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Jail medical contract to be renegotiated, may be bid out

WARREN — The contract to provide some medical services to inmates in the Trumbull County Jail has been unchanged since 2012, but may be put out to bid or quietly renegotiated.

Dr. Phillip Malvasi has run the inmate medical program since 2000. The last time his contract was altered was in 2012, when it was raised to $304,000 per year — an increase of approximately $29,000 to add a medical assistant. The contract has been renewed automatically on a month-to-month basis since.

Malvasi uses the money not just to pay for his services, but also the medical support staff that work with him in the jail.

“I haven’t asked for a raise since 2012 because I know the county is in a situation where we can’t afford any large price increases,” Malvasi said.

Trumbull County Sheriff’s Office Maj. Dan Mason, jail administrator, said the office is renegotiating the contract with Malvasi to add enough cash to pay for another medical assistant. Malvasi employs about six people now on the medical contract, Mason said.

“He has been providing adequate service. But we are always trying to improve our services and we are hoping to get some more medical employees on staff, which will cost us more money,” Mason said.

Trumbull County Commissioner Mauro Cantalamessa said the sheriff’s office is pleased with Malvasi’s service, and that is important to consider.

“One of the things we need to be vigilant for is getting the most bang for our buck in every contract and every service that we provide. Requesting proposals is something we should do. It doesn’t hurt to look at other interested parties as well,” Cantalamessa said.

The commissioners have not settled on a path forward yet, Cantalamessa said.

One proposal introduced earlier this month and shelved was to raise the contract amount to $372,000 per year, but the increase would require Malvasi to hire more support staff. The jail’s population has increased in response to the opioid crisis, Mason said.

“We have to meet the Ohio jail standards, and part of that is a medical evaluation. With us above capacity, it is taxing (Malvasi’s) employees. We need more to handle the workload,” Mason said.

There were 324 inmates in the Trumbull County Jail on Friday. It was initially built with 286 beds, but some are out of commission. Some inmates sleep in “boats,” which are portable, mattress-like cushions on the floor.

Malvasi said he has been able to keep costs low for the county and ensure the public’s tax dollars remain in the area while holding the contract. Mason said he has received calls from other counties across the state curious about how Trumbull County handles the inmate medical program.

“They want to review what we do, because some counties are paying up to $3 million a year on their programs. It is taxing their budgets,” Mason said.

The sheriff’s office pays for the program and its other medical services with the budget commissioners allocate them each year. The jail also pays separately for psychological care, through a contract with Coleman Behavioral Health, and has a separate contract for dental services. The jail also pays for the inmates’ pharmaceutical drugs separately and in some cases has to pay inmate bills to local hospitals, Mason said.

Many other counties hire a company to handle their programs, which often include psychological care, drugs, dental and optometry care.

In a contract that is dependent on the average daily population of the Mahoning County Jail, Correct Care Solutions of Nashville, Tenn., earns $158,690 per month if its population has an average of 534 inmates, which was the Mahoning County Jail population on Friday. Using the scale in the Correct Care Solutions contract, an average of 324 inmates would cost $145,134 per month.

“Mahoning County uses a third-party entity out of Tennessee. That is a lot of Valley tax dollars being sent to Tennessee. That is the point of getting someone local, you can keep the tax dollars local,” Malvasi said.

The contract with Malvasi now works out to just over $25,000 per month for Trumbull County. Not included are costs the jail pays to other providers. The jail also collects small co-pays from inmates who can afford to pay.

Clermont County, which has a similar population to Trumbull County, contracts with Southern Health Partners for all medical, dental and mental health services at the jail. Its two-year contract is for $1.65 million, or $825,000 per year, according to the county’s website. The contract includes support staff and mental health services.

rfox@tribtoday.com

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