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County reviews EverHealth (NavCare) proposal for jail medical services; staff to bring contract for action next week
Summary
After a year-long procurement, Spokane County staff recommended awarding a multi-year jail medical services contract to the incumbent (EverHealth/NavCare) unless the board opts to bring medical services fully in-house — a change staff warned could cost roughly $9.3 million in 2025 staffing plus increased liability and IT costs.
Spokane County staff told commissioners Jan. 21 they will ask the board next week to approve a multi-year contract with EverHealth (formerly NavCare) to provide medical, dental, pharmaceutical and behavioral-health services at the county jail, while outlining the alternative option of moving services in-house and the associated costs and risks.
Procurement and recommendation: County staff ran two RFPs over 2024; the first attracted no bids. After expanding scope to include behavioral health, EverHealth responded to the second RFP. Staff said the company is a national correctional-health provider with an electronic health record platform and telehealth capability; staff recommended moving forward with a three-year contract with up to four one-year extensions and a phased transition for behavioral-health staffing.
Cost considerations: Staff presented two paths: - Contracting (recommended): The proposed EverHealth contract for 2025, with expanded staffing and services, would raise the county’s contract budget (staff presented a model showing a total medical/behavioral budget of about $16.47 million for 2025, subject to true-up and funding offsets). Staff said the contract includes monthly credits if contractor positions go unfilled. - Bringing services in-house (alternative): County staff and the union presented a scenario to keep mental-health services in-house by hiring registered nurses and other clinical positions locally. County estimates showed that hiring to meet National Commission on Correctional Health Care (NCCHC) staffing levels would require roughly $9.3 million in new 2025 compensation alone, plus added liability insurance (initial estimate $5–750k premium increase and a suggested $10 million boost to liability fund balance), IT implementation costs (EHR and servers estimated as a one-time $700k plus recurring fees), and third-party administrative and claims costs. Staff warned the county’s insurance pool might not cover the additional malpractice/liability exposure if the county assumed full clinical responsibility.
Patient-care improvements: EverHealth’s proposal would include expanded RN/provider staffing levels, 24/7 nursing coverage in high-acuity housing areas, enhanced opioid-use disorder treatments (including MAT expansion phased in after launch), telemedicine integration, electronic health records upgrades, discharge planning and performance metrics. Staff said some measures (for example, the opioid withdrawal protocol and 24/7 clinical checks for acute housing) already reduced transports and improved on-site care.
Procurement next steps: Staff said they will bring a contract and resolution to the Board of County Commissioners for formal action next week, with a proposed contract start of Feb. 1 for core services and a phased mental-health transition in May. Commissioners asked for final contract language and the financial true-up figures prior to signing.
Ending: Commissioners instructed staff to finalize materials for a decision next week and to provide clearer budget scenarios and risk analyses for both contracting and in-house alternatives.
