BOISE — Idaho’s state Board of Correction voted this week to extend its $46 million-plus a year contract with Corizon Health for inmate health care for another two years, but also to immediately launch a process to take the contract out to bid at the end of the two-year extension.

Corizon, based in Brentwood, Tennessee, has held the multimillion-dollar contract since 2005, and it’s grown each year. The contract allowed for an additional two-year extension after this one, but the board opted against that.

“There were lots of hesitations, let’s put it that way,” said Debbie Field, board chairwoman, “because the contract ends the 31st of this month. We talked about can we do a one-year extension.”

But even a full year wouldn’t allow sufficient time to develop a new request for proposals and go through the bidding and selection process, she said. “So we realized, OK, we will extend, but we will start the RFP process immediately.”

The three-member board’s vote was unanimous.

Idaho has faced lawsuits and court orders over inmate health care, including orders in a long-running class action lawsuit over prison conditions that started back in the 1980s; in 2017, a federal judge found that both the state prison system and Corizon were violating a 2014 order regarding inmate care.

This year, Saint Alphonsus Health System sued Corizon over the reimbursement rates it’s been paying the hospital since 2015, saying millions more were due, something the private firm disputed. St. Luke’s Health System also sued Corizon this summer, pointing to low reimbursement rates and underpaid medical bills, Boise State Public Radio reported.

And an inmate lawsuit filed early this year charged that a 65-year-old inmate had to have his leg amputated in 2016 after prison and health officials ignored a serious infection; inmate Gary Merchant charged that it wasn’t until he’d swallowed a razor blade to get attention that he was taken to the hospital. That lawsuit still is pending.

“Obviously there are things that haven’t gone as smoothly as we would like them to go with the current contract that we have,” Field said. However, she said, “We don’t have any performance issues really in the last 12 months. We’ve really monitored it well and will continue to do so.”

Field also said there are “several other entities that have approached us that would like to bid on the contract.” Representatives of some of those firms attended this week’s Board of Correction meeting at which the board approved the extension.

Martha Harbin, director of external relations for Corizon Health, said in a statement that Corizon believes the two-year extension “shows we are delivering a quality health care program.” She said the company “very much appreciate(s) the trust and confidence of the department.”

“We respect the public procurement process and the board’s responsibility to be good stewards of the taxpayer dollar,” Harbin said, “and look forward to submitting a robust proposal that allows us to continue caring for our patients in Idaho.”

Field said concerns prior to the past 12 months included staffing issues and long delays in implementing electronic health records. “We held money back from the contract until they did,” she said.

Just under two years ago, Field said, Corizon’s top officials came to Idaho and met with the board “explaining that they were going to be on it. Since that meeting, they’ve been very compliant meeting all of their staffing. They’ve made some changes to some of their staff that represented Corizon.”

The contract calls for Corizon to be paid $16.50 per inmate per day. In fiscal year 2019, the Legislature appropriated $46,496,500 for payments under that contract.

The contract provides that if the contractor meets performance requirements, that rate could rise by 3 percent on Jan. 1, 2019; that would bring it to $17 per inmate per day. If Idaho’s inmate numbers remained static, that would bring the total to nearly $48 million, but Idaho’s inmate population is growing quickly, so it likely will be more.

“It’s a lot of money,” Field said. “We just have some real concerns. It’s a tough climate to offer services, we understand that.”

With the ongoing court cases and the need for intensive compliance monitoring under the contract, Field said, “There’s just so much. … It’s going to be a contract that has to be heavily monitored, and that will be. … It’s going to be a work in progress.”

She said the board’s action sent a message. “For the people that were wanting to bid on a contract, know that we’re going to get at it — that we’re not going to wait ‘til the end of the two years to put anything out on the street,” she said. “We’re going to start soon.”