New health care provider benefits county jail
The Shelby County Criminal Justice Center in Memphis, Tenn., is one of the nation’s largest county jails, housing an average of 2,600 inmates at a time. Several years ago, when the Regional Medical Center of Memphis stopped providing health care services to the jail, the county put out requests for proposals to private health care providers.
In 1995, St. Louis-based Correctional Medical Services, even before submitting its bid, got to work on a joint transition plan involving clinical personnel, county officials and jail employees. The plan dealt with such issues as quality assurance and expected staffing levels at the time of start-up. Start-up planning meetings provided a forum for all members of the team to consider each aspect of health care at the jail.
Recruiting a sufficient number of qualified health care professionals was one of the key challenges. In December 1995, after the contract was awarded to the firm, human resources representatives, seeking to hire about 30 people, traveled to Memphis to interview and screen applicants. First on their list were former county employees who worked at the jail. About 99 percent of the staffing positions had been filled when the new three-year contract went into effect on Jan. 1, 1996.
A facility analysis, review of security procedures and assessment of the institution’s medical staffing levels also were needed prior to start-up. A team, put in place to ensure a smooth transition and to firm up alliances with health care facilities in the community, evaluated the implementation plan and determined what further actions were needed to ensure quality care for the patients.
Today, about two years into the contract, Shelby County Contract Administrator Conrad McCrary points to the benefits of the county’s privatization efforts, including more health care professionals on site and a significant reduction in unnecessary off-site hospital visits. Under the old system, the jail’s physician had no set schedule; now, the physician is required to be on site a minimum of 30 regularly scheduled hours per week.
Moreover, three full-time RNs work at the jail, compared to none prior to privatization. Two full-time employees staff the pharmacy, and a full-time psychiatric coordinator and two dental health care professionals also have been added.
McCrary says improving the quality of care was the county’s primary objective with privatization. With many of the inmates staying only a short time, and with about 150 newly incarcerated people per day, illnesses can spread rapidly, McCrary says. Prior to privatization, medical conditions could go undiagnosed for longer periods of time and become serious by the time medical help was sought.
McCrary says the new staffing improvements have enabled the jail to treat patients’ conditions before they require emergency treatment and have reduced the need for referrals to specialists. Transportation of inmates from the jail to the regional medical center emergency room has been reduced by 60 percent since the contract began, and the number of inmates transferred to the hospital for pregnancy and chest pain evaluations has decreased by 76 percent.