Summary
Board members and community partners discussed the county’s in‑house medical services since the end of the Turnkey contract, potential requests for proposals, concerns about medical request fees and response times, and the need for prerelease reentry planning and community partnerships to reduce recidivism.
Citizens Advisory Board members and community health partners debated whether the county should continue in‑house medical services for detained people, consider issuing a request for proposals, and build stronger prerelease reentry partnerships with community providers.
Board member Jimmy Durant — who said he represents SSM Health Saint Anthony Hospital — thanked Director Greg Timmons for cooperation and said he had not heard new complaints after recent meetings but remained concerned about “the speed and the amount of time that it's taking … for inmates to get the needed care” and recommended the board monitor response times. Durant said in prior years the contracted provider Armor delivered poor care, that Turnkey’s service was “a breath of fresh air,” and that the county’s current in‑house model must be evaluated against both cost and quality.
Board member Jeff Dismukes raised operational concerns that could hinder timely medical care: a reported $15 fee for making a medical request and anecdotal accounts that request fulfillment sometimes took days or longer. He asked whether the board could obtain a system‑wide monitoring report to identify where delays occur. Director Timmons said medical staffing was a recruiting priority and that medical staff are now employed by the detention center rather than an outside contractor; he said staffing has improved since Turnkey but that more hiring was needed.
Members discussed reentry and prerelease work as a way to reduce repeated bookings. Several board members urged a community‑based approach: convene hospitals, CCBHCs, treatment and housing providers and criminal‑justice partners to create prerelease navigation, medication‑assisted‑treatment initiation and warm handoffs to community care. One board member said similar Department of Corrections models had tied treatment initiation inside facilities to community follow‑up but cautioned that sustaining the connection at release can be challenging.
The board did not make a formal policy decision at the meeting but directed staff and subcommittees to develop recommendations. Members suggested the community‑relationships subcommittee lead reentry collaborations and asked staff to prepare material on medical staffing levels, the $15 medical‑request fee and any service‑delivery metrics that could be provided to the board.
