Health care behind bars: San Juan County sees sharp rise in contracted health care costs at jail
Editor's note: This is part of The Daily Times' occasional series on health care at the San Juan County Adult Detention Center. Find more stories at daily-times.com.
FARMINGTON — San Juan County will pay almost twice as much to contractors providing medical and mental health services at the San Juan County Adult Detention Center in the next fiscal year as it did in fiscal year 2014.
Altogether, the county will pay San Juan Regional Medical Center and Presbyterian Medical Services approximately $2.5 million in fiscal year 2016, which begins July 1, to provide services at the adult detention center that include medication distribution, physician and psychiatrist visits and on-site medical and mental health care.
In fiscal year 2014, the county paid one health care provider, Correctional Healthcare Companies, approximately $1.3 million, plus the hourly salaries of certain mental health staff, to provide those same services.
However, County Executive Officer Kim Carpenter said CHC underbid the project, which eventually caused the company to break its contract in February 2014, four-and-a-half months early. Carpenter said Tuesday that CHC resubmitted a much higher bid for the county contract, but was beat out by lower bids made by the hospital and PMS. Those companies took over the medical and mental health services, respectively, on Feb. 17, 2014.
Carpenter said that CHC held the contract for more than 10 years because it was always the lowest bidder, but in 2014 it was not meeting service needs, which are now offered by the county's current health care providers.
"The bottom line is we've been really pleased with the services of the hospital and PMS," Carpenter said.
As reported last week by The Daily Times, the county commission unanimously approved a $616,000, or 41.5 percent, increase in San Juan Regional Medical Center's contract to provide medical services at the jail, which begins on July 1.
Thomas Dean, the chief administrative officer for the hospital, told county officials in January that the vast majority of that increase, $504,216, was necessary because CHC was using unqualified staff to perform services that New Mexico law requires nurses to perform.
The hospital is thus required to replace those personnel with qualified staff, Dean said.
Correctional Healthcare Companies merged with Correct Care Solutions, a Nashville-based correctional health care company, in June 2014.
Karla West, Correct Care Solutions director of communications, did not respond Tuesday to a request for comment.
Carpenter said, for legal reasons, he could not discuss Dean's allegations.
Dr. Jacqueline Moore, a correctional health care consultant with 35 years of experience in the nursing field, served as chief operating officer for Correctional Health Care from 2005 to 2007.
She said in an interview that it was common for CHC to use unqualified staff to dispense medication and do sick call at detention facilities where it was providing contracted services.
"It's my biggest complaint with private companies, that they put in a lesser staff than is required," Moore said.
According to the New Mexico Nursing Practice Act, dispensing medication is considered part of the "practice of nursing." Non-nurses can dispense medication, but must be certified by the state to do so.
The county commission also approved increasing the county's contract with PMS from $485,819 in fiscal year 2015 to $804,880 in fiscal year 2016, a 66 percent budget increase.
PMS Northwest Regional Director Mike Renauld said Tuesday that the increased budget would allow for a significant increase in the hours of psychiatric services available to inmates. Renauld said PMS will also hire a new medical records technician and a full-time case worker to help inmates transition back into the community.
The county's contracts for medical and mental health services at the jail have been under increased scrutiny as a result of several high-profile lawsuits, including two wrongful death lawsuits, filed by the Tucker, Burns, Yoder & Hatfield Law Firm on behalf of current and former inmates.
The law firm is asking not only for financial restitution for the plaintiffs but also changes at the jail in policies, procedures, supervision, training and contractual payments for medical services.