Travis County Commissioners Court
September 19, 2006
Item 41
41 is for an internal pharmacy for the sheriff's office. And we had a presentation last week, but this needs a little bit of time to bake, right?
>> yes, sir, it probably does.
>> let's just simply leave the money in reserve and when it's done, we'll pull it out. The court seemed to be supportive last week, but there are some I's that need dots and t's to cross, and when we are done, the money will be there. In contractual payments as though the services are rendered --
>> yes, sir,.
>> -- up until the transfer is made-how does that sound?
>> sounds fine.
>> let's give you an opportunity to give the brief presentation.
>> the court asked for a side-by-side presentation and we got it to you a little bit late yesterday, and I hope that you have it. I have a few more copies if you don't. The numbers we collaborated on, and our best estimate they are -- in essence to make this very brief, last week we had two alternatives for you, and this week we have one alternative, a hybrid of that, and then the third alternative. The issue is how much money do you care to spend based on your perception of the risk in operating the jail pharmacy? We can by our estimate extend less money if we hire one and a half pharmacists and two pharmacy techs. We run the risk if we do that of having to close the jail pharmacy if we have a pharmacist out ill, or if we can't fill the positions or if we have trouble retaining them. We have included our best estimate for hiring two pharmacists as an alternative. That mitigates the risk of being without a pharmacist somewhat. It does cost an extra half slot for a pharmacist, and then the third alternative -- pardon me -- is to contract for somebody to provide us for a pharmacist to operate the jail pharmacy. That has in our perception less risk because a contractor would be obligated to provide that pharmacist and it would be something that we would not have to worry about tf so the risk is lower, but in our estimate it is the highest dollar investment. So I believe that is the range of alternatives that we see for the court to consider.
>> bill, help me out in terms of understanding how successful do you think we could be on the hiring of somebody to work there, considering that we have had challenges to get medical personnel to work in there? Help me walk through that, because it may sound really great, hire our own and then you can't find anybody that wants to work there.
>> the answer is: we don't know. We have a lot of trepidation considering what we've seen with contract nurses. But we are willing to try if if that is the court's direction --
>> I'm sorry to interrupt you, bill --
>> last week your recommendation was to bring it in house, and with trepidation we said, okay, and give us more details -- I'm sorry, in June to return to the court with the lowest cost alternative and that's what we did last week --
>> the only thing I'll add to the question, Commissioner is that, yes, we've had a very difficult time in filling our vacancies with nurses. However, when we decided to go to our medical doctor we descrint a problem attracting any folks and we hired dr. Heart and he has been with us for a number of years now. I don't know if that translates to pharmacists. You know, I just don't know. We could get lucky and as has been pointed out we could hire a pharmacist because he or she feels if I work at walgreen's or whatever, I've got all of the issues of running the pharmacy and the store when the manage senior not there -- or whatever else coming with that, when in the jail, he is just running the farm circumstances and the clients probably are pretty happy. I don't know, but bill is correct. We just don't know. If we hire our own, we believe we're in budget. If we go contract, we need more money. There are pros and cons for each, we're just trying to give you both of the alternatives.
>> yes, sir.
>> I've had a conversation since last week with the former chairman of the pharmacy board, and we have a meeting Friday afternoon at 3:30. Bill and mike and a couple of us are going to go and talk to him. But the question that I asked him, which is the question we posed last week, how difficult is it to hire pharmacists? He told me that when you pass your pharmacy boards, that you can get a six-figure job anywhere in the united states, period. They are not plentiful. This industry is going to be very difficult for us to manage. The fact that you're Monday through Friday with us verses working retail, and you have crazier hours, I think that come Friday we're going to either get some information on that, but I would think that give us a little time to do a little more due diligence with this thing. I'm expecting to get perhaps some recommendations from someone like this, but the first thing he told me when I said I want to talk to you about pharmacy as it relates to jails, he just went oh, no. I mean, just bad subject. They just don't like -- the pharmacy boards understand it's a really issue, but I have access to this guy and I think we're going to get valuable information and be able to bring that back to the court.
>> what do our countries do?
>> I've asked a lot of my fellow jail administrators do and so far I've only had one response. Frankly at one in florida, an 800-bed jail, they contract with the walgreen's across the street, and get them delivered. But that is a small jail and not a good example. Some are supplied by their hospital districts. I think that dallas is, but I don't know. So I don't know, judge. I'm waiting for the reports so that I can report back to you guys.
>> well, in addition to doing additional research the only way to find out if we can hire a pharmacist is to postthe position, but if we don't bring it in house, then it's contracted out, right?
>> we can contract it out to be operated in howrks and still have the pharmacy in our health services building run by a contract company. That, of course, you know, is -- we believe that is anywhere from, what? 25 to 35% higher cost because of their profit margin, but like bill says, it eliminates the risk. And you don't have to worry about in if our pharmacist breaks his leg and has to be out for six weeks. If you have a company, you say give us another pharmacist and they have a contract to have them there within x amount of hours and if you have difficulty hiring them, the contract said they get them there, how far they do that. Theywe have a contract for dental services and if there is not one, they get us another within hour, they do that, and they meet their hours and days but it's a higher cost, throw.
>> when do we need it back on?
>> one week or two, judge, your option.
>> I'm not doing the work, I'm waiting.
>> two weeks.
>> two weeks.
>> that gives us time to get you comparisons, and if we are given ideas it gives us the time to react to what we find out --
>> and the money is already in the budget.
>> October 3 again?
>> October 3.
>> we'll be back.
>> thanks so much.
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Last Modified:
Wednesday, September 20, 2006 10:25 AM