Travis County Commissioners Court
June 13, 2006
Items 10 & 11
Do we do have the right folk here on 10? Number 10 -- beg your pardon? 10 and 11.
>> 10 is to approve termination of contract number ps 960359, kw. Rx management consultants, incorporated. For pharmacy management services.
>> judge, could you pull up, 11, also,.
>> no, ma'am, we will take it up immediately. Number 11 I was going to put on consent until a ran into a problem with 10.
>> good morning, cyd grimes, Travis County purchasing agent. Over the past -- good morning, sheriff. Over the past several months --
>> [indiscernible]
>> I will come back and get the proclamation. I overlooked it.
>> all right.
>> over the past several months, the purchasing office has been working with the sheriff's office looking at the pharmaceutical issue. The increases in the drug costs. We have been working to try to figure out how we can save some money. We have had for the last 13 years, I believe, a contract with -- with rx management, if he's a -- if he's a pharmacy -- a pharmacist who runs his own pharmacy, and he has provided the services out there for us. We have currently been operating under a contract -- that we were paying him $139,000 a year. And also on top of that, we are having to pay for the cost of our -- of our drugs themselves. We went out for proposals back in February to see if we could get this service, this pharmaceutical service at a better price. We actually sent this out over our new rfp system, 230 vendors had an opportunity to look at that solicitation. We did receive only one proposal back from rx management. And the proposal that we received -- was for $225,000 -- $220,000 a year, almost double, not quite double, almost double what we were paying then, that was just for a consulting pharmacist. The -- in the proposal that we recently received, or that you received and I致e gotten copies of, we -- which is an unofficial proposal from rx management, the terms are different and he's offering to be a full-time pharmacist at 295,000 a year with annual increases. What we have done -- also during this process utmb and Texas tech, who are -- who are large university teaching medical teaching schools that have pharmacies called us, interested in this process. I believe years ago there was discussion with utmb about doing this. Utmb provides this type of service -- to -- to many state agencies, all of the state jail system. Some county jails. So he wanted to look at this system, to do that, next item, to do that we need to terminate our contract with rx management?
>> under what authority did we --
>> the sheriff has the authority to request this be terminated within three days of notice. We came to Commissioners court to get that approval, so we could send mr. Wade a termination letter, which will be effective June 19th.
>> legal agrees with that conclusion?
>> yes, sir.
>> ms. Clayton, are you here to represent the -- not to cut you off when I read the backup, it was as simple as we had the right to terminate the contract within three days.
>> yes, sir, we do.
>> that's what we are relying on. Yes?
>> okay, all that I知 asking --
>> your full name and your relationship to our rx management consultants, inc.
>> eye diane clayton, a registered pharmacy technician under the employment of rx management. I have been there since day one of the contract, almost 12 years. We were the only one that's did respond, ms. Grimes did -- did ask, but we've had no notification or no requests to -- to further discuss opportunities additions or changes to the proposal. We -- we are very, you know, amenable to bring on the pharmacist. When we started out there, we started out with two technicians and a consultant pharmacist, a part time medical doctor, a part-time psychiatrist. We still have two technicians and a consulting pharmacist, however now we have a full-time md, a full-time psychiatrist and five practitioners. So needless to say back when we came on board, we are averaging about 100 orders a day, we are averaging 300 plus a day. So we do need another body in the pharmacy to help meet the need of the staff. And of the inmates. We also need, if that person be a technician or a pharmacist, it's definitely up for negotiation. The medical staff has -- we have worked real well together over the last few years. I really think a mail order provider has some really wonderful opportunities for you. But the turn around time for the medications is going to be much slower than it currently is. And I just -- would like to have the opportunity to have a working session so that we can just kind of banter out what's best for everybody, the taxpayers and the inmates and the medical staff at the jail.
>> let me ask this question.
>> I知 sorry?
