Centurion, the state’s contracted correctional health provider for physical, mental and dental care, told the appropriations subcommittee that rising medical needs, an older and sicker incarcerated population, and marketplace wage pressure are driving health-care costs above initial contract assumptions.

Tim Harlan, Centurion’s CEO, and GDC health directors presented data showing a 30% increase in inmates classified as mental-health severity level 2–4 since 2022. Centurion said the contract’s approved staffing complement has not kept pace with caseload growth and that fill rates for critical positions — especially psychiatrists and licensed mental-health clinicians — have dropped. Centurion presented a staffing matrix showing approved FTEs versus filled positions and identified an approximate 160-FTE shortfall in the mental-health contract, estimating it would cost about $33 million annually at market rates (including benefits) to close that gap.

On physical health, Centurion said rising inpatient acuity and more frequent off‑site specialist care have increased average inpatient admission costs from about $22,487 in early contract months to about $27,206 year-to-date — a roughly 20% increase — and that approved off-site encounters and total approved encounters are up ~13% year-to-date. Centurion noted a recent $15.8 million supplemental appropriation to address off-site overages but said pressures continue.

Centurion also pointed to operational successes since contracting: large reductions in sick-call backlogs, diagnostic backlogs and audit findings, plus an electronic health-record (EHR) system that the state now owns, which will improve data and oversight. But the contractor asked the subcommittee to consider funding for wage adjustments to keep pace with the free-market demand for health professionals and to fund additional off-site care as necessary to meet constitutional standards of care.

Committee members posed detailed questions about the type and severity of mental illness in the system, the mix of in-person and telehealth services (Centurion uses a hybrid model), dental backlogs and the role of the state pharmacy vendor (CorrectRx) in controlling drug costs. Centurion and GDC officials said they will work with the committee to provide costed options for addressing FTE gaps and off-site-care overages.