Tired of quick turnover and of losing nurses to other employers, Ramsey County will start providing in-house health care for inmates at the county jail and other detention facilities.
The county will essentially create a new health division for its four correctional facilities, adding five full-time nurses, three mental health professionals, four clerical workers as well as a part-time physician and part-time psychiatrist to its existing staff.
The county also will hire a nurse clinician who will manage the roughly 20 nurses in the new division. Corrections nurses will be bumped to a higher pay scale than the county's other public health nurses to make the jobs more attractive.
The total cost of the higher wages and new employees will be about $1.8 million a year, up from the $1 million Ramsey County paid this year to hire contractors for the same work.
The new structure will help health officials make sure the county has the right protocols in place when inmates need medication or if a contagion breaks out, said Commissioner Victoria Reinhardt.
"It's about the quality of care and consistency," she said.
The county for years has been contracting out much of its health care work for the roughly 700 people housed at the county's jail, workhouse, juvenile detention center and Boys Totem Town.
But officials believe they have a better chance of keeping nurses, managers, physicians and mental health professionals on staff if the county takes over management and makes the hires itself, said Anne Barry, Ramsey County's deputy manager of health and wellness.
"What we've found with contractors is this discontinuity of care," Barry said. "We still need to bring in the contract person and train them for our environment, our policies and practices, but then sometimes they'll be hired away and we start all over again. We know that can still happen with our own staff, but the nature of contract work is that it's not always permanent."
The changes will make the program more efficient and lead to better care in the long run, Barry said.
"We've been studying this, and to have contractors manage all of our services just wasn't satisfactory for what we want," she said. "Our salaries weren't competitive and we needed more support. We think it's going to be much more effective with these as permanent Ramsey staff positions."
The county's registered nurses are paid on a scale ranging from $61,000 to $93,000, depending on experience. The nurses in corrections will be paid between $69,000 and $105,000 a year, virtually identical salaries to what Hennepin County pays its correctional nurses.
Ramsey County hasn't seen the same turnover among nurses in its other public health fields, Barry said.
"It's a hard job," she said. "It's a 24/7 operation in a different kind of environment and it really takes a specific kind of expertise to handle an institutional environment. We have to recognize that."