SALISBURY — After terminating a contract with its former provider a month early, the Rowan County Sheriff’s Office signed a deal with Wellpath to provide health care services to inmates at the Rowan County Detention Center.

With a presence in 33 states, Wellpath is one of the largest medical and behavioral providers to jails, prisons and other behavioral care facilities in the country. The Nashville-based outfit, owned by the private-equity company H.I.G. Capital, was formed in 2018 after a merger between California Forensic Medical Group and Correct Care Solutions.

Wellpath’s 13-month, $1.03-million contract at the jail started on June 1 after Rowan County elected to terminate its contract with Mediko a month before it was set to expire. An amendment to the contract also credited Rowan County with $50,000. Wellpath was selected as Mediko’s replacement over Southern Health Partners and Advanced Correctional Healthcare, whose bids came in at $1.037 million and $1.17 million, respectively.

“(Wellpath) understands our needs and our facilities and we think that it’s a good opportunity,” Sheriff Kevin Auten said. “We do have confidence in Wellpath.”

Rowan County will have the option to renew Wellpath’s contract after the 13-month term is up at a 3% cost increase.

Wellpath is charging the county a per diem of 69 cents for health care services per inmate, per day. The 368-bed detention center projects its average daily population to be about 325, but the detention center’s population is in constant flux. If the detention center’s population drops below 275, Wellpath will refund the county at the same rate.

Mediko, based in Richmond, Virginia, provided health care services to the detention center for the previous two years. However, the county’s relationship with the company soured in recent months due to staffing issues.

“The biggest problem was understaffing on their part,” said Gregory Hannold, detention administrator for the Rowan County Sheriff’s Office. “They just couldn’t keep enough nurses here to, in my opinion, fulfill what they agreed to in their contract. The other problem was, there seemed to be, toward the end, a lack of support for the nurses they did have here from the home office.”

Auten said Mediko’s inability to keep the Rowan County Detention Center appropriately staffed could partially be attributed to the pandemic.

“You do have to throw in the COVID curveball,” Auten said. “This is an industry problem with companies like Wellpath, Mediko, Southern Health, all those companies that provide services. They’re in competition with hospitals for the past year that have been paying people double time, time and a half and COVID money left and right. There is a shortage.”

With Wellpath now in place as the health care provider for the detention center, Hannold said he believes the understaffing problems will be remedied.

“Wellpath is a much larger company,” Hannold said. “They have a lot more resources to draw from. They have the larger counties in North Carolina, to where if we’re short a nurse one day, they can redirect a nurse from one of the larger agencies to come here and complete those tasks.”

Wellpath currently provides services to more than a dozen facilities in North Carolina, including the Mecklenburg County Jail.

According to its contract, Wellpath is obligated to provide 332 hours of coverage per week — split among nurses, mental health professionals and administrative staff at the Rowan County Detention Center. That’s more than the 304 weekly hours Southern Health Partners proposed and significantly more than the 208 weekly hours Advanced Correctional Healthcare projected in its bid. With Wellpath taking over, Auten said the Rowan County Detention Center will be able to once again provide 24-hour health care coverage.

The switch to Wellpath will also result in improved mental health services, Hannold said.

“This company is providing a mental health professional here Monday through Friday for eight hours a day,” Hannold said. “We didn’t have that with Mediko.”

Even though Wellpath is now managing the jail’s health care, many of the same nurses and health care staff members have carried over.

“To be completely honest, some of the nurses that were here are still here,” Hannold said. “It’s not like the staff and the people who know our inmates are changing that much. It’s the company and their procedures and quality and things like that.”

The companies that merged to form Wellpath in 2018 both have a lengthy history of being targets for litigation. Correct Care Solutions was sued at least 1,395 times in federal court from 2008 to 2018, according to the Private Equity Stakeholder Project, a critic of correctional health care. California Forensic Medical Group has also faced a bevy of lawsuits alleging negligence.

Despite those lawsuits, Hannold said he isn’t concerned about the company’s capacity to provide quality health care to Rowan County inmates.

“They do have a few lawsuits, but it’s a company of 30,000 employees. Lawsuits are kind of common in this business,” Hannold said. “I have known their representative since I took over the jail and I’ve discussed those lawsuits with her and some of her bosses before. I don’t have any reservations about their ability to protect our county against lawsuits.”

One of the ways the jail gauges the level of health care being provided, Hannold said, is by listening to its inmates. Inmates can file grievances, which may be delivered to their attorney, judges, or detention center leadership, about a number of concerns by writing them down on paper or by inputting them into an electronic kiosk.