Today is the first day that all medical operations at the Pulaski County jail will be placed in the hands of a private corporation — Oklahoma City’s Turnkey Medical Clinics.
Last week, the county signed a deal with the company that will privatize all medical services performed at the jail for its inmates. The deal will save the county $750,000 annually by reducing the jail’s $4.45 million annual medical budget to a $3.7 million annual contract with the company, according to county officials.
The change will mark the first time the jail’s medical wing will be operated by a private corporation since 2002. Since then, the county had contracted out several individual positions and operations, including physician, dental, psychiatric and pharmacy services.
Within the past year, several of those contracts expired and came up for rebid.
“I think after six or seven of those contracts were put up for bid, somebody said, ‘you know, we used to be private. How much would that be?’” said Maj. Matthew Briggs, the jail’s operations manager.
The Pulaski County sheriff’s office began soliciting bids for proposals in August and received three other proposals. However, none was within $600,000 of Turnkey’s $3.7 million bid.
The county’s contract will require the company to continue all medical care and treatment the county provided previously, including a partnership with UAMS Medical Center for pregnant inmates.
“Just about anything you can get done by a primary-care physician, we can do here,” Briggs said.
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There are several areas in which the company plans to cut costs and operate with a smaller budget.
For instance, the county has paid a third party for “medical coding” services for reporting treatments and processing billing through Medicaid. With a full-time staff of medical coders at its headquarters in Oklahoma City, Turnkey absorbs those costs into its “corporate overhead,” said Jon Echols, a Turnkey co-founder and director.
The company also will be shaving payroll costs in a similar manner. Whereas the medical wing previously employed 29 full-time employees and 19 part-time employees — with salaries between $24,000 and $58,000 — Turnkey will reduce payroll to 36 full-time employees on-site with additional staff members working remotely.
The majority of the medical employees working under the county will be retained by the company and will receive slight raises, Echols said.
Out of this rearrangement, the company plans to double psychiatric hours, add another nurse practitioner, and increase nurse and emergency medical technician hours.
“I think we’ll have substantial savings with the increase in physician oversight,” Echols said. “We can deliver care faster to inmates that need it and there’s less likelihood that they’ll have to be transferred to a higher level of care.”
“The drive is to identify issues quickly so they can be handled without having to see a specialist,” he said.
The Pulaski County jail will be the second-largest facility the company has contracts with after the Tulsa County jail in Oklahoma, a facility with roughly 500 more beds than Pulaski County’s roughly 1,200 beds. The company signed a contract with the Oklahoma county in late October.
Since 2007, the company has signed contracts with about 20 county jails in Oklahoma, one in Kansas and six in Arkansas.
The company signed its first contract in the Arkansas market in March 2015 and now operates in Greene, Jackson, Pope, Saline, Pulaski and White counties.
About two months ago, the company signed a contract of up to $130,000 with Jackson County for its 110-bed jail, according to Sheriff David Lucas. However, the company will charge an amount based only on average daily population, which for the past two years has hovered around 30, according to a county official.
And in early November, the company signed a $203,982 contract with White County’s 380-bed facility, replacing one with Advanced Correctional Healthcare, which officials said was about $30,000 more expensive and served inmates only five days a week.
“It’s definitely beneficial to us,” said Maj. Clayton Edwards of the White County sheriff’s office. “Actually, it’s more beneficial for the inmates than it is for us.”
Upon the signing of the Pulaski County contract, the company has established a corporate office in downtown Little Rock and plans to expand around the state.
“Obviously we’re investing in infrastructure right now as a company, so our anticipation is that this will be a long-term relationship with both Pulaski County and our other Arkansas partners,” Echols said.