Geary County sheriff warns jail costs rising; seeks new medical contract and higher per-diem for housed inmates

The Geary County sheriff told commissioners on Monday that the county jail has seen increased activity and growing medical and operational costs and that staff are preparing procurement options for a new jail medical services contract.

The sheriff said the jail's average daily population for the two-week reporting window was 92 and that the facility continues to have two inoperable cell doors on the north side, preventing closure of that wing until repairs can be completed. "If we can stay in the low nineties and get these doors fixed," he said, "we should be able to close that north side down once again."

The sheriff told commissioners the county's current outside-housing rate is $65 per day and described that figure as outdated. "That $65 per day was a number Jeanette came up with in 02/2009," he said. "We have not changed it since 02/2009. As you know, the cost from 02/2009 to 2025 is not even in comparison anymore." He said he expects to recommend a new rate in the $95-to-$100 range at a future meeting, but that neighboring counties' lower rates complicate the market for housing inmates.

On medical costs, the sheriff gave the commission year-to-year figures: about $560,863 in 2023 and $695,702 in 2024 for medical services and associated expenses, with pharmacy costs separated out in 2024. He said the county's current contract with TK Health (formerly TurnKey) quoted a medical-provider-only proposal of $355,865 and included an annual escalation provision of roughly 3.95%. "TK Health said that each year they will increase it by almost 4%, 3.95 to be exact," he said. "They appear to be the best one for what they are giving us, but we are getting more proposals." He said the county had received only one formal proposal to date and that staff were reaching out to at least a dozen potential providers to get comparative quotes. He warned commissioners that some proposals from non-correctional providers might be cheaper but could introduce legal or operational risks.

The sheriff also reported rising direct medical expense totals to the board: contractor/interim payments and medical bills accounted for roughly $413,000 in 2024 (up from about $291,000 in 2023), and pharmacy costs were about $59,000 in 2024. He said the jail's current provider contract expires in mid-April, creating a compressed procurement timeline. "We are scrambling right now...to get proposals to present to you guys on what company we can propose to go with," he said.

Other operational items raised in the Sheriff's presentation included prisoner transports, arrests and incident counts (the two-week incident total was about 710, up from 470 the previous period) and the county practice around reimbursing outside agencies for medical care when those agencies bring in arrestees. The sheriff said the county pays medical costs for prisoners arrested on county charges, not routinely for detainees brought by other jurisdictions unless court records show county responsibility.

On equipment and property issues, the sheriff told commissioners a vehicle ordered in late 2023 and paid for in early 2024 had not been delivered, and the county attorney has filed a petition in court to recover it or funds. "We have paid that individual, and we have not received the vehicle," he said. "We have filed him on a petition to the court, and we're waiting for that to be settled."

The sheriff sought no immediate vote but said he would return with procurement options, cost comparisons and a recommended per-diem for boarding outside agencies' inmates. He told the commission he expected to present more detailed cost breakdowns in four weeks.