Supervisors weigh jail prescription drug options
Sheriff Greg Hagwood called a decision the county supervisors are facing “a perfect dilemma.”
“I’m glad you have to make it and not me,” Hagwood told board members during their March 20 meeting.
County leaders are trying to decide if the sheriff should switch to a mail-order company to provide prescription drugs for the growing inmate population in the county jail.
Doing so would likely save the county tens of thousands of dollars annually, according to the sheriff. But it would cost a local pharmacy, Quincy Drug Store, at least $38,000 in revenue. That is how much the sheriff’s office spent on prescription drugs last year.
For the second time in three weeks, the supervisors weighed the pros and cons before again deciding to not decide — at least for now.
“I think we need to bring this back for more discussion,” board chairman Robert Meacher said.
“No problem,” Hagwood said.
The sheriff stated three times during the discussion: “I’m not looking to implement this as soon as possible. I want to be perfectly, perfectly clear about that.”
Hagwood said he was merely doing his duty to the taxpayers to identify potential savings when he sees them.
“As a steward of public funds, it’s incumbent on me to explore avenues and ways to spend the taxpayers’ dollars as efficiently as we can,” Hagwood said. “I’m not going to advocate for, or argue against, this contract with US Script.”
US Script is a national pharmaceutical management company. It claims it can save the county as much as 70 percent on prescription medications at the jail.
With the jail’s population expected to double because of Assembly Bill 109 inmate realignment, the savings could be substantial.
The discussion in the supervisors’ chambers was as much philosophical as it was financial.
The supervisors said the county has a policy of paying up to 10 percent more for products if they can be purchased locally if they are put out to competitive bid.
However, County Counsel Craig Settlemire noted that pharmaceuticals don’t apply because “they are considered a service rather than a purchase of goods.”
Supervisor Jon Kennedy said it wouldn’t make financial sense for a local business to discount products and services 70 percent, even if it could.
“This is a matter of us making a philosophical decision of how we are going to proceed with this,” Kennedy said. “Because there is no way no how a local pharmacy is ever going to beat this mail-order program.”
Hagwood said his office has received “outstanding” service from Quincy Drug.
“Mr. (Mike) Kibble and his staff have been very responsive,” Hagwood said. “And I have no complaints with their service.”
Kibble said Quincy Drug was willing to try even harder to keep the county’s business. He admitted he couldn’t compete with mail-order suppliers on price. But he said he would do his best.
“I would like to have the opportunity to see what else I can do for the county, in terms of the cost associated with the medication that I’m currently providing,” Kibble said. “I’m willing to look at the price, look at the cost, and see if there is some wiggle room.”
The price difference
Hagwood read an example of his comparison shopping to give the supervisors an idea of the potential savings.
“These are some medications that are regularly prescribed to our inmates,” Hagwood said. “Vicodin (painkiller): We currently purchase 30 tablets for $15.45. With US Script, we can get 100 tablets for $5.
“Klonopin (used to prevent seizures): We buy 30 tablets for $19.15. With Script, it’s 100 tablets for $3.
“Elavil (antidepressant): We get seven tablets for $6.10. With Script, it’s $3.31 for 100 tablets. And I can go on.”
Kibble told Hagwood that the prices US Script gave him were likely for bulk purchases. “But that’s not how you provide the service,” he said. “You have to repackage it.
“There is no way that (US Script) can provide you, at that cost, unit-dose packaging for each individual inmate … which is how we do it, for no additional charge,” Kibble said. “There is absolutely no way. I’ll go on record as nearly guaranteeing that.”
When Assistant Sheriff Dean Canalia originally brought the US Script proposal before the supervisors March 6, two board members (Meacher and Terry Swofford) were absent.
Kennedy said during that meeting that he would vote against US Script. However, he recommended the board wait to vote until all five members were present. He said the proposal would have failed with his “no” vote. “And that’s not fair to you guys if I’m wrong,” he told the board.
During the March 20 meeting, Swofford sounded like he shared Kennedy’s opinion.
“It’s human nature to buy something as cheap as you can get it. I understand that,” Swofford said. “But we have local businesses that need the business. This is like Wal-Mart coming into an area and destroying all the local businesses. We are screwing our own county.”
Supervisor Lori Simpson said the issue “is a larger discussion on medications and the cost.”
“Our insurance companies are forcing us into this,” Simpson said. “They are telling me, ‘You need to buy it from mail order.’ And I said, ‘No, I’m not going to do it.’ I go to my local pharmacy instead. It’s complicated.”
Supervisor Sherrie Thrall called it a “bigger balancing act.”
“If we don’t take advantage of savings, (we might) end up having to cut some other department in order to provide the funding to pay more for medication to support one business in our county,” she said.
Thrall suggested combining the local service with mail order. “Could we do it the way you have been doing? But then contract out with Script for some of our long-term prisoners?”
Thrall emphasized that whatever local pharmacy the county uses, the contract should be put out to bid.
“I’m sure we have lots of businesses in our county that would like county support in one form or another,” she said.
Meacher said there is already a local track record of national pharmaceutical companies providing poor service.
“North Fork Medical Group has to use a national pharmaceutical — because of corporate rulings — for the Quincy nursing home. And they say it has been an absolute nightmare,” he said.
“I won’t go into the details, but they have listed a number of instances where the public good was not served by having to follow the corporate model,” he said. “They have tried to adjust … tried to use local.”