Jail health care will stay, but sheriff seeks millions more for repairs, staffing

Fulton County Sheriff Patrick Labat (left) listens to grievances from inmates at Fulton County Jail on Thursday, March 30, 2023. Plans for a new multibillion dollar facility on the 35 acre campus are underway. (Natrice Miller/ natrice.miller@ajc.com)

Credit: Natrice Miller / Natrice.Miller@ajc.com

Credit: Natrice Miller / Natrice.Miller@ajc.com

Fulton County Sheriff Patrick Labat (left) listens to grievances from inmates at Fulton County Jail on Thursday, March 30, 2023. Plans for a new multibillion dollar facility on the 35 acre campus are underway. (Natrice Miller/ natrice.miller@ajc.com)

Fulton County commissioners on Wednesday approved a $4.8 million contract amendment with NaphCare to provide physical and mental health care at the troubled Fulton County Jail for the rest of this year, but pushed back on further requests from Sheriff Patrick Labat for an additional $27.6 million.

In the wake of criticism following several inmate deaths, NaphCare announced it would quit serving the jail by June 30. Labat said months earlier he was looking for a new medical provider. But he was unable to find one to take over NaphCare’s contract for the remainder of 2023, so the company agreed to stay on — in return for more money and greater security.

“The concerns that have come to light in recent months have not magically gone away or been resolved,” Labat said. “My intent remains to provide the best standard of care for inmates while also ensuring there are no gaps in service. Per the advice of legal counsel, this extension through the end of the year is the best option to meet those goals.”

NaphCare has provided physical and mental health services at the jail since 2017, under an initial contract for $20.7 million that has been renewed five times, and rose to $27.1 million as of Sept. 21, 2022.

The amendment would add to that contract by $4.8 million.

The amendment also says the full cost of HIV treatment will be passed through to the county, cutting NaphCare’s costs by $3.6 million. Likewise, the county will pay the cost of Hepatitis C medications, except when the inmate already has a prescription.

The amendment lists several moves by the sheriff’s office to improve “security and cleanliness” at the jail, 6% raises for NaphCare employees and authorization to hire 13 more.

The contract amendment passed 7-0. Commission Chairman Robb Pitts noted that NaphCare will not be prohibited from bidding on remaining as the jail’s health care provider under a new contract next year.

The main Fulton jail on Rice Street was designed to hold 1,125 inmates when it opened in 1989. Its regular occupancy passed 3,000 during the pandemic, leading the county to lease space for hundreds of inmates elsewhere. The largest contingent is in the Atlanta City Detention Center, which agreed to take up to 700 county inmates.

Consultants have recommended, and Labat has endorsed, construction of a new jail four times the size of Rice Street. It would include much more room for mental and physical health care, education and reentry programs. But the expected price tag is $2 billion, and county commissioners haven’t made a final decision.

If built, a new jail would not be ready until 2029. In anticipation of that wait, Labat showed commissioners a “bridging plan” to maintain operations in the crumbling Rice Street jail until then.

It calls for spending $27.6 million more than currently budgeted: $11.1 million for personnel costs, $7.7 for maintenance and repairs, $4.6 million more for medical expenses, $3.8 million for food, and $500,000 for public information. None of those items was proposed for a vote Wednesday.

Labat said he wants to hire private security guards to occupy the jail’s internal “towers,” which monitor cell blocks from above but have no contact with inmates. That would cost $2.3 million for the rest of this year, he said.

“Some of those towers have been unmanned at times,” Labat said.

Recruitment and retention of jailers is a major problem, with many jobs always open — and now senior staff are leaving, he said. Jail deputies and associated personnel got raises earlier this year but those ranking as sergeants or above got nothing, Labat said.

“They’re starting to leave,” he said. Labat requested 20% raises for those senior jail personnel, at a cost of $4.1 million.

Labat and Commissioner Bob Ellis got into a sharp dispute over a discrepancy of about 60 in the claimed number of vacant jobs at the jail. Expressing frustration, Ellis wondered how commissioners could make decisions about the jail without being sure of the information they were getting.

“What we have is a problem with our own data,” Labat said. One number came from the county’s human resources department, the other from jail staff, he said. Labat said there are now 122 job vacancies at the jail, with 15 new hires in orientation.

A recent survey of jail facilities found almost 700 broken cell doors, more than 500 electrical problems, more than 100 broken toilets and more than 300 broken sinks, Labat said.

To fix those problems he proposes a “blitz” repair: emptying one full cell block of minimum-security inmates, reopening the now-closed South Annex in Union City to hold them, and moving another batch of inmates into that cell block when it’s been cleaned and repaired. All 11 of the jail’s housing units would be moved in succession to newly repaired units. The medical and mental health units would be repaired without moving inmates, Labat said.

He wants to create a “dashboard” of measures to track progress at the jail, and create a joint information center to coordinate with other agencies, put out consistent messages, and deal with media.