, only nurses are qualified to perform.

Dean did not specify in the letter what work the unqualified staff members performed or whether the practice was discontinued.

Hospital spokesman Haroon Ahmad declined to answer questions about Dean's allegations, stating that it was "too closely related to ongoing litigation." Stark, in an email, referred questions from The Daily Times to Dean. Jail administrator Tom Havel did not respond to a request for comment.

According to the American Association of Medical Assistants, certified medical assistants are qualified to perform administrative duties, such as filing insurance forms and arranging laboratory services, and such clinical duties as taking medical histories, assisting during physician exams and administering medications as directed by a physician.

Licensed emergency medical technicians are qualified to provide emergency care and transport patients for additional care, according to the National Registry of Emergency Medical Technicians.

Dean alleged the staff members were employed by the jail's former healthcare provider, Correctional Healthcare Companies, or CHC. That company merged with Correct Care Solutions, headquartered in Nashville, in June 2014.

Karla West, Correct Care Solutions director of communications, declined to comment Monday because the merger happened while CHC was still an independent company.

As previously reported by The Daily Times, 18 current and former inmates alleged in a civil lawsuit filed in district court on April 17 that the jail provided negligent medical care while they were incarcerated, resulting in civil liberty violations, emotional distress and permanent injury. Seven more inmates have since joined the lawsuit and it was moved to federal court on May 26.

Three inmates have also died at the jail in 2015, a relatively high number of deaths in that period of time, according to records provided by the jail. Olga Salazar, mother of deceased inmate Jesus Marquez, filed a lawsuit in federal court on May 15. The family of another deceased inmate, Sharon Jones, has also retained legal representation.

Dean's letter was included in information provided to San Juan County commissioners, who will vote today on whether to approve a $2.15 million contract with San Juan Regional Medical Center to provide medical services to jail inmates.

The hospital began providing medical services at the San Juan County Adult Detention Center, juvenile detention center and alternative sentencing division in February 2014 after the jail's former provider, CHC, broke its approximately $1.5 million contract with the county.

The company's then vice president, Don Houston, told The Daily Times in January 2014 that the company backed out of the contract because of the rising cost of healthcare.

If approved, the new contract would increase the hospital's budget for those services in fiscal year 2016, which begins July 1, by $616,000, or 41.5 percent, over the previous year.

Dean said that more than 80 percent of that amount, or $504,216, is needed to hire or pay employees qualified to do the work that was being performed unlawfully.

The remaining $112,000 is needed to hire a new registered nurse to work nights at the jail and to pay for the time and call expense of the jail's nurse practitioner.

San Juan County Commission Chairman Keith Johns said the board has been aware of the hospital's expected budget shortfall for a while and, based on conversations among commission members, he expects the new contract will be approved.

"What we are trying to do is catch up to where we need to be to provide a good operational setting for the people there," Johns said. "Frankly, when San Juan Regional got that contract, they looked at what CHC was doing and found out that they needed additional people, nurses."

Steve Garrison covers crime and courts for The Daily Times. He can be reached at 505-564-4644 and stgarrison@daily-times.com. Follow him on Twitter @SteveGarrisonDT on Twitter.

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