HomeMy WebLinkAboutAgenda 06-18-19 Item 8-j - Letter of Agreement to Increase Medical Director’s Services at the Orange County Detention Center
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 18, 2019
Action Agenda
Item No. 8-j
SUBJECT: Letter of Agreement to Increase Medical Director’s Services at the Orange
County Detention Center
DEPARTMENT: Sheriff’s Office
ATTACHMENT(S):
Letter of Agreement Dated May 22,
2019, Effective July 1, 2019
Overview of the MAT Process
INFORMATION CONTACT:
Sheriff Charles S. Blackwood,
919.245.2900
Jennifer Galassi, Legal Advisor to the
Sheriff, 919.245.2952
Caitlin Fenhagen, Criminal Justice
Resource Director, 919.245.2303
PURPOSE: To approve a Letter of Agreement to increase the Medical Director’s services at the
Orange County Detention Center by one hour on-site per week.
BACKGROUND: Since 2009, the County has contracted with Southern Health Partners (SHP)
to provide a structured and comprehensive medical program for inmates housed in the Orange
County Detention Center (OCDC). On September 20, 2018 the Board approved an amendment
to the Agreement which increased the medical and support personnel staffing from 12 hours per
day/seven (7) days per week to 18 hours per day/seven (7) days per week, resulting in an
additional annual cost to the County of $60,540.48.
The proposed Letter of Agreement increases Medical Director Dr. Eugene Wade’s services by
an additional one hour on-site per week, beginning July 1, 2019, to assist with establishing and
supporting a Medicated Assisted Treatment (MAT) program at the OCDC. The program is a
result of the collaboration of the Orange County Sheriff’s Office (OCSO), Dr. Evan Ashkin at
UNC, the Criminal Justice Resource Department (CJRD), the Health Department, and Southern
Health Partners. Details regarding the MAT protocol are included in the attachment entitled
“Overview of the MAT Process.” Additionally, specific policies and procedures will be
established to implement and regulate the MAT program.
FINANCIAL IMPACT: Effective July 1, 2019, the current contract price of $377,745.36 would
increase by $2,460 annually ($205/month) to reflect the additional hour per week of the Medical
Director’s services, resulting in a total contract price of $380,205.36. Sufficient funds are
available in the Criminal Justice Resource Department’s FY 2019-20 budget to cover the
increased costs.
Other financial obligations under the Agreement remain unchanged.
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SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable
to this item:
• GOAL: FOSTER A COMMUNITY CULTURE THAT REJECTS OPPRESSION AND
INEQUITY
The fair treatment and meaningful involvement of all people regardless of race or color;
religious or philosophical beliefs; sex, gender or sexual orientation; national origin or
ethnic background; age; military service; disability; and familial residential or economic
status.
• GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY
The creation and preservation of infrastructure, policies, programs and funding necessary
for residents to provide shelter, food, clothing and medical care for themselves and their
dependents.
• GOAL: CREATE A SAFE COMMUNITY
The reduction of risks from vehicle/traffic accidents, childhood and senior injuries, gang
activity, substance abuse and domestic violence.
RECOMMENDATION(S): The Manager recommends that the Board approve the Letter of
Agreement and authorize the Chair to sign on behalf of the Board.
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Overview of the MAT Process
Four Tiers of the Program
All individuals coming into the jail will be screened for current MAT use and opioid use disorder
within 14 days of commitment. Screening for opioid use disorder will be done using a validated
tool. The program will have four tiers of implementation conceptualized as 1=the easiest to
implement and 4=a long-term goal of the program. They are:
1) MAT for Pregnant Women
a. Pregnant women will be screened, continued, and initiated on suboxone. This will
be done regardless of whether the pregnant woman is remaining in the jail or
being transferred to prison.
2) Continuation of MAT
a. For individuals reporting current naltrexone, methadone, or suboxone use in the
community, medical staff will obtain written consent to confirm medication and
dose with current prescriber and pharmacy, and suboxone or naltrexone will be
continued.
3) Initiation of MAT
a. If previous prescription of MAT is not confirmed, individuals who have opioid use
disorder will be referred to the MAT program and will be prescribed either
suboxone or naltrexone at a dose that is clinically appropriate. The decision of
which MAT to offer a patient will be determined clinically, primarily by past
experiences, patient preference, and logistical considerations.
4) Introduction of methadone prescribed by an opioid treatment provider
a. We will partner with an opioid treatment provider in Durham (e.g. BAART) to
begin offering methadone during incarceration. Importantly, if someone prefers to
be linked to a methadone clinic upon release this will be done as a part of
discharge planning.
All individuals who are in the MAT program will have access to group counseling, individual
counseling, discharge planning services, and prerelease linkage to comprehensive treatment
and wrap around (e.g. housing, transportation) services in the community.
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