HOT SPRINGS — The Garland County jail’s new inmate health care provider began operations Dec. 1, replacing the contractor that ushered in the county’s shift to privatized inmate care in 2015.
The $979,080 bid that Turn Key Health Clinics LLC of Oklahoma City submitted for annual services was the lowest of the four the county received in response to its Sept. 1 request for proposals. Its Garland County contract makes Turn Key the inmate care provider for seven county jails in Arkansas, including the facilities in Pulaski County and Saline County.
Advanced Correctional Healthcare Inc. of Peoria, Ill., bid $1,315,856, the highest of the four bids submitted in response to the request for proposals. It was followed by a $1,120,168 bid by CorrHealth of Royse City, Texas, and a $1,101,660 bid by Southern Health Partners of Chattanooga.
The county paid its previous contractor, Southwest Correctional Medical Group, $890,000 a year. Spun off from the California Forensic Medical Group, Dallas-based Southwest Correctional chose not to respond to the county’s request for proposals. Chief Deputy of Corrections Steven Elrod said Southwest Correctional is no longer operating in Arkansas, noting that Garland County was its lone contract inside the state.
“[Southwest Correctional] stated they would not be pursuing other opportunities in Arkansas in the near future,” Elrod said.
Southwest Correctional had the inmate medical contract since January 2015, beginning the county’s transition to privatized care five months before the $42 million jail at 3564 Albert Pike Road opened in June of that year. The four examination rooms and dental treatment room allow most inmate care to be handled on site, reducing the need for off-site medical treatment that poses cost issues and security risks.
The operating agreement calls for Turn Key to provide 353.75 staff hours a week as part of its $81,590 monthly fee. Elrod told the Garland County Quorum Court’s Finance Committee in October that the agreement provides 18 fewer staff hours a week than were delivered by Southwest Correctional, which he said had a staff-to-inmate ratio that exceeded the jail’s needs.
Turn Key’s staffing matrix allots 224 hours a week of licensed practical nurse care, with 140 of those hours provided during evening shifts. The request for proposals required 24-hour availability of nursing services upon request in the booking area to evaluate the physical condition of new inmates.
Contractors were instructed to develop bids allowing physician services to be provided within 24 hours of triage referrals and at a minimum of 4.25 hours a week per 100 inmates.
A nurse practitioner or physician assistant will be on site 16 hours a week under the operating agreement, as the request for proposals allows “physician extenders” to handle a portion of the required physician services.
A mental health professional will be on site 32 hours a week to administer psychiatric medications, which, according to the third quarter jail report, are required by more than a quarter of the inmate population. The operating agreement also calls for four hours a week of psychiatric treatment, and three hours a month of dental care.
Nineteen hours a week of licensed practical nurse coverage at the 22-bed juvenile jail at 222 Woodbine St. is also provided in the agreement.
Turn Key is responsible for annual off-site medical expenses of up to $47,500 per inmate, and annual expenses for special medications, such as those treating HIV or AIDS-related diseases, hepatitis, neuromuscular diseases and cancer, of up to $3,500 per inmate. All other medications are entirely Turn Key’s responsibility.
The agreement runs through December 2020 and allows Turn Key’s annual fee to increase by the amount of the consumer price index up to a maximum of 2 percent. Either party can end the agreement for cause with 60 days’ notice and for convenience with 120 days’ notice.
Turn Key can renegotiate compensation terms if the average daily inmate count exceeds 373 for three consecutive months.
The inmate health care contract is the second-biggest cost in the 2018 Detention Facility Operations Sales Tax Fund budget after $4.9 million in personnel expenses. The three-eighths percent sales tax voters passed in 2011 to operate and maintain the jail supports a $7 million annual budget.