SPOKANE, WA – Facing a $20 million deficit, Spokane County is preparing to replace the health care provider overseeing the two local jails, which could impact the general fund by as much as $16 million.
Michael Sparber, senior director of the Law and Justice division, and his team presented their options to the Board of County Commissioners on Tuesday. The upcoming transition follows a letter from NaphCare in June, signaling its intent to leave Spokane under a “without cause” provision by January 1, 2026.
Spokane has contracted with Naphcare to provide services at the local jails since 2017, and extended that agreement through 2028 in January. Project Manager Ken Mohr said the letter wasn’t a surprise, and mentioned hearing “rumblings” that NaphCare wanted to leave the state amid costly settlements.
He recommended that the board select Mediko, Inc. as the replacement and requested permission to enter negotiations with the health care provider next month. However, neither he nor Sparber outlined how it would impact the ongoing budget hole, although Mohr confirmed that pricing had been quoted.
“Not looking for the lowest cost provider,” he said. “We want a quality provider at a reasonable price.”
Regardless, price point is a factor. The county is currently grappling with a $20 million deficit ahead of next year. The commissioners must exercise caution regarding any further impact on the general fund to avoid dipping into their reserves after backfilling $2 million last winter to balance another shortfall.
Staff fast-tracked a request for proposal in June after receiving notice from NaphCare, which turned up four applicants. The county graded each based on five criteria, including service offerings and staffing, level of expertise, interviews and presentations, transition plans and value, according to a slideshow.
Mediko received a perfect score of 100, while Correctional Healthcare Partners scored 66.89, Advanced Correctional Healthcare, Inc. earned 60.22, and Wexford Health Sources received 45.64. Mohr said the Washington Association of Sheriffs & Police Chiefs recommended those applicants along with “folks in the jail.”
Experience is what sets the Virginia-based company apart, as Mediko has been operating for 28 years across the east coast and has recently expanded into Washington state. Mohr said they have contracts in Nisqually, King County and Cowlitz County, and have yet to lose in court when faced with litigation.
“What we would hope for is probably a three to four-year contract with annual renewals,” Mohr said regarding his plan for the upcoming negotiations. “Certainly, pricing has been quoted. We don’t want to get into details on that, because we want to get further along in negotiations before we share that.”
According to Tuesday’s agenda, the switch could impact the general fund by $13 million to $16 million.
Mohr told the commissioners that NaphCare may agree to extend its contract for an additional 30 days or so, allowing the county more time to transition to a new provider. Notably, he said that Mediko is a physician-owned and controlled company, unlike others that rely on direction from an executive board.
Staffing was a concern last January when the board considered providing its own services, but Mediko intends to match the existing staff plan, with the exception of one psychiatrist. If the board approves a motion next week to enter negotiations, Mohr said the process could last approximately two months.
The goal is to wrap up by December so Detention Services can transition over the following 60 days.
“Ultimately, our recommendation to the board is that we move forward with Mediko,” Mohr said.
