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The latest candidate to enter the Georgia Republican primary for governor is a health care executive whose company supplied hospital and nursing home workers during the Covid emergency under a state contract.
Billionaire Rick Jackson’s companies have been paid nearly a billion dollars by state agencies since fiscal 2020, according to a Healthbeat analysis of government records.
That includes about $710 million, starting in 2020, from the Department of Community Health, for health care staffing services. Much of that work ended by 2023, but Jackson Healthcare subsidiaries remain state contractors for other services.
The candidate’s campaign materials describe a rags-to-riches story of growing up in foster care and going on to build a health care empire. Jackson Healthcare, founded in 2000, has grown to include 21 subsidiaries, most of them providing health care staffing. Jackson Healthcare also owns USAntibiotics, which says it is the country’s sole manufacturer of two widely used antibiotics. The company operates in all 50 states, according to his campaign website.
Jackson, 71, who entered the governor’s race in early February, has quickly gained steam against previous front-runner Lt. Gov. Burt Jones in the primary, with two recent polls showing Jackson leading among voters who have made a decision. Jackson plans to spend at least $50 million of his fortune to fuel his campaign, according to news reports.
Jackson’s companies have active contracts with the Department of Behavioral Health and Developmental Disabilities but the agency did not respond to multiple queries about the value of those contracts.
A Department of Public Health representative also refused to answer questions about that agency’s contracts with Jackson Healthcare subsidiaries.
If Jackson becomes governor, he may need to take steps to separate his business interests to avoid ethical or legal challenges over conflicts of interest, legal and ethics experts said.
His campaign wouldn’t make Jackson available for an interview with Healthbeat but said the company “has always and will always follow the law” with respect to its state contracts.
Georgia law generally prohibits elected officials from holding contracts with the state government, said Matt Maguire, a longtime Atlanta attorney who specializes in government contracts. But there are several exceptions – including for contracts that existed prior to an official being elected.
And Georgia law isn’t clear on whether Jackson Healthcare or its subsidiaries could bid for new contracts, Maguire said, pointing to a possible exception for professional employment services. There are also exceptions in the case of an emergency, or if there is only one company that could provide the needed services.
Edward Queen, an attorney and professor at the Emory University Center for Ethics, said that if Jackson is elected, he should disengage from decision-making related to his businesses, and assets related to those businesses should be put in a blind trust.
Queen said he would expect Jackson to resign from Jackson Healthcare and its subsidiaries, and the company should refrain from bidding future contracts with the state while he is in office.
“If you want to do the state’s business as an elected official, then focus on the state, not whatever your ongoing organization or corporate interests are,” Queen said.
It’s important to create such firewalls to bolster the public’s trust in the government and ensure that officials act in the public interest, experts said.
“If there are any questions as to whether the government contracts with this governor are changed, enhanced or in some way further benefit the governor, there will always be a cloud of suspicion as to whether he’s violating that fundamental ethics principle,” said Kedric Payne, an attorney who leads the ethics program at the Campaign Legal Center, a nonpartisan national organization focused on democracy.
Queen and Payne said the public should be informed about elected officials’ business interests well ahead of Election Day. Georgia’s party primaries for governor are scheduled for May 19, with the general election set for Nov. 3.
“Information about the government contracts of the candidate should be made public,” Payne said.
Jackson Healthcare supplied doctors and nurses during Covid
Jackson points to his health care experience as evidence of his commitment to the state’s well-being.
“When Covid hit Georgia, Gov. [Brian] Kemp asked Jackson for more doctors and nurses,” a campaign ad states. “And Jackson delivered again, refusing to send help to New York until Georgia got the emergency care it needed.”
Georgia’s largest health agency, DCH, paid a Jackson Healthcare subsidiary $709 million in federal American Rescue Plan Act funds starting in 2020 for the staffing services. The agency also paid the Alpharetta-based company an additional $511,353 in state funds, said spokesperson Lauren Williams.
The funds paid for doctors, nurses, therapists, laboratory technicians, housekeeping, and food service workers during the pandemic.
DCH worked with DPH to “triage” requests from Georgia facilities that faced staffing challenges, Williams said.
Jackson Healthcare subsidiary Healthcare Workforce Logistics then created contracts with the selected facilities. The costs were subsequently paid by DCH after approval of documentation, Williams said. She did not answer a question about whether those contracts are still active.
The DCH agreement was described as a sole-source contract by Georgia Health News in 2021, and the bidding opportunity is not listed in the Georgia Procurement Registry, the online database that details state contracting opportunities.
Healthbeat requested a copy of the contract from the state via an open records request on Feb. 10 but had not received it by Friday.
Jackson will work to increase health care access and lower costs for Georgians, campaign spokesperson Brian Robinson said, adding, “Other politicians talk about it, Rick will get it done.”
Subsidiaries have had contracts for mental health services
Jackson Healthcare subsidiaries held contracts with other state agencies as well.
DBHDD has held contracts with subsidiaries since at least 2015 for mental health care professionals to work at state psychiatric and other facilities, state records show. Those contracts appear to have been awarded through a competitive bidding process, with other companies also winning contracts.
Department spokesperson Camille Taylor did not respond to a question about how much the company had been paid for its services, but state records indicate the agency has paid Jackson Healthcare subsidiaries about $239 million since fiscal 2020.
Jackson Healthcare subsidiaries also worked for the Department of Human Services, which includes the Division of Family and Child Services that oversees the state’s foster care program. DHS used the existing DCH contract with subsidiary Healthcare Workforce Logistics in 2022 and 2023 due to a staffing crisis, agency spokesperson Ellen Brown said.
DHS paid a total of $7.4 million to the company for workers to help with “complex youth in foster care, including youth who require hospitalization at psychiatric residential treatment facilities, youth with intense behavioral and mental health needs, youth with moderate developmental delays, and youth with autism,” Brown said.
That contract is no longer in effect, she said.
Jackson has been a longtime donor to GOP politicians, including to some of his current opponents for governor: Republican Secretary of State Brad Raffensperger; Attorney General Chris Carr; and former Lt. Gov. Geoff Duncan, who was then a Republican but is now running in the Democratic primary.
Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.
