Travis County Commissioners Court
April 10, 2007
Item 31
Number 31 is to receive and take appropriate action on report of pharmacy operation operations and request to fund permanent slots in the sheriff's office for one pharmacist and two technicians.
>> judge, I'll bill campbell sheriff's finance director. To make a long story short, we appeared before you in November. We committed to analyzing three alternatives in terms of running our pharmacy. One of them was to continue to use university of Texas medical branch, utmv one was to see if we could hire a pharmacist and technicians, and the third was to see if we can get contractors to run the pharmacy. We have gone all the way through that process with one final step still being conducted by purchasing. They are working with vendors for a best and final offer on the scenario that we proposed to you today. Utmb is in the middle of a legislative session and their executive pharmacist retired. So they are not in a position to commit one way or the other to us right now now. We advertised unfunded slots for pharmacist and pharmacy technicians. We received more than adequate response to those. If you approve, we are ready to go ahead into the board process and begin our hiring process for those slots. The contracting proved to be very interesting. We received three proposals back to the solicitation.
>> actually four but one was not responsive.
>> corrected.
>> three we considered . We have costed out as many alternatives as we think are reasonable, and we believe that the lowest cost to the county as far as the sheriff sheriff's office, to go ahead and hire one pharmacist and would pharmacy technicians, and at the same time that we contract with one of the proposing vendors to provide some contract services and to also provide contract labor. If our pharmacist was to take vacation or get sick, or they have training requirements , we would backfill that position with contract labor. It would come out to be a fractional slot if we tried to hire one, perhaps one tenth or two-tenths of a slot. We feel like it will be easier and cheap for we go ahead and set that up as a contract labor requirement. We are estimating the cost for the vendors. The vendor would come in and provide us with assurance that we are meeting all of the rules and regulations. They would assist us in preparing form you preparing form--form u u larlary. We think if we do with this scenario, it saves costs to the county, pending negotiations, and for that reason we hope the court will see fit to approve the positions, go ahead and fund and make them permanent, and allow us to go ahead and hire.
>> just want to mention on backfilling, possible backfilling when the needs a arise, and also with the hiring of the pharmacist and also the pharmacy technician does this mete all requirements specified by the Texas pharmaceutical board?
>> Commissioner Davis, it will meet all the requirements.
>> is this in agreement with what they require ?
>> yes, sir, it will, and it will provide us with an independent contractor's assurance that she have looked at it and that it does that.
>> okay.
>> we met with the pharmacy board several times over this process.
>> okay. They have no qualms about that.
>> they have been very help helpful.
>> about this type of structure.
>> no.
>> as we go forward.
>> no, they have no problem.
>> and as far as the contract labor to do the backfilling, is that still going to be with utm b or will it be whoever will be able to fill the backfilling when need ?
>> it won't be utm b. It will be one of the contractors that submitted a proposal to us that we are looking at right now.
>> so utm b is out.
>> they are out.
>> all together.
>> I mean they are not out yet, but when we do, yes, sir, they will be out.
>> as far as this cough stuff--kind of stuff is concerned.
>> yes, they will be.
>> I want to be sure I get that. For some reason, until I heard something earlier about the disposition of utm utmb.
>> yes.
>> now, as far as what we have to do as far as pursuing and moving forward, and I'm really still concerned about the availability of having to distribute the necessary pharmaceutical to the inmates, whether it be del valle or the correction the facility, one thing that we do look at and encounter was that underserved situations, I'm just wondering, will this type of structure be adequate to make sure that all those persons are served with the pharmaceutical needs with this situation before us today.
>> yes, sir, gardener, juvenile, gardener bets group was part of our process. They are still in this process. And those are issues that we will work out with the consultants and the new pharmacist and his shop. So yes, all those issues will under consideration and being considered and being taken care of.
>> okay. Thank you.
>> if I may amplify on that, Commissioner.
>> please.
>> we are basing our calculations on 300 prescriptions a day.
>> 300.
>> 300 for every business day. As we exceed that, we probably will need to add just in terms of the personnel we have got. It probably will be cheap tor do that for a period of time with the contract labor but sooner or later we will need more people it's a question of how many years in the future that occurs.
>> one of the things the consultant is going to help is look at best practices and help us determine how we can, you know, they are going to help us go through the bid process for pharmaceuticals, to find the best way to procure those, so we are getting them at the best price, look at best practices in the system on how to distribute those, so that is part of the services that we will be buying from this consultant, to help us figure out the best, most efficient, most cost effective way to run a pharmacy at our jail and handle our downtown jail and also our juvenile jail.
>> Commissioner dougherty and and--and then bill deriv deriverie.
>> I just want to say I really am pleased with this (inaudible). My office got very involved with this. The biggest question that we all had, because we went to the pharmacy board, our big biggest question was, can you hire pharmacist. All you hear out in the workplace is that they are really very difficult to do. Given the fact that we had 13, I mean, that response is pretty amazing. And that really is the thing that has allowed this thing to move forward because at this stage, I mean, I'm very pleased with not only saving the money but to do it in house, we're going to get to for lack of a better word, redistribute the drugs, I think there's another term that they actually use, and you get to take back.
>> the term is recycling.
>> that is the word I'm looking for. The fact that we can do that that is a huge savings.
>> oh, yes.
>> we had to have a pharmacist on staff in order to really do that. So this really has turned out to be the best that we could have dreamed of. That is not to say that we still don't need to save on top of our, all of our pharmaceutical issues, but it is a very expensive program. And I do think that one of the areas that we have to be sure we get our pharmacist involved in, it was obvious, amazingly enough, to find that pharmacist know, I know that sigh cy chricy-- chricy--psychiatrists don't want to hear this, but pharmacists are important in all of this from a drug distribution standpoint. Talking to the doctor saying this drug really does this better than that drug , and so having somebody in house that can talk with, you know our medical folks, quite frankly, the ones that I think there have been some questions about, is this just sort of routine or aught matic that you go and do this, I'm very excited that we have the ability to have somebody in house of I think we will stay on top of this more than maybe we were before because we realize what kind of a train wreck you can have if you don't stay on top of this pharmacy stuff. So I i applaud bill, your efforts, and all the staff, and cyd, and pulling this thing together, both bills.
