Winston County Commission asked to pay more for inmate health care

DOUBLE SPRINGS    - Officials with the company that provides medical services for Winston County Jail inmates are claiming to be in the red, offering a solution which would cost the Winston County Commission an additional $84,000 per year.
Ritchie Harbison chief operating officer, and Brandon Channell, national sales director, for Quality Correctional Health Care of Birmingham, approached Commission Chairman Roger Hayes and Commissioners David Cummings and Rutger Hyche about a proposal to improve the jail’s current healthcare situation. during the June 24, meeting.
“We’ve been losing money every month,” Harbison told the commission. “We’re losing about $2,000 a month.”
A suggestion had been made to increase   the number of hours the nurse is on duty at the jail, up to eight, but the company did not feel that was feasible, Harbison explained to the commission.
“I thought we were doing it on four hours?” Hayes told Harbison.
“It was eight hours a day,” Harbison responded.
Currently, the company is providing a full time nurse and a part-time nurse for jail inmates, but due to increased work load, the part-time nurse is working over 30 hours a week, which brings her up to needing health insurance and benefits given to full-time employees, company officials explained.
“That’s not our responsibility,” Hayes told Harbison.
“That is why I am here,” responded Harbison. “We’re losing money.  We can’t continue to lose money. I know October 1, is the new fiscal year. We can’t wait until October. We’re losing about $2,000 a month.
“We’re trying to stay in business, too,” Harbison continued. “I understand. If you feel like you need to contact another healthcare company, get them to come in and make a bid.”
Harbison offered a proposal to the commission to have two full-time nurses at the jail.  The current part-time nurse will then work 40 hours, company employees stated.
“So three days a week, you would have two nurses here, but you have a nurse eight hours,  for seven days a week, which is what the contract is,” Harbison explained.
The company also provides services for the Marion County Jail, which has three nurses with eight more inmates than what are housed in Winston County, according to Harbison.
The costs for medical tests and supplies have increased, Harbison added, which is also leading to the company’s issue.
“You have a fixed contract, which means you pay us every month. We handle it, so if prices go up, labor goes up, pharmacy goes up, that comes out of our profit,” Harbison told commissioners.  “The costs have been going up and we have been steadily losing money.
“We have been here for years,” he continued, “and there were several years, we didn’t even do increases. Last year, we have just gone up two percent.”
“My question is,” Cummings stated. “You’re saying our coverage is going to stop and we’re not going to even get to October?”
“No sir,” responded Harbison. “The contract has a 60-day out for you guys.  It’s vice versa. We can give you guys 60-days notice.
We don’t want to go anywhere.  I am being on the up and up here.  You can shop it out.
“I would like to have waited to October 1, and a fiscal year, but I am trying to keep a business together,” Harbison continued. “We can’t just continue to lose money.”
“My concern is,” Cummings repeated, “We’ve already budgeted this in this year. I don’t know what we are going to have to do, but we’re three months away from October 1.”
“I am just trying to have an honest conversation, tell you my situation,” Harbison stated.
“Let us look at it,” Hayes then said. “Let’s give you a decision by the end of this week.”
Cummings asked how much of an increase the county would be facing.
Harbison responded their costs would go from $16,000 a month to $23,000, which would equal about $84,000 a year. This would give the county jail two full-time nurses and would alleviate the debt faced by Quality Correctional, Harbison told commissioners.
“That’s $84,000 (a year),” Cummings then said.
“Well, we’re on track to lost $24,000,” Harbison responded.
“One lawsuit, it’s going to take us 10 years to be profitable,” Harbison pointed out, “because, if you get sued, an inmate back there, something goes south, we’re paying your insurance.”
Hayes figured the county is currently paying $189,000 a year, which, if increased by $84,000, would mean they would be paying over $270,000 per year.
“That is going to be an increase, and that comes with a nurse, and that gets us out of the hole,” Harbison told the commission. “That gets us where we need to be and we can continue the standard of care that we need to be giving here.”
Quality Correctional presented a chart to commissioners, obtained by the Alabamian,  showing that the company has consistently lost money over the county’s inmate healthcare situation from November, 2023, through April, 2024.
The chart showed that in November, 2023, the company’s total revenue was $19,162.56, but they had sustained a loss of $2,106.86 for that month.
Each month from there through April 2024, showed losses, ranging from $1,610.97 in December, 2023,  to $2,550.25 loss in April, 2024.
“We haven’t made a decision,” Hayes stated when contacted by the Alabamian the week after the meeting.
When asked if he was concerned about the $84,000 additional funding the commission would have to provide to meet the company’s demands, Hayes responded, “Absolutely.  We could have done some roads with that. How many people would like to have roads?
“When we built that jail, we were under a court order.  We had people say, ‘We couldn’t care less about that jail and the people who are in there because they committed the crimes. I didn’t commit the crimes. I want my road fixed,’” Hayes stated. “We had to deal with that.
“That  is what the everyday citizen was saying,” Hayes continued. “But the federal courts and state courts said the sheriff, myself and the commission have got to deal with that and we agreed to deal with that when (I) ran for this office.
“I am not whining and crying,” Hayes added. “I am just telling you like it is.”
When asked whether dealing with the situation meant having to pay for inmate healthcare, Hayes responded, “It means I either have to cut it or pay it.
“If we cut it, it (inmate medical services) won’t be paid for. The sheriff can’t pay for it,” Hayes continued.
Sheriff Caleb Snoddy stressed he had full confidence in his commissioners to be able to wager a good deal with the medical supplier.
“I believe there can be a road forward with a good outcome for everyone,” Snoddy said.
“There have been several valid points made on both sides.  The increase of prices affects everyone, but I still believe we can get this done,” the sheriff added.
When asked whether or not the jail had adequate medical coverage for their inmates, Hayes responded, “(Company officials) say you don’t. I say you do.
“We have to come to an agreement,” Hayes pointed out.
“There is no law that says we even have to have them in the jail, but it puts more pressure on the sheriff, and it puts more pressure on lawsuits.  We’re trying to accommodate everybody,” Hayes stressed.
“We’ve got to figure out what we’ve got to work with,” he added.
“There is no law that says we have to have those nurses or the doctors in the jail,” Hayes continued to stress. “But we’re doing that to try to help the inmates, the sheriff’s department, our lawsuit situation.  We’ve got a limited amount to work with.”
Hayes noted the company has indicated they are in the red, and all he has to go by are their statements.
“I don’t know how they can prove they are in the red,” Hayes said. “The commission has got to talk about it.
““If the everyday person knew what crime was costing us, they would absolutely go berserk. It would drive them crazy.
“Crime is costing people money on insurance. Crime is costing more police departments to have to hire more people, work more hours, have more