Lenawee County switching jail health care providers
ADRIAN — Lenawee County has selected a new health care provider for jail inmates after the current provider requested nearly $90,000 more to cover staff pay hikes in December 2022.
Nashville, Tennessee-based Wellpath has been the inmate health care provider at the county jail since 2017.
Under the current contract, all inmate medical services are provided for or arranged by Wellpath. The company provides a physician who is at the jail four hours a week and on call 24 hours a day, seven days a week; a social worker for 40 hours a week; psychiatric services for eight hours a month; a registered nurse for 40 hours a week; and nurses on site 24 hours a day, seven days a week.
All routine medical services, including physical exams, health appraisals, sick calls, lab work, X-rays and dental evaluations are provided by Wellpath as part of the contract. Wellpath also provides the jail clinic, medical supplies and recordkeeping. Emergency and follow-up medical care are provided at the local hospital or local specialist offices as part of the contract. The annual base amount of the contract for 2023 is $928,221.72.
In December 2022, Wellpath asked for two compensation adjustments. One was for a contractually negotiated 3.5% Consumer Price Index increase. However, the second one, which had not been contractually negotiated, was for an additional $87,969.48 to cover staff compensation increases.
Following several emails and meetings in an attempt to negotiate with Wellpath, the county agreed to pay the 3.5% CPI increase, but could not pay the staff pay increases cost because it was in the middle of a budget cycle.
On May 11, Wellpath sent a letter to the Lenawee County Sheriff’s Office, exercising its 90-day contractual right to terminate the contract, leaving the contract to expire Sept. 30.
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As a result, the county was forced to submit a request for proposals (RFP) to find a new inmate health care service provider.
The sheriff's office sent out the RFP June 23 for vendors currently providing health care to correctional facilities. Proposals were accepted and opened on July 24.
These vendors submitted proposals for the medical service contract:
MedTrust of San Antonio, Texas.
Advanced Correctional Healthcare (ACH) of Peoria, Illinois.
VitalCore of Topeka, Kansas.
Wellpath.
On July 31, Sheriff Troy Bevier, Undersheriff Jeff Ewald and Capt. Randy Casey met to evaluate and rate each proposal. The evaluation was based on overall responsiveness to the RFP, experience and reputation for providing inmate health care, references, customer satisfaction, litigation history, personnel, electronic medical record (EMR) capabilities, medically assisted treatment (MAT) participation, training and total cost.
In terms of litigation, Wellpath listed 752 current and past claims and provided this statement: “More than 90% of all cases filed against Wellpath are dismissed with no payment by Wellpath or our partners.”
Wellpath was also tacking on a one-time fee of $45,147 to be billed at contract award for EMR implementation. It provided the highest bid at $1,444,506.
The evaluation team selected low bidder VitalCore at $998,888.32 as the Lenawee County Jail health care provider based on its personnel coverage, litigation record, references, EMR management and cost.
The Lenawee County Commission approved the bid at its Wednesday meeting.
Unlike the other three bidders, VitalCore does not use licensed practical nurses (LPNs), unless they are working directly with a registered nurse (RN). Typically, RNs are better at conducting patient assessments and making critical decisions. LPNs can perform other health care duties under the supervision of an RN or higher-level provider, but an RN must conduct sick calls, intake screening and emergency assessments under the contract.
This requirement protects the county, VitalCore and LPNs from liability. VitalCore will provide 254 hours of RN coverage per week. The other bidders use LPNs to cover the 254 hours.
VitalCore currently provides services to five Michigan counties: Kent, Ottawa, Ingham, Muskegon and Saginaw. Four of the counties supplied strong references and recommendations. Saginaw County was contacted but never returned the call.
In terms of litigation, VitalCore provided a legal action log containing 81 claims, most of which are still pending.
Unlike the three other bidders, VitalCore is accepting responsibility for all costs associated with establishing and maintaining an EMR system at the Lenawee County Jail. VitalCore will provide a comprehensive EMR system that manages and maintains individual patient records for each inmate who receives health care services at the facility.
VitalCore will prioritize the EMR system as part of the first phase of its transition plan so that it is fully operational on day one of the contract. The EMR system will be hosted remotely in a secure online environment.
VitalCore has an annual cost increase of 3%, which is spread over the term of the contract. This increase does not equate to its competitors' year-one cost.
This article originally appeared on The Daily Telegram: Lenawee County switching jail health care providers
