Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Corrections Medical Budget topic
No spam. Unsubscribe anytime.
Montana DOC details medical contracts, Medicaid rate limit and automated pharmacy plan
Summary
Department of Corrections staff told lawmakers the department pays outside medical providers at Medicaid rates per statute, described typical contract terms, and outlined a proposed automated pharmacy machine intended to cut nursing staff time.
The Department of Corrections told the Legislature’s Section D work session that outside medical services for incarcerated people are mainly for specialty care — surgery, MRIs, dialysis, cardiology, oncology, urology, orthopedics and ophthalmology — and that statute limits payments to no more than Medicaid rates.
Natalie Smithson, the department’s chief financial officer, said many specialty providers under contract come into facilities for routine services such as optometry and X-ray, while others require transport to outside hospitals. She also described typical contract terms: "typically, we do the 7 year contracts with options to renew up to 10 years," and noted contracts are staggered to ease staff workload around renewals.
Committee staff also walked lawmakers through the department’s change packages for health services. A spreadsheet shown in the session summarized a biannual request the staff described in aggregate as about $47,600,000 over the base budget. The staff emphasized that the figures shown are biannual totals, not annual rates.
On pharmacy changes, staff described an "automated remote pharmacy" machine proposed for the Montana State Prison infirmary that would store medications and automatically package daily dosages into labeled envelopes for inmates. The department said the machine would reduce time nurses spend sorting and preparing multiple prescriptions: a department explanation said it produces individually labeled envelopes, and is supervised by a remote pharmacist contracted through the pharmacy provider.
Lawmakers asked for cost comparisons. Department staff said the automated pharmacy request includes a $12,000 one-time facility implementation fee plus a recurring monthly rental fee that would also cover materials and the remote pharmacist service. Staff told the committee medical staff had estimated that without the machine two nurses might spend about 12 hours per day on medication-related tasks; the monthly fee also covers the packaging materials and pharmacist oversight.
The committee asked about controlled substances and on-site storage. Staff said some routine medications are kept on site, while highly controlled or infrequently needed drugs are requested from off-site providers.
On nurse pay, the department provided proposed rates for fiscal 2026: certified nursing assistant/psych tech $24.13 per hour, licensed practical nurse $31.50 per hour and registered nurse $47.99 per hour. Committee members asked for comparative cost analytics to weigh the automated pharmacy monthly fee against staff time saved; staff said they would provide multi-year cost data and nurse hourly-pay details.
Why it matters: Corrections medical care is a significant operational cost and subject to statutory limits on payment rates. The automated pharmacy and proposed pay changes are intended to address growing medical complexity in the incarcerated population while managing limited budget resources.
The department agreed to provide the committee a multi-year summary of outside medical spending, more detail on equipment line items included in decision packages, the automated-pharmacy vendor documentation and a cost comparison that shows estimated staff hours saved relative to the monthly rental fee.
