Commissioners Court has long explored the opportunity to utilize its own hospital district to provide quality healthcare services to inmates held in the County’s detention facilities. The goal continues to be quality, effective care, including mental healthcare, in a cost-effective manner to meet jail standards and address issues that contribute to incarceration. As such, the Court has made this initiative a high priority on their policy agenda. Through a unified partnership with El Paso County Hospital District (EPCHD) and the El Paso County Sheriff, the County brings forward this interlocal agreement to accomplish this initiative.
The interlocal provides for the County to pay actual costs of providing inmate health care services at both detention facilities. Services that will be provided include intake, transfer, and regular assessments, sick call, dental care (emergency and palliative), mental health services, laboratory and radiology services, emergency care, care of pregnant inmate, detoxification, care of disabled inmates and inmates requiring long-term convalescent care, pharmacy services, care of detention system staff (TB testing and emergency situations only), case management services for referrals, and administrative services. All services will be provided in compliance with applicable standards including Texas Commission on Jail Standards. EPCHD will also create and maintain complete and accurate medical records on each inmate and provide regular reporting on services provided.
The staffing that will be used by EPCHD to fulfill these services is outlined in Attachment C to the agreement. It includes a physical health provider at each facility at a minimum of forty (40) hours per week, on call coverage for all additional hours, physical health nursing, staffed with registered nurses on a 24/7 basis, administrative staff for physical health consisting of a medical director and clerical staff, dental provider coverage at a minimum of 40 hours per week, and a third party provider for mental health care services.
It is understood that the County’s preferred provider of mental health services is Emergence Health Network (EHN). The agreement provides that EPCHD make a good faith effort to subcontract with EHN for these services. If EPCHD’s good faith efforts to subcontract with EHN fail to secure an agreement, then EPCHD will ask the County for authority to contract with a different subcontractor to provide the mental health services. EPCHD may, at its discretion, bid for mental health services at the same time they are negotiating with EHN to ensure a subcontract is in place by the Commencement Date. Once the subcontract for mental health services has been obtained, EPCHD will propose an amendment of the Rate Schedule in Attachment D to cover the actual cost of those services. EPCHD will coordinate with the Mental Health Provider to ensure access to the EMR system as well as to provide appropriate and necessary mental health medications.
The El Paso County Sheriff will be responsible for drafting and updating the Texas Commission on Jail Standards required Health Services Plan and Mental Disabilities/Suicide Prevention Plan, designating appropriate personnel to handle operational matters under the agreement, training EPCHD staff on department policies and detention system policies, providing security and transportation of inmates needing treatment in the Detention System, providing EPCHD with a daily census on the number, names, and locations of inmates booked in and housed in the Detention System, providing inmates access to EPCHD providers, transporting inmates to off-site health care when required, providing input to EPCHD on performance of on-site medical staff, and reviewing and accepting EPCHD policies and procedures.
The County of El Paso is responsible for allocating funding for the services and certain capital equipment, assisting with the implementation and installation of the wiring/cabling for the Electronic Medical Record (EMR), and reviewing of contract to address contractual issues and for alignment with County strategy.
The estimated annual costs for services to be provided, including staffing, operations, administrative support services, third party administration for outside services, and administration fees are $8,684,211.
A separate additional agreement will be brought to the Court for consideration in the next 90 days to address transition services, which will not exceed $583,000. These services are necessary for a seamless transition of services between the current provider and EPCHD. These costs will include the hiring of a Director, HR staff for recruitment and support, IT support, and nursing staff at various intervals prior to the actual implementation date.
In order to prepare for the interlocal and necessary equipment, the County will be required to reimburse EPCHD for the necessary capital, including the electronic medical record system and information technology equipment of $1,288,000. This funding would come from the capital improvement fund unallocated miscellaneous balance.