Spokane County aims for accountability in negotiations with jail medical care contractor

Spokane County plans to add measureable performance standards to its contract with NaphCare Inc., the Alabama company that provides medical care to county jail inmates.

The county commissioners voted unanimously Tuesday to allow a new contract to be negotiated with NaphCare, which beat two other correctional health care companies in a recent bidding process.

NaphCare, which is headquartered in Birmingham, was hired last May to address a shortage of nurses at the jail and the Geiger Corrections Center. Officials say the company has dramatically improved the quality of care that inmates receive. They said medical and mental health care became their top priority after a spate of inmate deaths in 2015.

“We have increased the level of care, I believe, with the current contract,” John McGrath, the director of Spokane County’s detention services, told the county commissioners on Tuesday. “We’ve provided a number of different staffing positions that we didn’t have in the past that allow us to provide that care. We’ve fixed a lot of the issues that have caused us heartburn – processes that either cost us money or cost us litigation.”

But privatization also brought challenges. Former jail nurses accused NaphCare of routinely delaying treatment in an effort to save money, and a Spokesman-Review investigation found that one inmate spent 40 days in jail without treatment for a badly broken elbow. Other inmates described similar experiences.

To fix any lingering problems, the county consulted with Dr. Marc Stern, a correctional health care expert at the University of Washington who once served as the state prison system’s top doctor. Stern helped review bids and recommended that future contracts allow for periodic audits of NaphCare’s performance by an independent physician.

NaphCare will continue serving Spokane County on a monthly basis until a new contract is finalized. County officials anticipate paying the company more than $5.1 million per year.

Sgt. Tom Hill, who oversees medical operations at the county’s two detention facilities, said government contracting rules prohibit officials from commenting on the negotiations with NaphCare. But he said the company is well equipped to treat inmates.

On Monday night, he said, NaphCare nurses revived a woman who had just been booked and was overdosing on an opioid. That was only possible, he said, because the company has a nurse in the booking area and keeps an inventory of the life-saving drug naloxone.

“I’m quite confident that we actually saved her life last night,” Hill said.