Jail considers private sector medical staff

The Pierce County Sheriff’s Department is exploring the possibility of saving money by contracting out medical care provided by 38 nurses, physician assistants and other workers at the county jail.

Declining jail bookings and revenue, coupled with overtime expenses, are putting pressure on the Sheriff’s Department to reduce costs.

Sheriff’s spokesman Ed Troyer said the department wants to find out if a private company could do the medical staff’s work at the jail clinic for less money.

“That’s no put-down of our current employees,” Troyer said. “Times are tight and budgets are budgets. We’re required to do certain things to get the most bang for our buck.”

Undersheriff Eileen Bisson said the Sheriff’s Department will ask for proposals and study the price and level of medical care that private companies offer.

She said the process will take several months.

“We are nowhere near making a final decision at this point,” Bisson said.

A contract would not include mental health services, Troyer said. Mental health care is “a whole different issue,” he said, and jail staff will continue to provide those services.

Medical staff members, who are union employees on the county payroll, were told last week that the Corrections Bureau is looking into contracting the work they do.

Dylan Carlson, who represents medical staff for the American Federation of State, County and Municipal Employees, said he opposes contracting out the clinic positions and is worried his members will lose their jobs.

The Sheriff’s Department can’t fill current nursing vacancies for what it pays, Carlson said.

“I find it difficult to believe that another organization could provide the same quality of care at a lower price,” Carlson said. “I think that a better solution is working with the union to fully staff the jail so we can stop spending money on overtime and let our members go home at the end of their shifts.”

Some other Washington counties, including Kitsap and Clark, already contract out medical services for their jails.

Bisson said there are no plans “right now” to let go of any medical staff. To the contrary, the jail’s clinic has six openings for nurses and a physician assistant it is trying to fill.

For the past year, the Sheriff’s Department has paid private companies to provide temporary, fill-in medical workers to maintain the level of medical care while vacancies exist, Bisson said.

Troyer said it’s competitive to hire medical workers.

“You just don’t go out and find RNs (registered nurses) and doctors who want to work in a jail,” he said.

The 38 full-time-equivalent medical positions — including the six vacancies — account for $6 million of the $52.55 million jail budget for 2013.

The medical staff is led by Dr. Miguel Balderrama, whose $189,000 salary makes him Pierce County’s third-highest paid employee.

The jail’s budget for mental health care is $1.7 million and includes 10 full-time-equivalent positions, Troyer said.

The jail’s clinic provided service for 66,547 inmate “sick calls” during 2012, said Corrections Bureau chief Martha Karr.

Several issues are exerting pressure on the jail to contain costs:

• The City of Tacoma decided last month to shift its misdemeanor bookings from the county jail to Fife’s jail to save money. County officials aren’t sure yet how much money the county stands to lose because of Tacoma’s switch.

• Corrections deputies and other workers at the jail racked up nearly twice as much overtime as budgeted last year. Overtime spending was $1.7 million more than budgeted, primarily due to guarding more inmates with mental health problems, officials say. More mentally-ill offenders are being brought to the jail because they can’t get care elsewhere due to cuts at Western State Hospital in Lakewood and other state cuts. Despite the overtime costs, the jail didn’t overspend its total budget last year.

• A significant number of medical staff at the jail are nearing retirement, said county spokesman Hunter George. That would leave even more vacancies to fill.

• Because of a drop in bookings last year and budget cuts for this year, the Sheriff’s Department closed an 84-bed unit in the jail on Jan. 1. Nine unfilled corrections deputy positions were eliminated in this year’s budget. The unit closure reduced the jail’s budgeted capacity to 1,381 inmates. For the first 11 months of 2012, the jail had an average daily population of 1,289.

Two jail studies

The county’s Performance Audit Committee gave the go-ahead Monday for two studies on costs at the Pierce County Jail.

One study will examine rates the jail charges for housing misdemeanor offenders so that they are competitive but also cover the county’s full costs per inmate.

County Executive Pat McCarthy and the County Council requested the study to help deal with the jail’s drop in bookings and revenue.

A second study will examine the “efficiency and cost-effectiveness” of moving the Corrections Bureau out of the Sheriff’s Department. Former County Council member Tim Farrell, D-Tacoma, who left office in December, suggested last year examining how other counties administer jails within their organizations.

In every county in Washington except King County, the jail falls under the administration of the sheriff, said Bill Vetter, Pierce County’s performance audit coordinator.

King County’s jail is a department under the administration of County Executive Dow Constantine.

The committee approved both studies as the top priority of a performance audit work program for 2013.