Criminal justice authority asks Oklahoma County for $42.2 million as jail medical costs surge after vendor transition

The Criminal Justice Authority asked Oklahoma County's Budget Evaluation Team on April 16 to fund a $47.3 million FY25-26 budget, including a $42.2 million request from county general funds, citing a roughly $8.2 million increase from the current year largely driven by medical costs.

At a presentation led by the Authority (Speaker 4), staff said outside medical and pharmacy expenses are the principal drivers of the request. The presenters identified an estimated $1.56 million increase in the outside medical expense account and said the authority budgeted $840,000 for outside medical this year but is currently projecting substantially higher expenses based on recent months’ claims.

Committee members repeatedly pressed officials to explain why recent high monthly averages (about $200,000 per month over the past four months) were used to extrapolate a $2.4 million annual line item when the authority has since discovered billing errors. Speaker 5 said an outside vendor, Heritage, processed and paid bills that, on review, may have included payments for preexisting conditions; Heritage is now reviewing and pursuing credits and reimbursements. "We're still reviewing the deals and going back to October to reconcile what shouldn't have been paid," Speaker 5 said. Presenters estimated the recoverable amount could be in the neighborhood of "a little bit over $1,000,000," but cautioned the figure remains under review.

The group also discussed a structural change in how medical costs are recorded: when the jail ended a contract with Turnkey and absorbed employees, many previously recorded M&O (contract) expenses moved to salary and benefits lines. Speaker 4 said salary lines for medical staff now show about $7.1 million, while remaining medical operating costs add roughly $1.1 million, together accounting for the roughly $8.2 million increase the authority presented.

Members asked for detailed reconciliations and repeatedly warned against relying on one-time lapse/carryover funds to finance recurring operating costs. "We have to be deliberate when we look at increases," said Speaker 1, the meeting chair, asking for a clearer breakdown of what is recurring versus one-time, and for documentation of vacancies, transfers, and annualized costs.

Committee members also scrutinized vendor contracts. The authority said it uses a VHS contract to hire temporary staff for site checks and that the contract was negotiated after concerns over overtime and scheduling. Questions arose about entering multi-year contracts when funding beyond year one is not guaranteed; committee members asked whether contracts include provisions to avoid converting temporary staff into full-time county employees at unexpected cost.

The authority reported efforts to control costs, including renegotiating contracts, monitoring overtime, and switching some supply sources to reduce unit prices. They also highlighted ongoing revenue negotiations with Oklahoma City for inmate housing and inspection fees; the authority said it expects a minimum of $1.2 million from Oklahoma City but that the city has not paid in recent years.

No formal appropriations were made at the meeting; the committee received the authority's estimate of needs for consideration. Members asked the authority to provide a detailed reconciliation of: (1) how the $1.56 million outside medical figure was derived; (2) the precise time window and dollar value of post-transition billing errors under Heritage; (3) the staff-count reconciliation between budgeted FTEs and actual filled positions; and (4) a list of contracts and their renewal terms that create multi-year commitments.

Next steps: the authority will report back with the requested reconciliations and supporting data so the Budget Evaluation Team can assess which costs are extraordinary, which are recurring, and whether mid-year adjustments (in September) or programmatic changes are appropriate.