NEWS
Bernalillo County Commission approves $4M budget reconciliation for MDC medical costs
Officials attribute rise in jail healthcare budget to reliance on travel nurses
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Modified
The Bernalillo County Commission on Tuesday approved $4 million in changes to its biennial budget to cover increasing medical costs at the Metropolitan Detention Center.
Commissioners voted 4-0 on the motion. Barbara Baca was absent for the vote.
The $4,012,583 in reconciliation funding for the medical contract with University of New Mexico Health System 鈥� which provides healthcare at MDC 鈥� was covered by $1.97 million from the general fund and $2 million in Healthcare Gross Receipts Tax money.
In a statement, Warden Kai Smith, said, 鈥淢DC works closely with UNM Hospital to ensure that inmates receive best practice healthcare, while continuing to be good stewards of the public鈥檚 tax dollars. Budget updates reflect MDC鈥檚 commitment to inmate and community well-being.鈥�
During Tuesday鈥檚 commission meeting, Shirley Ragin, the deputy county manager for finance, said the county in 2025 budgeted just under $27.5 million 鈥渂ased on preliminary estimates鈥� from UNMH. An additional $3 million in risk insurance brought the total healthcare budget at the time to more than $30 million.
It wasn鈥檛 enough.
Ragin said the roughly $4 million add-on primarily reflects increased staffing 鈥渟uch as the use of travel nurses鈥� amid a nurse hiring shortage.
UNMH spokesperson Chris Ramirez said 38%, or 19 of 50, of the nurses working at MDC are contract/travel nurses, compared with 10% across all of UNMH. He said the increasing costs at MDC were driven by both contractual obligations with the county and clinical standards established by the McClendon settlement agreement.
鈥淚t鈥檚 worth noting that MDC鈥檚 census is higher today than it was when UNM Hospital began providing medical and behavioral care, meaning the Hospital is treating more patients in the facility,鈥� Ramirez said. 鈥淯NM Hospital has also worked to increase staffing in the medical unit, increasing the cost of labor.鈥�
Since 2020, 49 people have died at the jail or died after falling ill at the jail, seven of them in 2026. UNMH took over healthcare at MDC in July 2023 after two for-profit medical providers were contracted at the facility.
Amid the rising death toll, MDC has been beholden to a 2017 settlement agreement in the McClendon case, which mandates reforms at the jail. As part of that agreement medical experts conduct audits on healthcare in the facility.
In the most recent audit report, a doctor found MDC was continuing to provide unconstitutionally poor medical care 鈥� detailing long waits for detox, poor staffing and unreliable responses to medical emergencies, among a host of other issues.
Kate Loewe, an attorney representing those incarcerated at MDC under the McClendon settlement, said Bernalillo County 鈥渕ust spend money on good healthcare, more than it has in the past.鈥� Referring to the findings of the latest audit, she said UNMH 鈥渘eeds to figure out鈥� how to provide constitutional care.
鈥淭hey 100% need more staff ... The facility relies too much on nurses, paramedics, and EMTs to provide direct care creating delays in patients getting the care they need,鈥� she said. Loewe added that the lack of staff has led to less Suboxone distribution to treat withdrawal at MDC, where many of the deaths happened to those in detox.
During Tuesday鈥檚 meeting, Commissioner Eric Olivas said it was important to acknowledge 鈥� amid budget conversations 鈥� that those jailed at MDC 鈥渁re by and large the sickest people in our community.鈥�
鈥淚t is a very expensive situation to put a lot of people with health problems of all kinds together and then try to keep them alive and improve their health,鈥� he said. 鈥淚deally we want people to leave that facility better off than they came in.鈥�
In addressing the budget mismatch, County Manager Cindy Chavez said part of the challenge has been 鈥渞ightsizing this partnership鈥� with UNMH. She added that UNMH鈥檚 reliance on contract/travel nurses is tied to a statewide crisis.
鈥淏ut we are really anxious to get that traveling nurse number down,鈥� Chavez said. Due to the budget snafu, Chavez said a staffing study was underway at MDC 鈥渟o we would have an agreement about what the actual investment needs to be in the facility.鈥�
Chavez said the study was expected to be completed in late fall.
Loewe said it鈥檚 important to have permanent nurses working at MDC who are well-trained to care for those in the facility and are invested in the community as a whole.
She said a staffing study 鈥� such as the one ordered in a Corrective Action Plan in the McClendon case 鈥� is necessary not only to reduce budget conflict but 鈥渢o tell the County and UNMH what staffing is needed to provide care.鈥� Although the court-ordered staffing study was supposed to be finalized by November 2025, Loewe said she was pleased to hear the county is undertaking one now.
Ramirez said one way or another, the provider is seeing the costs of MDC healthcare continue to increase over time.
鈥淗owever, UNM Hospital looks forward to continuing dialogue with Bernalillo County to appropriately and lawfully resource the medical unit to ensure patients receive safe, high-quality care,鈥� he said.
