Inmate health care out for bid in Hays

by ANDY SEVILLA

The Hays County Jail’s medical staff has been told to delay their job search for the time being, after initially being advised to begin an employment hunt immediately, when commissioners unanimously voted to move forward with steps toward the privatization of medical services at the facility.

Hays County Jail medic Adrienne Evans-Stark said medical personnel at the jail were recently made aware of the Sheriff’s Office intent to solicit bids for medical services, a process that could take months, as opposed to its original intent to sign on with a specific company she did not name.

“The Sheriff had apparently only in the last few days decided no to go with that company, as it was announced to us at the jail, so that we could make plans relating to our employment,” Evans-Stark said in an email to the Hays Free Press. “They had first told us to start looking for other jobs immediately, but then they apparently changed their minds, and told us they need us to stay for now, because the open bid process they were asking the Commissioners Court to vote on (Nov. 13) was going to take a bit longer.”

Capt. Mark Cumberland of the Sheriff’s Office said they have looked into different medical service providers for at least six months, and seriously looked at two companies before opening the position up for bids. He said they had the most dealings with Correctional Healthcare Companies (CHC), who on their website state that they are “a national provider of correctional healthcare solutions that improve public safety, manage risk, reduce recidivism and extend budgetary resources in the facilities and communities in which we work.”

Evans-Stark said the company the Sheriff’s Office wanted to partner with was chosen off a state list. She said she researched that company and found a “variety of evidence pointing to a pattern of apparent gross negligence in the provision of health care in many detention facilities by that specific company, resulting in multiple inmate deaths,” prompting her to advocate in writing to the commissioners and the sheriff against the hiring of that company.

Hays County Pct. 2 Commissioner Mark Jones said he was unaware of any movement by the court to sign a contract with any specific company to provide medical services to jail inmates, but said he was in support of what was presented in open court – an RFP (Request for Proposal) process seeking bids from health care companies with at least five years of medical correctional health care experience.

The Commissioners Court voted 4-0 last Tuesday to advance with requests for bids that could privatize health care services for inmates by February 2013. Hays County Judge Bert Cobb was absent for the vote.

“What we approved was to give the sheriff’s department the opportunity to go out and look at different proposals… to see what’s out there and get bids and compare to what we’re doing now and see if we can do it at a lower cost and get better service,” Jones said.

The county spent $875,175 in 2010 for medical services at the 362-bed jail, that figure is down to $828,545 this year for services that include medical staff and physicians’ salaries, pharmaceuticals and outside medical care.

A private provider would be responsible for rendering quality physical and mental health services, related administrative duties, and for the hiring, employing and supervising of necessary staff, according to county documents.

Cumberland said the chief interest behind privatizing medical services was to attract a “higher level of qualified medical personnel to staff the infirmary.” He said inmates are often taken to hospitals for routine procedures including stitches and casts.

Cumberland said a Licensed Vocation Nurse currently runs the medical infirmary, and the Sheriff’s Office hopes to at least have a Registered Nurse fill that position. He said the jail is largely staffed with part-time entry-level technicians, because for years, the infirmary could not attract employees.

But the “rushed” search to privatize the county jail infirmary, which was on the Nov. 13 Commissioners Court consent agenda on their first public look at the proposal, has some in the jail’s medical community worried.

“My main concern is that inmates may die under the care of a private for-profit entity,” Evans-Stark told commissioners on Nov. 13. “… These for-profit prison companies in general have a poor track record for keeping inmates alive.”

But the jail, too, has had errors with keeping an inmate alive.

In 2008, five days after Torrey Lamar Smith turned himself in to Hays County authorities for falling behind on fines related to a 2006 felony child endangerment charge, the 32-year-old father of four died at the jail.

An autopsy report later found that Smith died of an attack brought on by his sickle-cell anemia, and a subsequent internal investigation found that a jail medic accused Smith of faking his illness, gave a false medical report about his condition and was unable to use lifesaving medical equipment.

It took the county more than 24 hours to notify his widow of Smith’s death. The county later settled with the inmate’s family for $245,000.

The county’s RFP outlines a mechanism for inmate requests for health care services.

“There may be a chance we can get a higher level of service by seeing what’s out there and this is an opportunity for them to see if there’s a better option, but not to change anything at this point,” Jones said.

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