>> a lot--
>> my role has been minor.
>> a lot of folks.
>> your minor role.
>> is important.
>> very well needed.
>> very important.
>> anyway, I think that we are moving in the right direction.
>> talk to us about the budget. Mr. Deriverie.
>> okay. Bill indicated that the positions that were authorized by y'all in January that will end in April 30, bee need y'all to make a motion to remove the end date and make them on ongoing with this proposal here. We are actually funded, just funded in the wrong line item. We will need permission from you all to move, rearrange the line items internally in the sheriff's budget so that we have dollars in the personnel line items rather than in the contract line items. That will not need to occur until we make the transition from utmb, which will be sometime probably this summer, I guess.
>> we are hoping it will be at night.
>> okay. There also is a possibility, because of the fact that there is an overlapper handshake that has to take place between the contractor and the staff coming on board, et cetera, that there will be a cost that is not, that is larger than will occur on an ongoing basis. There is still $15,000 in the reserve, the frarm si reserve, that has not been appropriated by the Commissioners court, and we would like to go ahead and be able to move that if it is needed, only if it is needed, as we go through the rest of this fiscal year. None of that will need to take place or occur until toward September or so and we evaluate how the sheriff sheriff's budget looks on a bottom line basis. So at this point, the only thing that the court needs to did is to approve removal the endates on the pharmacist and the pharmacy tech positions so that they can go ongoing. All in is accommodated readily within the target budget for fy '08.
>> speaking of fy 58 target budget--'08 target budget, there is a budget for fy '07.
>> yes, sir.
>> and toward the end of page 2 of mr. Hampton's memo he seems to indicate that if the court were to take four reasonable steps, the amount budgeted for '07 gets us through the end of the fiscal year. Right ?
>> that is correct.
>> we will need to in all likelihood use salary savings, but we do believe it will be there. So we think we are completely within the target as stated.
>> and I just have a question. Does that include the software that we need to buy buy?
>> it includes the software. It does not include an estimated $20,000 for pharmacy equipment that we are planning to buy out of the inmate welfare fund. And if we need computer equipment, we will go to the inmate welfare fund. If we do not have general fund available all the end of the year.
>> it was very evident this process that we need some software out there. It's just, they have to have some software.
>> the law approves of the recommended use of the in inmate fund.
>> yes, sir, it does. Yes, sir.
>> may I ask about software.
>> yes.
>> I think this hybrid structure that we are embark embarking on with the consulting pharmacist and the three fte's, I think it has the real potential for opening the door to potential partnerships with other organizations for the purchase of medications. Med medications are driving our healthcare many places, in the employees clinic and other healthcare providers. I see this and the possibility of a need for software, that this could move forward to a time where we are actually getting the economies of scale off of a purchase for more than just tsso and gardener bets. We could be getting economy of scale for purchases of people's clinic, nhmr and even other counties if they want to buy in with a sufficient software system so people could move from independent gent care f they get arrested we would-- would--independent independent--indigent care, if they get arrested we would already know, and from the outside we would have continuing wrap around service and reduce the likelihood of them ending up on the inside again. I see this as a huge potentially. Am I crazy in thinking that ?
>> no. I asked the same crazy question. No, what you have, we know we have this whole ijs system and we talked about how that plays in the specific software that we are talking about here deals with the drugs coming in and case management. So how you tie all that together is beyond me. It is a thought.
>> is it similar to the software system that mhmr and people's clinic are both using ?
>> I am not sure about that of the one of the things that we have, I didn't personally meet, but the group met with trish young for the hospital district and discussed. Some county , all of their indigent costs in their jail are paid for out of the hospital district. So we have tried to push it that way or ask her to participate with us in looking at this. And we haven't gotten there yet. So there's a lot more.
>> I remember that conversation did come up some time ago as far as combining--
>> some of the things are legislative. Hospitals get a different sort of, you know, people know a lot more about this than me, but hospitals baw of the classification get different rates. There might be some legislative changes that we need to have made. I mean, it's what we need to work towards but it's going to be a ways down the road for for--
>> but this is a step in line with that possible future world of being able to purchase in bulk for all of our indigent and emergency medication needs.
>> yes, this is just like the inventory, like what comes in and what goes out, sort of accounting controls it's a very basic level.
>> Commissioner dougherty.
>> I would move that we approve 31 as read plus the special attention to the approval of the removal to April 30th date.
>> second.
>> permanent ongoing positions.
>> ongoing positions.
>> with that, I would like to say this to you, bill, and the sheriff's department I do really do thank you for doing a lot of this. It has been a head-on collision with tough consequences when this issue came before this court. I want to thank you and the staff and sheriff for look looking in this direction to see what we could do about this. Thanks for spending the time with my staff on this issue. Thank you.
>> may I ask, can the recommendation or motion also include the necessary steps to move the internal line items to fund these positions as it becomes necessary ?
>> (inaudible)
>> I will mention also they were counting on the 15,000 left in reserve to cover that gap for the overhead, the handshake. We will bring that back to you as it is needed.
>> okay.
>> we will be bringing the contract back to you.
>> anymore discussion or delay? All in favor? That passes by unanimous vote.
>> thank you all very much.
>> thank you.
>> thank you.
>> appreciate it.
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:
Tuesday, April 11, 2007, 8:34 AM