County commissioners hope updated medical facilities in the new jail will draw competitive bids from contractors interested in providing health care to its inmate population.
Under state law, counties are responsible for ensuring inmates in their jails have access to adequate medical and dental care, and the expense is one of the county's largest service contracts.
"People come to the jail with all kinds of issues, and the taxpayer inherits those problems and bills," Commissioner Jeff Warr said.
The county currently contracts with Southern Health Partners to provide staffing and medical care for its incarcerated population — at a cost of about $1.46 million a year, or $122,000 a month.
This week, county commissioners approved terminating the current contract when it expires at the end of September and going out for bids in hopes of finding a better rate.
Sheriff Larry Smith initially was looking to provide medical care internally, but he decided against it because of potential liability issues, he told commissioners on Tuesday.
"Before, we had very limited facilities," Warr said. "It wasn't very attractive to providers to operate properly and safely. I think that is one good reason to look at (rebidding) it now. I think we will get more bids and more attention."
The current facility can handle the same procedures as a minor emergency room with the exception of dialysis and deep lacerations, said Marie Taylor, a registered nurse and medical team administrator for Southern Health Partners.
The facility has 10 rooms for immediate care, an infirmary that can hold six patients, isolation cells for contagious patients and a pressure room.
The facility inside the jail is staffed 24 hours a day with nurses. A doctor comes once a week, and a dentist visits twice a month, Ms. Taylor said. Counselors and psychologists also serve patients at the facility. Ms. Taylor said the facility treats about 100 patients a week.
Kim Gould, Smith County purchasing director, said she is happy with the level of service Smith County is receiving but not with some of the terms in the current contract. She said the University of Texas Medical Branch, a nonprofit agency, has shown some interest in bidding for the service.
"They are a larger nonprofit that has a lot of buying power when it comes to supplies and medicines," Ms. Gould said. "I feel it would be due diligence to the county to see what is out there."
"We have a new medical facility, and I think that will be very appealing to UTMB, our current provider or some of the private corporations," she said. "It will be a nice space to have their employees work."
Ms. Gould said the current contract has an auto-renewal clause with an automatic 2 percent increase each year. The price tag for care would have increased by $29,400 automatically, if the commissioners hadn't voted to terminate it at the end of its first year.
"I don't like automatic renewals, and I don't like percentage increases," Ms. Gould said. "I feel like all of that should go before the court and be justified."
Another concern is that the current contract covers the maximum jail capacity of 1,140 inmates, Ms. Gould said. So far this year, the jail had a peak population of 640 inmates, so the county could be paying for additional coverage it is not using.
"I don't think they would make any money if they had to provide medical care for 1,140 inmates," she said.
Ms. Gould expects to go out for bids in a few weeks, and the commissioners to select a vendor by August to allow time for a transition period if a new company is awarded the contract.