Agenda - 06-14-2001-4a - Laserfiche WebLink

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Sheriff 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.