By Anne Polta
West Central Tribune
WILLMAR — The Kandiyohi County Commissioners are contemplating turning over the health services at the county jail to a private contractor.
The move was formally recommended Tuesday by Sheriff Dan Hartog.
Although the cost would be higher, there would be more coverage, especially on weekends, and improved access to mental health care, Hartog told the county commissioners.
It also would remove some of the risk involved in providing health services to jail inmates, he said. “It would take a lot of the liability away from the county.”
The County Board will not be asked to make a decision until next month.
But the clock is ticking because a vacancy is opening this week among the current health staff at the jail and action will soon be needed, warned Larry Kleindl, county administrator.
“We have to make a decision one way or the other,” he said.
County officials said the current jail health program has worked well. It’s staffed by two Kandiyohi County Public Health nurses who work full time, Monday through Friday, plus a physician assistant who visits once a week and a physician who comes once a month. Trips to medical clinics and the emergency room also are provided as needed. Limited psychiatry services are available as well.
There’s been “a great relationship” with all the health providers, Hartog said. “We just felt, talking, that maybe this was a good time to look at it.”
Health needs at the jail have evolved considerably in the past decade, said Ann Stehn, director of Kandiyohi County Health and Human Services.
Chronic health and medical conditions often co-exist with mental health conditions in the jail population, and the acuity has been steadily rising, she said, noting that this population is “different than it was five to 10 years ago.”
A shortage of community-based mental health services also means that individuals in crisis may end up in a jail as a place of last resort, she said.
Nationally, mental health within the correctional system has been “a conversation for years,” Stehn said.
Hartog said it’s a growing challenge for the jail staff to meet all the needs.
This month, for instance, 16 inmates were waiting to see the doctor but there was only enough time to accommodate half of them, forcing the rest to wait until next month, he said.
Handing out daily medications and conducting blood glucose checks is done by one of the jail’s correctional officers and takes an average of 10 hours a day, Hartog said. It’s especially a challenge on weekends, when the jail nurses aren’t available and new prisoners often are coming in.
The shortage of mental health services also means that jail staff often are transporting prisoners for mental health care, sometimes as far away as North Dakota, Hartog said.
He’s recommending a contract with MeND Correctional Care, a private company based in Waite Park and founded by a family medicine physician. MeND has correctional health contracts in some two dozen counties in Minnesota and Wisconsin.
A contract with MeND would allow the county to add weekend hours for nursing staff at the jail and would shift the responsibility for handing out medications to the health personnel instead of correctional officers, Hartog said. Eight hours a week of mental health care also would be provided.
The company typically hires its medical personnel from within the community, Hartog said.
The estimated annual cost will be substantially higher: $389.900, compared to the approximately $222,000 the county is currently spending for nursing and medical professional services. County officials believe this could be at least partially offset by a reduced need for transport and greater staffing efficiencies.
The hope is to make it “as cost-neutral as possible,” said Kleindl.
“This is a program change,” he said. “Right now this information is for you to start thinking about.”
The reaction from county commissioners Tuesday was a combination of support and caution.
“I think it would be prudent,” said Jim Butterfield, chairman of the County Board.
Harlan Madsen said he sees both pros and cons but wondered what would happen if the county decided to end the private contract after a few years and had to rebuild its correctional health program.
“I have some anxiety with this,” he said.
“There’s always risk,” Kleindl acknowledged.
But the pending turnover in the jail health staff offered an opportunity to explore the possibility of a different model for providing health care services in the county jail, he said. “The timing would be right for us.”