HomeMy WebLinkAboutAgenda - 06-14-2001-4aSheriff s Proposal to Provide Jail Health Services
PURPOSE: To consider establishing one permanent Nurse Practitioner position and a half-
time permanent Registered Nurse to provide required health services for Jail inmates.
BACKGROUND: Federal and state laws require County jails to provide medical services,
including pharmaceutical supplies, to prisoners. These services include:
• Health screenings of new inmates upon admission to the jail
• Assessing, diagnosing and treating sick inmates
• Managing special needs inmates
• Dispensing medications
Historically, Orange County has contracted with Orange Family Medical Services (OEMs) for
the provision of medical services and purchased all prescriptions from local pharmacies. The
current contract with Orange Family Medical expires June 30, 2001. Contracts will be continued
with Gatewood and Associates Family Dentistry for dental services, with OPC Mental Health for
mental health services, Hillsborough Family Practice for x-ray services, a local pharmacy for
limited prescriptions not covered in an established formulary, and for some laboratory services.
The Sheriff is interested in establishing a program that would enable the department to provide
many of the same medical services in-house thereby eliminating the need to continue the
current contract with OFMS. Arrangements for providing other services under contract, such as
x-ray services, have been managed by jail personnel with a minimum of coordination and
feedback to medical personnel. The plan proposed by the Sheriff would create a permanent
Nurse Practitioner position and ahalf--time permanent Registered Nurse position to provide the
services in-house and to manage the coordination of needed services for inmates on a timely
basis. The health department has cooperated fully with the Sheriff in developing this plan and
will be providing medical oversight and supervision for the nurses, and the pharmacy and
laboratory services.
There are several reasons for pursuing this arrangement at this time.
• A recent inspection report completed by the Federal Marshal's Office indicated that the jail
was not in compliance with national standards regarding jail health. This arrangement would
meet minimum required health services to inmates. Through the current arrangement,
OFMS provides direct services one and one-half hours two times per week and phone
coverage far serious medical problems at other times. The proposed arrangement meets
minimum standards and allows for~in-house staff to be available eight hours per day, seven
days per week to offer. This will provide on-site assessment, sick call, medical management
of chronic conditions, referrals to needed contracted services, and oversight of arf in-house
prescription formulary for the most commonly prescribed drugs for inmates.
• The existing contract with OFMS expires June 30, 2001. Should the Board approve the
positions at this time, start-up costs, including a minor renovation of one small office and the
purchase of medical and pharmaceutical supplies, could take place immediately. In
addition, recruitment for the positions could begin immediately with the intent of having the
positions filled no later than August 30, 2001. A "not-to-exceed 90 day extension° of the
existing agreement with OFMS is recommended to ensure continuity of Jail .medical
services. OFMS has indicated a willingness to allow the extension at the current rate of
$1,512.50 per month.
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+ 'The Federal Marshals Office currently reimburses $55 per day far housing each federal
inmate. The Sheriff is negotiating with the Marshals office for an increased per diem amount
to off set costs associated with this proposal. The current jail census is approximately 115
inmates.
FINANCIAL IMPACT: The current contract with OFMS totals $18,15Q and historical expenses
for prescriptions filled at local pharmacies average $4,5prJ per month. Estimated costs to bring
the services in-house are outlined below:
Personnel Costs (including
benefits) $88,940
Contract Services $11,385
Operating Expenses
Pharmacy Supplies $fi,125
Medical Supplies $5,105
Other Operating (training,
office supplies, etc.) $3,035
Adminstrative (indirect) Costs $14,500
Non-Recurring Capital Start-Up $11,000
Total $140,~9~
The Sheriff s Department anticipates additional funds from the Marshals office to offset the cost
of providing the services in-house.
The Sheriff requests the Board approve afull-time Family Nurse Practitioner I and a .5 FTE
Public Health Nurse I position to provide jail health services for the Orange County Jail effective
June 14, 2QQ1.