By Jennifer Edwards
The Cincinnati Enquirer

LEBANON - Warren County commissioners expressed sticker shock Tuesday over a 60 percent increase in the latest contract with a private company to provide health care to inmates at the county jail.

After realizing total personnel costs jumped from $265,013 last year to $424,764.60, commissioners ordered a re-examination of the $573,342 contract and indicated they may opt out of it through a 90-day clause if services can be provided more cheaply.

"This whole thing is a mess," Commissioner Mike Kilburn said. "These are prisoners. We are not looking at running the Mayo Clinic here."

Kilburn was flabbergasted Tuesday that the other two commissioners, Larry Crisenbery and Pat South, gave County Administrator Bob Price approval to sign the contract at the March 27 commission meeting. Kilburn was absent that day because he was headed out of state with his family. Then last week, the commission was on vacation.

But Crisenbery told Kilburn on Tuesday the county prosecutor said the new contract had to be signed before March 31 to continue health coverage for prisoners. The new contract has an exit clause the county can use if the costs are deemed too exorbitant, he added.

"The only reason we went ahead was the 90-day clause," Crisenbery said.

"You guys bought a hog, then," Kilburn snapped. "Why are we boxed into approving this at the last minute? That's just bad, bad business. We need two months' leeway on negotiating these contracts and knowing what we are doing."

The county's 2002 contract expired with Phyamerica Correctional Healthcare Inc. of Washington D.C., at the end of December. Since January, the county has extended that contract.

Under the new one, personnel costs per day rose from $4.27 to $6.85 per day. There are 220 inmates at the jail, which was built for 196, said Maj. Tim Lamb of the Warren County Sheriff's Office, the jail administrator.

After a long debate, commissioners agreed to hold another work session on the contract and directed Lamb to provide details on a similar contract for the county's juvenile detention facility, which did not rise as drastically.

But Lamb and Roxanne Walters, the jail's health service administrator, stressed to the commission that the jail contract was not excessive. For instance, other county jails in surrounding areas pay their nurses more - and still will even with the new contract, they said.

Walters pointed out that the previous contract only showed a nurse working part-time when she really worked full-time, so the health care company lost $4,056 a month.

Price warned commissioners that cutting additional staffing in the new contract could come back to hurt the county. If adequate medical service isn't provided, that could lead to a potential greater liability for the county, he said.

"This is just providing basic care to the inmates," Lamb said. "There's nothing fancy."

E-mail jedwards@enquirer.com