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Clark County Case Study

The Problem

In an effort to contain legal liability and emounting costs, Clark County (Vancouver), Washington contracted out health delivery services for its adult and juvenile corrections facilities to a private corporation, Wexford. Due to perceived inadequacies in that care, Clark put out an RFP for a complete evaluation of the adequacy and quality of this care. The scope of the study covered medical, psychiatric and pharmaceutical services for multiple facilities.

At the start of the study and due to internal exigencies, the County shortened the timeline and requested a draft within a month during the holiday season.

The Process

The evaluation covered all aspects of health care delivery, from facilities, training and staffing to policies, procedures and cost containment measures. ILPP’s Chief Medical Officer and staff performed an extensive review of medical and pharmaceutical records, staffing charts, policies and procedures, contract monitor reports, meeting minutes, and other relevant documentation. These were compared with nationally accepted best-practice and operations in other similar jurisdictions.

Deficiencies were found in virtually all areas of Wexford's operations reviewed and were reported to the county, along with recommendations of cost-effective improvements.

The Aftermath

The report was delivered in thirty days of the contract, as requested ; the findings led to recommendations of structural changes that would encourage appropriate levels of adherence to protocols, of intensive and emergency care use, of staffing levels, and other measures that would generate prevent costs and ensure better preventative care. The County Commission and jail management were very pleased with the resulting report and cost-effectiveness of the study. Several reference letters are included with this case study.

Alan Kalmanoff
Executive Director
Institute for Law and Policy Planning
Phone: (510) 486-8352