County studies alternatives for healthcare and psychiatric services at adult detention center; committee backs adding a medical director to contract oversight

County staff presented a review of possible service models for medical and psychiatric care at the Loudoun County Adult Detention Center (ADC) ahead of the next procurement window. The current provider contract (Wellpath) runs through June 2027; the sheriff’s office and budget staff presented three alternative models beyond the current enhanced-contract approach.

Models discussed: (1) fully internal clinical staff (county/sheriff employees) with no contracted services; (2) continued contracted services with the addition of civilian medical oversight (a medical director/contract manager); and (3) a hybrid with civilian medical oversight plus some county clinical positions along with contracted specialty services. Comparable jurisdictions were referenced: Alexandria, Prince William/Manassas and Montgomery County use contractor‑centric or hybrid approaches; Arlington is moving toward a county‑run model.

Sheriff’s office preference and committee direction: The sheriff’s office indicated support for a civilian medical director role to oversee and add clinical expertise to the contract-manager function; staff said the medical director could be included as a resource request in the FY27 sheriff’s budget so the position could be in place to support the next contract procurement. The committee asked for additional details, including clarity on current “limited mental health services” language, current ADC population and capacity (staff reported average ADC population in 280–300 range, with facility capacity about 460), and how medical oversight would be hosted (county department vs. sheriff's staffing). Staff said they would record committee questions and follow up with the sheriff’s office for operational answers.

Why it matters: Committee members emphasized clinical accountability, continuity of care for individuals while incarcerated, and the importance of linking in-custody treatment to reentry and community services. Supervisors also noted risks associated with for-profit contractors and said clinical oversight would strengthen quality control.

What’s next: Staff will collect and provide operational answers from the Sheriff’s Office, and if the committee supports adding a medical director, the sheriff’s office would work with OMB to add a FY27 resource request in the upcoming budget cycle. The current contract will remain in force through June 2027 unless changed by future Board procurement actions.

Quoted: “The Sheriff's Office is supportive of the addition of a medical director for all the reasons I laid out,” OMB said; the presentation added, “If that is something the finance committee is also supportive of, we would work with the sheriff's office to develop a resource request.”