Spokane County contracts with Alabama firm to provide jail medical services for $2.6 million

The inability to recruit nurses at the Spokane County Jail prompted officials to sign a six-month, $2.6 million contract this month with a company specializing in medical treatment for inmates.

County Commissioner Al French said the contract with NaphCare Inc. is a short-term solution to a long-term problem.

“At this point, I fully expect that we’re probably going out for a longer-term bid for filling these positions,” French said.

In his proposal to the Spokane County Commission, who approved the contract unanimously, Spokane County Detention Services Director John McGrath said the need for immediate help intensified recently when three registered nurses quit their jobs.

The county already had been looking at contracting the jail’s medical services. NaphCare, which also contracts with Pierce County to provide services at its jail, had experience with correcting immediate staffing issues, McGrath said.

“They’ve kind of got this backbone in a place that we’d never seen before,” he said.

In 2014, commissioners authorized the hiring of four additional nurses to staff the booking area of the jail so medical and prescription drug needs would be identified immediately. McGrath said after two years of advertising those positions, they were never filled.

The jail is authorized by the county to pay a staff of up to 22 registered nurses and four licensed nurse practitioners. It currently employs 10 RNs and 2 LNPs, or about half the authorized staffing levels, McGrath said. Those staffers will remain employed by the county at the jail during the length of the contract.

The NaphCare contract will add 13 full-time employees and cover medical care for each inmate up to $15,000, including services provided outside the jail..

“We can focus on the future, instead of firefighting,” said Commissioner Shelly O’Quinn. “We’re looking at all our options. The nursing industry is so competitive right now.”

The contract pays between $50,000 and $175,000 more than what the county had budgeted to pay new hires. Cost savings in other departments will offset the amount over budget for medical services, according to staff.

County commissioners had to balance that immediate cost with mounting overtime pay for the existing staff, which is stretched thin, and potential liabilities from experiencing a medical emergency without the necessary health professionals, French said.

“With the criminal justice system representing such a significant part of our budget, we are very critical of every cost,” he said.

The contract amount is based on the average daily population at the Spokane County Jail and Geiger Correctional Center in Airway Heights, both of which add up to a total of 975 inmates per day. If more people are incarcerated, NaphCare, which was founded in 1989, will charge the county more.

NaphCare also accepts liability for substandard care that occurs under their watch, according to the agreement, McGrath said. Nursing staff from the company began work there May 7, and while there have been some bumps, “it’s starting to smooth itself out,” McGrath said.

NaphCare, based in Birmingham, Alabama, has faced legal issues in the past for its standard of care, as has Spokane County. Earlier this month, the family of a Virginia man who died at the Hampton Roads Regional Jail sued the company for $60 million alleging he starved to death in his cell under NaphCare’s watch.

A NaphCare statement, quoted by CNN, denied any wrongdoing in Jamycheal Mitchell’s death in August.

McGrath said recent lawsuits filed against the jail and its medical staff illustrated the need for his staff to ensure they were providing a standard of care consistent with state laws. Both the jail and Geiger Center are now staffed around the clock by at least one, and in many cases several, licensed practitioners and registered nurses.

Commissioners will now need to take a look at their options, as the current contract expires in November, McGrath said. That could include a hybrid system, in which workers on contract are paired with staff recruited by Spokane County, or handing all services over to a firm such as NaphCare.

“This is our short, six-month solution while we find that long-term solution,” O’Quinn said.