Management and Performance Review of County Government ...

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Judicial and Public Safety Functions county auditor or any other Jefferson County official. The contract does not contain monitoring provisions; and ‣ the contract offers no incentive to the vendor to encourage appropriate utilization review, because the county pays for all services above the expenditure cap. COMMENDATION The contract for the provision of inmate healthcare is generally very good and is substantially cheaper than a county-run inmate healthcare program. It also includes an inmate co-payment requirement, which will reduce costs to both the county and the vendor and provide revenue for the county. RECOMMENDATION 7-7: Include formal contract monitoring provisions in all contracts to ensure vendor compliance. The Sheriff’ office is monitoring contract performance, but provisions for such are not clearly stated in the contract. The county should monitor and document vendor performance in meeting all key contract provisions on at least a quarterly basis. Nonperformance on critical contract provisions should be grounds for penalties. The contract does provide penalties for the vendor not filing vacant positions. FISCAL IMPACT This recommendation can be implemented within existing resources. RECOMMENDATION 7-8: The county should adopt a “shared risk” approach to medical service management. The key to controlling hospitalization expenditures is to establish reasonable treatment guidelines, combined with aggressive utilization review (a critical examination by a medical professional of health-care services provided. It is conducted to help ensure costs are controlled (by identifying unnecessary procedures) and the quality of care is appropriate) and appropriate incentives, to manage care responsibly. Under the current contract, the vendor has little incentive to encourage appropriate level of care because the county pays for all services above the expenditure cap. Page 7-21
Judicial and Public Safety Functions The county should modify the contract so that the county and vendor equally share costs above an agreed level to give both parties an incentive to manage service delivery responsibly. FISCAL IMPACT This recommendation can be implemented within existing resources. Downtown Jail Facility Since May 1998, Jefferson County has had in place a management agreement with Correctional Services Corporation (CSC) to operate the old jail facility (Jefferson County Detention Center) in downtown Beaumont to house state and federal prisoners An August 2001 contract amendment modified the per diem rates paid to the county for each offender housed in the downtown jail. The facility houses county prisoners at a rate of $31 per inmate per day. TDCJ pays Jefferson County $31 to $32.26 per prisoner per day for the housing of state prisoners, while federal agencies (U.S. Marshall Service, INS, Federal Bureau of Prisons) pay as much as $51 per prisoner day for their prisoners. The downtown jail can house up to 411 inmates. Jefferson County pays the jail operator, CSC, about $31 per inmate. This contract is clearly advantageous to the county and should be continued. The county should continue to monitor the per diem amount and modify it to maintain the going rate for leased beds in this region. COMMENDATION The housing of federal and other inmates in the CSC-run downtown jail facility by contracting with CSC for all operations earns the residents of Jefferson County about $1 million per year. Page 7-22
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Management and Performance Review o
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TABLE OF CONTENTS (Cont’d) 7.0 JU
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ACKNOWLEDGEMENTS This review has be
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EXECUTIVE SUMMARY MGT was selected
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Executive Summary To finance these
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Executive Summary from generating e
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Executive Summary assistant chiefs,
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Executive Summary in good working o
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CHAPTER 1.0 INTRODUCTION AND BACKGR
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Introduction and Background 1. Ford
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Introduction and Background EXHIBIT
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Introduction and Background The rev
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Jefferson Peer Average Brazoria EXH
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Introduction and Background Jeffers
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Introduction and Background Jeffers
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Introduction and Background EXHIBIT
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Introduction and Background In Augu
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2.0 JEFFERSON COUNTY EMPLOYEE SURVE
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Jefferson County Employee Survey Re
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3.0 ASSESSMENT OF THE ORGANIZATION
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Assessment of the Organization and
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4.0 ASSESSMENT OF THE FINANCE AND B
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Assessment of the Finance and Busin
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CHAPTER 5.0 HEALTH & WELFARE/LIBRAR
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Health & Welfare/Library/Veterans S
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8.0 ENTERPRISE OPERATIONS OF JEFFER
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Enterprise Operations of Jefferson
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APPENDIX 1 ECONOMIC DEVELOPMENT INC
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Economic Development Incentives Pol
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APPENDIX 2 FISCAL IMPACT SUMMARY
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Fiscal Impact Summary Recommendatio
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Fiscal Impact Summary Recommendatio
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