A proposal to privatize medical services at the Baltimore County Detention Center, intended to save money, initially could cost taxpayers more than they are paying now, county officials admit.
But the Hayden administration hopes that in the long run privatization will pay off -- not only in dollars saved but also in better health care for inmates.
Administration officials would like the County Council to approve a contract to Coastal Correctional Health Services, which submitted the winning bid. For a fee of $866,000, the North Carolina firm would offer basic health care to the growing inmate population. It would also try to find ways to treat inmates' illnesses and injuries without taking prisoners to a hospital, an expense over which the county now has no control.
Detention Center administrator James Dean said the county needs one year to determine whether medical costs, especially hospitalization costs, can be reduced if the services are contracted out. He added that if Coastal Correctional Health Services cannot demonstrate that it can save the county money, the contract will not be renewed. The hope and belief is that, over time, medical costs can be cut with privatization.
Currently, the county is paying cash for inmates' hospital visits at St. Joseph Hospital in Towson. This year alone, the bill for that care will hit an estimated $300,000. The county also will spend $70,000 for medicine. And the detention center will pay roughly $350,000 in salaries to its own staff of nurses.
Although the idea of using private contractors to do work traditionally done by government has long been touted as a cost-cutting measure, it may be easier said than done in this case.
Two of the eight staff nurses at the detention center have retired, for example, and another will leave at the end of the month. In addition, one county-paid nurse will be retained to monitor the privatized care. So it is difficult to determine how much money might be saved by contracting out this service, Mr. Dean said.
It is also difficult to calculate how much of the total overtime budget at the detention center now comes from paying guards to transport prisoners to the hospital and stay with them if they are admitted, he added.
In addition, despite the new contract, the county will continue buying medicine for prisoners, Mr. Dean said. And some hospital visits will still be unavoidable. That means the county will still shell out $70,000 for drugs, and at least part of the $300,000 in hospital costs on top of the $866,000 it will pay to Coastal Correctional Health Services.
As a result, Mr. Dean said, it is possible that initially privatizing medical services could actually cost the county more than it is spending now. But, he added, the county hopes that as time goes on the private firm can cut hospital visits by diagnosing and treating increasingly more inmates at the center, and by doing X-rays and electro-cardiograms on site, rather than at a hospital. Coastal Correctional Health Services will also have access to two rooms in the detention center to care for inmates who otherwise might be recuperating in a hospital.
But cost-cutting is just one goal of privatizing medical services, Mr. Dean said. Improving medical services for inmates is another.
The detention center currently does not have a medical staff on duty overnight, and a doctor's services are available only two hours a day.
Under the proposed contract, Coastal Correctional Health Services would provide a doctor 40 hours a week and offer routine physicals for all inmates. The current staff has a backlog of 400 physicals, Mr. Dean said.
Dorothy Whitaker, president of the Professional Staff Nurses Association, said the detention center nursing staff is unhappy at the prospect of privatized care and about not being consulted about the change.
Although Mr. Dean said they would be allowed to transfer to other public health nursing jobs, Ms. Whitaker charged that detention center nurses would lose the $3,000 to $4,000 extra they earn each year for working in a dangerous environment.
Nurses are also worried that they might lose their seniority if they are transferred to the health department.
The County Council will discuss the proposed contract at a work session next week, and will vote on it at the June 1 meeting.