Jails' drug machines costing the county

Contra Costa Times (California)
June 2, 2006 Friday

Automated system was supposed to streamline the dispensing process, but devices still don't work


By Rebecca Rosen Lum, Times staff writer

A new automated system was supposed to streamline the process for getting medications to inmates in Contra Costa County's jails -- and save more than $240,000 a year.

Instead, two computerized dispensers, called ROBOT, are gathering dust -- and leaking tens of thousands of dollars in unanticipated labor costs, according to a new report by the Contra Costa grand jury.

The county spent nearly $1 million on a five-year lease for three dispensers: one for County Jail in Martinez, one for the West County Detention Facility and a third for Juvenile Hall. Two have proved too problematic to get rolling, and a third was never delivered.

Though both the Contra Costa Sheriff and County Health Services departments jointly oversee the new system, it is no one person's responsibility, which the report says it part of the problem.

"No one is minding the store," the report says.

The report also faults the county for failing to thoroughly investigate the system -- and its estimated savings -- before laying the money down.

Before February 2005, when the county changed its tack, a doctor wrote a prescription, a pharmacist filled it, and a nurse dispensed up to a 30-day supply to the inmate.

As part of the shift to the new system, the county replaced the pharmacist with a pharmacy technician, saving more than $89,000 a year. Cutting down the inventory to include fewer brands of medications, then buying in greater bulk, saved another $100,000.

The third leg of the new plan called for the technician to type the prescription into a computer and for ROBOT to dispense only a single day's supply. That was expected to save another $60,000 to $120,000 a year on full prescriptions that must be thrown away

But the county did not reckon on the cost of overtime pay as technology staffers from the health and sheriff's departments struggled to get ROBOT -- which actually looks more like a vending machine -- working.

The bill comes to $60,000 already, and the system still does not function.

A savings analysis that was intended to justify the lease was seriously flawed, the report says. The county achieved three-fourths of its savings without ROBOT.

The county's chief of health services was not reachable for comment Thursday, and Jeff Smith, administrator of the Contra Costa County Regional Medical Center, did not return calls. A spokesman for the Contra Costa Sheriff said the report, while "righteously motivated," wrongly discredits the department.

"We have absolutely and scrupulously done whatever we can do to make this work," said Undersheriff Obie Anderson. "The sheriff isn't in the business of handing out medication. Deputies are in the business of creating a safe environment for that to happen."

Not entirely true, said grand jury foreman Bob Kennedy.

"The equipment is installed in detention facilities and dispenses drugs to inmates -- so yes, the sheriff is involved," he said. "Both departments have an interest in this."

The report recommends that:

The Contra Cost Sheriff and county Health Services get all three dispensers in place and running by September 30.

The county administrator scrutinize costs, savings and challenges in all projects as costly as this.

The county administrator appoint a project manager for this and other projects that involve multiple departments.

The system allows the jails to keep smaller quantities of drugs on site. But from a pure cost savings standpoint, the system is a drain, Kennedy said.

"I'm not sure (backing out) is an option," he said. "They've signed a five-year lease."