>> let me ask this question, I guess, of staff. If the court decides to terminate its contract, this relationship, that we have with rx management consultant, would that service continue if the court also decides to -- to have someone else to -- to provide that distribution of medication services.
>> we could certainly discuss it. The time of notice is not very reasonable. There's a procedure per the pharmacy board on shutting down an on site facility, which we are. So it involves anywhere from 50 to 30 day written notice to the d.e.a. For that license. The pharmacy board for that license. So it's not a matter of just locking the door and walking away. We have to deal with the inventory, we have to return it to the wholesaler if possible, we have got to destroy anything else that cannot be returned.
>> but I guess my question -- I知 hearing you, but I知 not hearing you. My question is this ... If the court decides to -- to terminate your contract.
>> yes, sir.
>> with Travis County.
>> yes, sir.
>> would you be able to continue to provide that service in lieu of -- if someone else is selected to provide the similar services that you are offering right now? That's my question.
>> I believe so.
>> all right. That's what I need to know. In other words, I didn't want anyone to think that -- this is the sheriff's call, I guess the -- that's his discretionary authority that he has. In his department. So we have got -- we have to look at that. But -- but at the end of the day, if we look at this and the voters out, there the people that say well wait a minute, Travis County is looking at -- at possibly terminating a pharmaceutical distribution contract, that -- yes, we have.
>> that's for the sheriff's office.
>> the sheriff's office had an opportunity to get with the consultant and discuss these issues?
>> yes, sir, we met with them in several meetings, including the folks from gardner-betts to discuss their initial proposal since they have made this -- this most recent proposal that -- that ms. Grimes referred to. We have not. Though we did -- we did several weeks ago in conjunction with gardner-betts, reviewing their initial proposal.
>> she is -- ms. Clayton indicates today that there are several steps that they must follow in order to close down the pharmacy.
>> we are not closing down the pharmacy. Judge, court. [multiple voices]
>> close down the pharmacy, ms. Clayton you were talking about you and your company exiting our facilities, right?
>> yes, sir.
>> we would not -- the sheriff's office would not be able to maintain a class c onsite pharmacy and also obtain medications from a class a pharmacy from another source.
>> utmb will be providing the license under the interlocal agreement and provide the pharmaceutical services and the pharmaceuticals.
>> we think those issues have been addressed?
>> yes, judge, we do.
>> so in spite of what was said today, the sheriff's position is that the department wishes to exercise the three day termination notice that the contract allows.
>> that is correct.
>> I would like to move approval of that. Particular motion. I would like to move approval of this item, item 10, for the sheriff to use their authority as far as giving three day notice to terminate the contract with rx management consultants. I would like to do that based on what I知 hearing, what staff has exhausted around the right and authority that the sheriff has under this particular contract.
>> Commissioner, may i?
>> Commissioner Daugherty? Commissioner Daugherty?
>> judge, I知 confused enough about this thing that I really don't want to vote on this thing today. I understand all sorts of -- I think that I -- I致e heard a number of things that if you don't do this deal today then come Monday, you know, we are already non-compliant, right?
>> correct.
