County contracts with Sapphire for inmate health care

By EVE BYRON for the Ravalli Republic | Jun 23, 2017

Ravalli County Commissioners put the brakes on a $500,000 contract for health care for inmates Tuesday after realizing the project first needed to go through the formal “request for proposals” process.

The current contract with Benefis Spectrum Medical Inc. runs out on June 30, after the company notified the county in December 2016 that it no longer would provide health care for inmates in small counties like Ravalli.

Other providers weren’t interested initially, so the county worked out an arrangement with Sapphire Community Health Center in Hamilton. But after the contract was sent to the commission for approval, commissioners realized that not only was it nearly twice as expensive as the Benefis contract, they needed to go through the request for proposal, or RFP, process.

“I think often times, especially when you have a bit of an administrative crisis like this, there is a tendency to drop a ball here and there. I feel like I dropped the ball,” said County Commissioner and former Sheriff Chris Hoffman. “I don’t think putting out an RFP would have made a difference in vendors being interested — we’re reaching out to some vendors to see if they’re interested that we already reached out to.

“But obviously, we know that by county policy, we have to go out for an RFP.”

The commission is slated to meet to discuss the matter further on Thursday, and Hoffman said he heard that another health care provider may be interested in making a presentation.

But with the clock winding down on the June 30 deadline, the commission is discussing contracting with Sapphire for a 90-day period beginning July 1, and go through the RFP process during that time.

They’ll also need to figure out where to find an additional $250,000 if the offer from Sapphire is the best that’s made.

“It will be a challenge in finding the revenue to cover that amount. It’s staggering, especially with some of the actions taken by the state Legislature that create extra expenses for us, as well as those from the federal government,” said County Commissioner Greg Chilcott.

The county recently began its budgeting process.

Janet Woodburn, chief executive officer for Sapphire, said it's flexible in working with the county. The contract Sapphire worked up had a clause that either partner could walk away with 60 days' notice, so contracting with the county for 90 days while it goes through the RFP process isn’t a big deal.

She noted that initially, the county approached Sapphire after a lack of interest from other potential providers. The small, nonprofit community health center considered whether providing health care to inmates fell within its goals and strategic plans, and decided it could work with the county.

“We felt it was our responsibility to provide what the community needs, so we felt we should step up,” Woodburn said on Tuesday. “We’re happy to hear they might consider a 90-day bridge, because we have been working so hard toward fulfilling the project. There’s only 11 days left.

“Our interest in this was sparked when no one else in the community was willing to put this together. If there are other professional organizations that can do it better or cheaper for the county, I hope they would come forward.”

A spokesperson for Marcus Daly Hospital in Hamilton couldn’t be reached for comment Tuesday afternoon.

Sheriff Steve Holton said that while there was some confusion regarding the contract, those involved were trying to ensure that emergency care services didn’t lapse for inmates with minor problems like headaches, or for those taking their prescription medications.

The plan with Sapphire calls for nurses or nurse practitioners, working under a physician, to hold regular hours at the detention center.

“If the commissioners decide to do that 90-day agreement, it gives us plenty of time to follow through with the RFP,” he said. “It is a very big contract. But I don’t think you can put a price tag on some expensive emergency room trips instead of taking care of minor problems in-house. We’re charged with providing for the safety and welfare of the inmates in our facilities. 

“This has been a difficult project, but I’m encouraged after this discussion.”