A REPORT BY
THE 2005-2006 CONTRA COSTA COUNTY GRAND JURY
725 Court Street
Martinez, California 94553

REPORT 0605

NEW AUTOMATED DRUG DISPENSER IN COUNTY JAILS
Who Drugged ROBOT?

MAY 25, 2006

APPROVED BY THE GRAND JURY:

Date: __________________________

______________________________
ROBERT W. KENNEDY
GRAND JURY FOREPERSON

ACCEPTED FOR FILING:

Date: __________________________

______________________________
TERENCE L. BRUINIERS
JUDGE OF THE SUPERIOR COURT

Grand Jury

Contra
Costa
County

725 Court Street
P.O. Box 911
Martinez, CA 94553-0091

Contact: Robert Kennedy
Foreperson
(925) 646-2345

For Immediate Release:

NEW AUTOMATED DRUG DISPENSER IN COUNTY JAILS
Who Drugged ROBOT?
Summary
Contra Costa County (“County”) signed a five-year lease for almost one million dollars for an
automated medication dispensing system commonly called ROBOT. The savings analysis was
flawed in that much of the anticipated savings has already been realized prior to getting ROBOT
up and running. The County must do a more accurate and complete analysis of costs before
entering a contract of this size.
In February 2005, two new dispensing systems were delivered to Contra Costa Detention
Facilities and fifteen months later, none are operational. There has been an ongoing series of
glitches in getting ROBOT installed. It seems that no one has been minding the store. The
complications involved in setting up such a system were not identified prior to leasing the units.
There have been delays and unanticipated problems. The Grand Jury found no one in charge,
and recommends the County assign a project manager from day one.
The complete report is available on the Grand Jury web site: www.cc-courts.org/grandjury.

CONTRA COSTA COUNTY GRAND JURY REPORT 0605

NEW AUTOMATED DRUG DISPENSER IN COUNTY JAILS
Who Drugged ROBOT?

One Grand Juror recused himself or herself due to a possible conflict of
interest and did not participate in the preparation or approval of this
report.

TO:

Contra Costa County Administrator
Contra Costa County Sheriff-Coroner
Director, Contra Costa Health Services

INTRODUCTION
Contra Costa County (“County”) currently utilizes a traditional medicine dispensing system to
serve the inmates in the detention facilities. The doctor sees the inmate, writes a prescription, the
pharmacist fills the prescription and the nurse administers the prescription. The pharmacist may
dispense a maximum thirty-day supply of medicine.
The County is in the process of introducing a new automated medication dispensing system
commonly called ROBOT. Under the new system, a doctor writes a prescription, a pharmacist
inputs the prescription into the system, a nurse enters the inmate’s identification number, and
ROBOT dispenses medication for a nurse to administer. Instead of a thirty-day supply, drugs are
dispensed in single doses. Use of ROBOT will allow nurses in each of the detention facilities to
see the doctor’s order online, preventing lost paper orders when inmates are relocated.
Advantages of the ROBOT are improved recordkeeping, better inventory control, less waste, and
fewer medication errors.
BACKGROUND
In September 2004, the County signed a five-year lease for three ROBOTS to dispense
medications at Martinez Detention Facility, West County Detention Facility, and Juvenile Hall.
Two of the ROBOTS were delivered February 2005, but are not yet operational. The third
ROBOT for Juvenile Hall has not been delivered. This overall program is managed by two
County departments, Sheriff-Coroner (“Sheriff”) and Health Services.

MAY 25, 2006

CONTRA COSTA COUNTY GRAND JURY

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REPORT 0605

NEW AUTOMATED DRUG DISPENSER IN COUNTY JAILS

Three computer systems must be interfaced for the ROBOT to become operational:
•
•
•

The Jail Management System, managed by the Sheriff, tracks and identifies an inmate.
The Medical system, managed by Health Services, contains patient medical profiles.
The ROBOT system.

Programs had to be written to transfer inmate/patient information between the three systems.

FINDINGS
1.

In September 2004, the County leased three ROBOT systems for five years at a total
cost of $971,082. Lease payments do not begin until the system is operational.

2.

In February 2005, two ROBOTS were delivered, one for the Martinez Detention
Facility and one for West County Detention Facility.

3.

As of May 2006, none of the ROBOTS are operational.

4.

A major reason for delays has been lack of management, coordination, and
communication between the Sheriff and Health Services departments.

5.

The County has not assigned an overall Project Manager to monitor and expedite this
project.

6.

The original justification for leasing ROBOT anticipated the following annual savings
and costs:
Replacement of a Pharmacist with a Pharmacy Technician
Simplification of drug formulary
Savings (already realized without ROBOT)

$89,468
100,000
$189,468

Savings from not wasting drugs*
Total Savings

60,000
$249,468

Lease cost for three ROBOTS
Medical system software/maintenance fees
Total Costs
Net County Savings

($194,216)
(2,400)
($196,616)
$52,852

*Estimated savings from not wasting drugs ranged from $60,000 to $120,000 per year.
7.

The anticipated savings of $189,468 for replacement of a pharmacist with a pharmacy
technician and simplification of drug formulary have already been achieved without
ROBOT being operational.

MAY 25, 2006

CONTRA COSTA COUNTY GRAND JURY

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REPORT 0605

8.

NEW AUTOMATED DRUG DISPENSER IN COUNTY JAILS

The County has incurred additional costs, which were not included in the original
proposal, including at least $60,000 in Health Services Information Technology staff
time and an undetermined amount of time from Sheriff Information Technology staff.

CONCLUSIONS
1.

It appears no one has been minding the store. The delay in completing this project is
due to the lack of coordination between the two departments and a failure to assign a
Project Manager.

2.

Three-fourths of the anticipated savings have already been achieved without ROBOT
becoming operational. The original proposal overestimated savings attributable to the
ROBOT system. Therefore, the economic justification for the ROBOT system was
flawed.

RECOMMENDATIONS
The 2005-2006 Contra Costa County Grand Jury recommends that:
1.

The Contra Costa County Sheriff-Coroner and Director of Health Services get all three
ROBOT systems operational by September 30, 2006.

2.

The Contra Costa County Administrator ensures future projects of this size (one
million dollars) receive an accurate and comprehensive analysis of costs, savings, and
implementation challenges prior to entering into purchase or lease contracts.

3.

The Contra Costa County Administrator ensures that an overall Project Manager be
assigned to track, monitor and take responsibility for projects of this nature,
particularly when projects involve more than one County department.

MAY 25, 2006

CONTRA COSTA COUNTY GRAND JURY

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REPORT 0605

NEW AUTOMATED DRUG DISPENSER IN COUNTY JAILS

REQUIRED RESPONSES
Findings:
Contra Costa County Administrator: 4 and 5.
Contra Costa Sheriff-Coroner: 1-8.
Director, Contra Costa Health Services Department: 1-8.
Recommendations:
Contra Costa County Administrator: 2 and 3.
Contra Costa County Sheriff-Coroner: 1.
Director, Contra Costa Health Services Department: 1.

MAY 25, 2006

CONTRA COSTA COUNTY GRAND JURY

PAGE 5