>> come Monday I guess we could still be non-compliant. After having met with the sheriff's guys the other day I was pretty convinced okay we are kind of moving in the right direction seems like it's the logical thing to do. But after having talked with ms. Clayton and having some information before me, I知 -- I am pretty interested in -- in knowing what the ramifications are with canceling this contract. Number one, I don't think that it's very fair to cancel a contract within three days mine, you are fixing to have some people lose jobs, it's not the right thing to do. Maybe there's some extended, some circumstances that call for us to really sit down with this vendor and say we have some questions and I知 convinced after having talked to the sheriff's department that there are certainly some questions that I would like to ask of this vendor. But I知 also equally concerned and -- and have a great deal of interest in -- in being able to have information from -- from, you know, the vendor to the sheriff about there are some issues that maybe you don't understand. I mean,, you know, for example turn around time with meds, now maybe this is something where utmb comes in and it's like it doesn't -- come Monday, we can do everything that we need to do, you know, granted I mean we are going to pay $80,000 for it for the rest of the year, but that's fine because we are also paying a service now I mean to get -- to get performance. I am concerned that -- that we got a pharmacist that obviously operates your -- owns your company and that we have been in non-compliance since January 1, which is a little befuddling to me because I mean I would think that somebody would say, hey, I mean since the law changed, we -- you all need to be operating differently than what we -- what we are operating. I would also like to know why the sheriff's department wasn't aware of that, but headaches that's something that no sheriff's department would be aware of when you have a contract with a registered pharmacist, you know, we would -- I would think that we should get that -- that's part of the service that we ought to be getting about hey, guys, there's a new law, here's what we need to do. I知 a little miffed by our present contract but I do want -- judge, I mean, I would love to have a week with this or at least like to have a conversation in executive session with this because I am convinced that there are a couple of -- a couple of things that don't add up to me. Not to say that I知 still not willing to listen to the sheriff's department about their issues that we have that we would like to have some answers to. At the end of the day, we may need to go to utmb I mean and get out of the contract. But there -- and this is just -- this just happened in the last week, in the last two or three days, I think that I understand enough about it now. I mean, for example, whenever you start reading -- reading information that says -- if you don't have the ability to have a pharmacist, you know, on -- on, you know, on staff just -- just the simple figures that I see here with the -- with the drugs that you were able to -- to -- to keep or to have turned back in, there's a savings here of $100,000 in six months. Maybe we could do that with utmb. I don't know that. Because I have been told that, yes, you can, I have been told, no, you can't. Therefore I知 concerned enough that I would like to at least have some of these things answered. I don't know if we can answer that in executive session or what, judge. I知 not ready to vote today to just say hey you guys are out of here, utmb is in here.
>> I think that we should take this in executive session so you can get some legal advice.
>> what's the situation today as to -- to a provision of medication?
>> the situation is normal. As we have been.
>> all right. They are still there.
>> uh-huh.
>> the -- the ut pharmacy is sort of on stand by.
>> they visited I believe they came out last week and started talking about the transition and how it's going to work.
>> yes is fine. So have we leveled, though, with ms. Clayton and the firm about issues that the sheriff has?
>> [indiscernible]
>> to the extents that we are able at this point, yes.
>> I think that -- that has been -- that can be asked and answered in executive session.
>> but -- but this [indiscernible] in executive session. The question was, from what I heard, and there's a lot been laid on the table, of course I guess some of the answers are going to have to be gotten in executive session. But at the end of the day, I asked the question would service be disrupted if we were to move on item 10 today as far as terminating this contract with -- with the folks, would you actually walk out the door. That's what I am trying to figure out from rx consultant -- management consultants from.
>> from my perspective it would be disrupt active.
>> in other words you would walk right out the door if we were to execute not execute but to --
>> proceed with another --
>> proceed with this notice today, you would walk out the door, is that what you are saying today? Today. You would quit working.
>> oh, no, no, no, no.
>> well, see that's the --
>> I知 sorry, I misunderstood your question.
>> ethically wouldn't you have to stay on board until there's a replacement, ethically?
>> personally, I would. Just because of the nature.
>> yeah.
>> of the task. Now, but -- but it becomes a compensation issue. So would I be volunteering my time, you know, I still have bills to pay, a family to support just like y'all do. So -- so I have done everything that I can to meet the needs of the department, I will continue to do so as long as I知 allowed to.
>> if you are back at 2:30 this afternoon, if we go do executive session, that's about the time that we would come out hopefully.
>> okay. That would request that we counsel with lawyers in executive session. Unfortunately there are other commitments that I made this morning. I thought this was a three second item. If we need to conference with legal in executive session, before deciding how to proceed, that will take place after lunch. We have corporations that will take 15 to 30 minutes, so I知 assuming executive session will take 30 to 45 minutes, you are looking at 2:30, 2:45. Sheriff?
