County commissioners are expected to sign off on the contract Monday. If the deal goes through, it would mark a shift in how the county cares for the people it locks up.
For years, the county has taken care of most of the medical needs of its inmates through informal relationships with a local doctor, dentist or psychologist.
With the new jail on Loop 121 in Belton set to open within the next two months, the county has been working on formalizing its relationships with care providers.
As a result, when the new jail opens there will be a new medical and dental provider operating inside it. Pennsylvania-based Dentrust Dental International, which specializes in jail dentistry, is slated to take over dental services for Belton-based dentist Dr. Norman Poole.
Phil Goodwill, project management director for Bell County, said it was time for the county to take a more global, modern approach to controlling costs at the jail.
Goodwill, who spent two months negotiating the proposed medical contract, said the deal addresses security and medical records issues as well.
The new contract would also provide healthcare to prisoners at the Juvenile Detention Center, which up until this point has operated its medical services separately.
Staffing levels for medical personal working within the Bell County corrections system would increase from nine to 21 people under the new contract.
Adding projected fees and supplies to the base contract brings the total the county plans to spend on inmate healthcare this year to $2.9 million, compared to the approximately $1.5 million it spent last year.
Much of the increase in spending would be for staff salaries, but the tradeoff is that there should be a higher level of caregiver available at all times with more coverage from doctors and nurse practitioners.
When Goodwill was asked why there were so few medical professionals working at the current jail, he said, “Even if we had that many staff there would be no place to put them. That is one of the issues we addressed in the design of the new jail.”
County leaders expect the medical contract to reduce the number of prisoners transported to local hospitals with minor injuries. Under the current arrangement, prisoners are transported to local hospitals when they have small wounds such as those that require stitches.
One inmate recently spent more than five hours on a Sunday afternoon at a local hospital emergency room waiting for stitches, said Bob Patterson, jail administrator.
“That takes a staff member out of the jail, there’s wear and tear on equipment, time and anytime we open our doors it’s a security risk,” Patterson said.
With higher levels of medical licensure in the jail full-time, those types of trips are expected to be greatly reduced or eliminated.
Last year, the county spent about $210,000 on prisoner trips to local clinics and hospitals.
Patterson and Goodwill are quick to point out that the medical care given to prisoners is quality of life care that is not excessive but required according to state jail standards.
The new jail has four wards for medical patients and a room for a mobile dentist who brings equipment onsite. Last year, the county spent $92,000 on dental care for inmates. With each procedure, the prisoner was transported from the jail to a local dentist office in Belton.
The new dental contract allows the inmate to be serviced while still in the jail. This year, the county expects to pay $75,000 for inmate dental work. The contract is based upon which procedures are done.
Prescription drugs are another issue addressed with the proposed medical contract, officials say.
Each month the county is spending an average of $45 per inmate for psychotropic drugs. Goodwill said that amount is much too high and should be between $20 and $25 per inmate per month.
“We deal with a criminal element that has drug tendencies and is very educated about these things,” Goodwill said.
The new contract would require more stringent validation of inmates’ claims about medications they are taking.
With more nursing staff available, jailers would no longer be required to conduct medical screenings upon an inmate’s arrival. Those initial screenings are required by law and consist of a questionnaire about medical and drug history.
Officials say it’s more appropriate for trained medical professionals to conduct the screenings.
“That doesn’t mean we’re not doing a good job,” Patterson said. “We just want to do a better job.”
Once the new jail opens and the downtown jail has been remodeled, electronic medical records will become more important.
There will be some movement by inmates between the facilities. Rather than have a file follow the inmate around, files would be stored electronically and retrievable at any site.
