Faulkner County Quorum Court is facing a time emergency, and potential liability, in coming to terms with medical services at the county detention center. Justices debated the solution proposed by Faulkner County Sheriff Tim Ryals for several hours at its regular meeting Tuesday night.
The debate was unresolved, with a special meeting for the court approved by justices for Thursday at 6 p.m. in the hope the county can have a solution in place prior to the forthcoming deadline.
At issue is the doctor who currently holds the contract for medical services at the jail has given his 30 days notice, ending his term of service July 8. If a solution is not in place by then and no medical service is available from July 9 and moving forward, the county risks liability by failing to provide medical care for inmates.
The proposed solution from the sheriff’s office would require time to be put in place, adding to the pressure.
Justices heard from local attorney Jason Owens, who has acted as attorney for the Arkansas Association of Counties and represented it in lawsuits, including in federal court. Owens explained that jails hold mostly pretrial inmates, who not having been tried have a presumption of innocence. Coupled with this, jails are expected to provide access to medical care for inmates, he said.
Owens told the justices of an incident where an Arkansas county was sued, and lost, when an inmate, a diabetic, died due to not receiving insulin when jailers did not recognize his health crisis. The county lost a lawsuit for $1.5 million, with $500,000 of that being covered by the Association liability pool and the remaining $1 million falling on the county to pay.
Owens was invited to speak by Justice Randy Higgins.
Jailers could take inmates to the hospital’s emergency room for medical treatments and for prescription medication being dispensed if no on-site service is available, justices heard from jail supervisor Captain Erinn Stone, but with the jail’s current staffing shortage – down by 12 jailers as of Tuesday night – overtime expense, not to mention jailers being away from the facility and in turn not being able to support other jailers during possible emergencies, could become a factor.
In a separate matter, a transfer of $12,000 was made to the overtime fund for jailers at the Tuesday meeting, to compensate for expenses incurred the previous month due to staff shortage.
Coupled with the imminent need due to liability is the expense of a replacement for the contracted doctor. Currently the sheriff’s office budget has a doctor at $42,000 per year for a weekly visit to the detention center, having been at the same cost since 2016, the last year for which statistics were available. Along with this is the contract for two nurses at $57,100.78 each, who are on-site throughout the week performing interim duties between weekly doctor visits. Total for doctor and two nurses is $156,201.56 per year.
At the Tuesday meeting, Ryals presented a contract by Oklahoma-based Turn Key Solutions which would provide all medical services to the jail, including mental health services and dispensing medication. To complete the contract through the 2021 fiscal year from July 9 to Dec. 31, the court was asked to transfer $384,999.96 from a criminal justice fund to support the Turn Key Solutions contract. The contract, going forward, would be an estimated $770,000 per year, justices were told.
The additional expense, reflecting additional services, was a matter of the county meeting contemporary standards. The current doctor and two nurses service, which had been in place for 15 years according to Faulkner County Judge Jim Baker, did not meet current standards for inmate care, Ryals said.
The county needs a “better medical department,” Ryals said. The current model, which had jailers, on occasion, dispensing drugs to inmates as well as limited access to medical professionals, plus the expense of emergency room trips for the times a doctor or nurse was not on site, was below contemporary standards.
“[We need] to not go backward, [to] not stay where we’re at,” Ryals said. The current medical service model at the detention center “can get us sued, can get our people in trouble.”
It was this go-forward need that prompted him to reach out to Turn Key, which provides the same service for other jails in the state, Ryals said.
Ryals also, to a question from Baker, said he had called some area doctors to see if they could assume the current contract, but changes in insurance left many doctors unable to provide services for detention facilities. To date no local doctor had shown an interest, Ryals said.
Justice Matt Brown, who had heard the initial proposal from Turn Key CEO Flint Junod at the previous night’s Budget and Finance Committee meeting, told the court Junod “became hostile” and became evasive as he pressed him about terms of the contract.
Justice Tyler Pearson, also on the budget committee, told the court he detected no hostility or evasiveness from Junod. He also pointed out that the criminal justice fund had $411,000 in it, more than the required amount in the proposed ordinance before the court.
Junod appeared before the Quorum Court, where Brown asked him about how his company was structured and how much profit it would make if the contract with Faulkner County was executed. A point of order was raised and the questions were not answered.
Justice Rose Roland said if the county approved the contract, it would not be able to approve pay raises for county employees, still currently held in committee, or afford an animal shelter. The alternative was for a tax and she would not support a tax, Roland said.
At one point Junod was asked if his company was “taking advantage of the situation” in the county.
Frustration levels raised as the debate continued.
Justice, and former sheriff, Andy Shock apologized to Ryals, saying: “Maybe sometime you can come before the Quorum Court without somebody being a jerk to y’all.”
Justice Kris Kendrick decried how “People are playing games – mainly along partisan lines,” as the reason the sheriff’s office proposal was being mired, as was the animal shelter and pay raise proposals also before court committees.
The court ultimately settled on tabling the request, giving justices more time to review it, and alternatives. Brown indicating he was going to check with other medical service vendors. He also asked for a Turn Key contract which did not include mental health services – despite Ryals pointing out that mental health issues are a known problem in inmate populations.
In determining how long to table the issue, justices were told that Turn Key normally needed 60 days to set up a service at a jail, but was willing to set up in 30 days in Faulkner County, due to the emergency due to the existing July 8 deadline.
Ryals expressed some concern about any delays. Faulkner County Sheriff’s office Fiscal Officer Angie Wooley expressed frustration, telling justices that the reason she had submitted what her office had, including a copy of the contract, was to expedite passage due to timeline concerns.
Normally contracts are not part of court debate, contract terms being left to department heads – in this case County Judge Baker – rather than negotiated by the court, as the court debates the expenditure or policy.
“We want to be transparent,” Wooley said.
Later she also asked the court why the contract with Turn Key was being “picked apart” when other contracts with the county, such as for road equipment, do not have the same level of scrutiny.
“Nobody asked [road contractor] Rogers Group how much they make,” Wooley said.
As the court agreed to delay the vote pending the Thursday special meeting, down from an initial 10-day table proposal, Justice John C. Pickett, who had earlier proposed “using the ER” if jail medical care was not available, wagging a finger at Wooley and Ryals, said: “If we delay this 10 days it’s not our problem, it’s your problem.”
An obviously frustrated Wooley asked the court to “please be understanding,” presenting a scenario where an inmate would be told “You can’t have your medicine because we don’t have a doctor on staff.”
As the meeting concluded Ryals once again spoke to the court, expressing frustration at statements made in the course of the meeting which indicated he was either trying to force the county to pass a tax, or “put someone in a corner,” neither of which he would ever do, Ryals aid.
Pickett responded forcefully: “You fundamentally don’t understand what you’ve done,” to Ryals, but a point of order was made before he could complete his point.