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County Administrator's Report 16. 5.

BCC Regular Meeting

Discussion

Meeting Date:	12/10/2015
Issue: Recommendation Regarding Correctional Medicals Services for Escambia County
From:	Jack Brown
Department:	County Administrator's Office
CAO Approval:

RECOMMENDATION:

Recommendation Regarding Correctional Medicals Services for Escambia County - Jack R. Brown, County Administrator

In May, Escambia County hired Alliance Medical Management as a consultant to conduct an analysis of the current corrections medical services. Two medical system improvement options were recommended by the group to enhance services and improve operations:

A. Given the complexity of the operations and the challenge of recruitment and retention of clinical staff, the team members recommend the privatization of the medical and mental health service:

1. Development of a detainee healthcare RFP;
2. Establish catastrophic caps or some type of capitated risk share for pharmacy costs. This approach will incentivize vendors to aggressively manage care;
3. Prerequisite that clinical practice meets or exceeds NCCHC standards with penalties for non-compliance;
4. Assist in the development of a Federal 340 B pharmacy program to access discounted pricing for HIV medications; and
5. Develop a managed care approach for the use of HIV medications which carefully prioritizes appropriate use of these treatments;

or

B. If the decision is to continue medical services as an in-house operation, AAM will develop a long-term multi-year operational plan. The Operational Plan will:

1. Establish a Medical Director position to provide clinical policy direction and overall management of the health care program, address clinical policy direction and provide overall management of the health care program;
2. Establish an independent monitoring position to provide review of the same;
3. Determine financial and budgetary requirements to meet the needs for a successful detainee health care program; and
4. Re-bid or restructure the pharmaceutical contract to ensure the County is receiving the best price to include all rebate, mark-ups, discounts, and any other remuneration.

Note: The County Administrator recommends Option B.

[Funding Source: 001 General Fund - Corrections - Cost Center 290402]

BACKGROUND:

In May 2015, the Board authorized Alliance Medical Management Group to move forward with an assessment of the Escambia County Correctional Medical Services. The Chief Corrections Officer was having an RFP developed through Corrections and Purchasing prior to bringing the report to the Board. The County Administrator recommends moving forward with Option B. On December 2, 2015, the Chief of Corrections was still checking on the status of the RFP. The Board doesn’t need an RFP to make a determination. Dr. Paul Henning, the current Escambia County Public Safety Medical Director, will fill the role as the Jail Medical Director until the position is filled.

BUDGETARY IMPACT:

To be determined.

LEGAL CONSIDERATIONS/SIGN-OFF:

N/A

PERSONNEL:

N/A

POLICY/REQUIREMENT FOR BOARD ACTION:

N/A

IMPLEMENTATION/COORDINATION:

If the Board approves Option A, the County Administrator will oversee the development of the scope of work and the RFP. If the Board approves Option B, the County Administrator will oversee the recruitment of the newly created Medical Director position.

Attachments
Review Of Correctional Medical Services, Escambia County, Florida