>> Commissioner Daugherty asked a question about -- about how were we out of compliance since the -- since this law went into effect. One of the things that I would like to say is that we had the auditor from the pharmacy board come out and we passed the audit and then we specifically asked the question about the pharmacist and then those individuals looked into it and at that point in time they told us that we were out of compliance, that's when we took action to address the issue.
>> did you know that we were out of compliance?
>> not until we had been at several months ago, it's been kind of a tug of war and it's -- it's a matter of resources. We can't bring a pharmacist on board if we don't have the resources to compensate them.
>> is your boss here?
>> yes, sir.
>> is -- would he mind -- because he is a pharmacist?
>> yes, sir.
>> I知 just -- I would just like to ask him that. That would go a long way to solving a couple of things for me.
>> I知 the owner of the company. As diane said, we have had the contract for 11 years. We knew that we were out of compliance, yes, we knew that we had to bring a pharmacist on board, that's why we went back and rebid the contract. That's why the numbers came back as they were. I need -- ask I ask cyd a question during this. Is utmb going to maintain a class b pharmacy in the facility.
>> class a.
>> see, you can't recycle drugs in a class a pharmacy.
>> they have addressed that with us, they think that there is a way for us to do that under their program.
>> those are some of the reasons why multiple multi-why -- different information that I知 getting that I would like to -- to make sure that we know. John, let me ask you this. Being a pharmacist and -- and obviously knowing that law as of January 1 had changed, why did you not tell us we have to do this differently. By the way I can get compliant with you, you are going to need to have a pharmacist on staff, because I understand that that is the qualifying thing, is it not? That if -- as of January 1, since the law changed, if you have a pharmacist on staff, then you would be in compliance.
>> part-time pharmacist. That was the reason when the meeting was called with the state board of pharmacy, we had to get dobson and we had the legal department as well. At that time, excuse me, we had been operating the same way for 11 years or 12 years, since 1994. At that time, they pointed out that we can no longer operating that way.
>> it wasn't until you asked. We were just assuming.
>> maintaining the status quo.
>> and then it was the board that said.
>> correct.
>> oh, hey by the way that doesn't qualify you as being compliant so you.
>> correct.
>> assumed that you were until you asked, you said nah you can't do it?
>> correct.
>> when did that meeting take place.
>> about twos ago.
>> when did the law -- about two months ago.
>> when did the law change.
>> I don't know when the law changed.
>> a reference made to January, what was that about?
>> I heard the beginning of the year, I don't know when the law changed.
>> I知 not sure that it changed.
>> the law has changed over the years since we have started but I don't know exact when it changed.
>> when we initially were approached by this contract, we visited the pharmacy board, explained how we would envision providing the service, the compliant officer that at times said hunky-dory fine, that is perfectly within the guidelines.
>> the pharmacy board between thousand and when we meet, barbara, let's -- we need to know that, the pharmacy board is probably going to tell our attorney as of January 1, 2006, this was -- this was when this was supposed to -- to change?
>> again I don't know that that was the date, I don't know when the law changed, just the way we have been --
>> I don't know if you were here, I asked her the question, I think it would be more appropriate for you to answer the question more so than her. That is the question that if this particular item supported by this Commissioners court, number 10, as far as terminating your contract, will you be able to continue to provide the distribution services at that -- at the facility where you are at, at del valle, would you be able to -- to continue to provide that service in lieu of the transition period for someone else to do -- to do the same service that you are doing now?
>> yes, sir. It's my understanding, however, that utmb is supposed to be on board on the 19th, that was our drop dead date. That's when we were supposed to be out.
>> but you will be able to continue until --
>> as long as we can be assured of being compensated, yes, sir.
>> okie-doke.
>> we will call this item up this afternoon, after executive session. My guess it's it will be 2:30.
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Last Modified:
Wednesday, June 14, 2006 9:58 AM