Provider for inmate medical services still unclear

By Rick Rowan for the Ravalli Republic |Sep 16, 2017

Once again, the Ravalli County Commissioners received no proposals for a contract to provide inmate medical services at the detention center on Thursday, according to Commissioner Greg Chilcott.

“The sheriff’s office is looking at options and a provider to continue medical services.” Chilcott said. “We’re continuing discussions with Sapphire Community Health Center and exploring all our options.”

Sapphire Community Health Center is unable to make a bid and will not be able to provide services starting Oct. 1, according to Janet Woodburn, the chief executive officer of Sapphire.

“Two issues are holding us up,” Woodburn said. “One is securing the appropriate staff. We currently have terrific staff there now, but when the county rebid we couldn’t offer them permanent employment after Sept. 30. The other is tail insurance - insurance is provided up to five years past an incident which may have occurred.”

Tail insurance is an insurance product purchased so that liability coverage extends beyond the end of the policy period of claims made for medical malpractice.

Woodburn said the staffing issue is far more challenging than the insurance issue.

“We have found it to be very challenging to find RNs who have experience in working full time at a detention center,” Woodburn said.

In order to run the detention center effectively, two or three registered nurses and one part-time nurse practitioner would need to be hired, according to Woodburn.

At a commission meeting Monday, Sheriff Steve Holton and the commissioners discussed what has become a long-standing problem for the detention center. An on-site medical center within the jail cannot find a contractor to provide medical services for the inmates, and law enforcement officers aren't even allowed to distribute medications. Those can range from aspirins to mental health medications.

Because there is so little time until the end of Sapphire’s services, Holton suggested the sheriff’s office work out an agreement where they are allowed to transfer inmates to either Sapphire or Marcus Daly Memorial Hospital to receive care. But that plan holds significant downsides.

“The minute they realize they can get out for a headache, they’ll all do it,” Holton said.

In addition to the potential for misuse of the transfer system, the sheriff and commissioners agreed that neither the hospital or Sapphire would be excited about having inmates in their waiting rooms. Woodburn said she was not sure that if it would work to have inmates transferred over for appointments.

“Bringing in inmates to the hospital or clinic in orange is no good without a separate room for them to wait in,” Holton said. “Historically they do not like to have inmates in their waiting rooms.”

If the commissioners and the sheriff’s office can to work out an inmate transfer system the sheriff would need to hire on part-time officers for the job.

“We can do overtime for a while, but my guys are worn out and assigning or forcing people to come in for transports is not something I’m crazy about,” Holton said.

Sapphire Community Health