LaSalle County jail administrator Jason Edgecomb told the county Insurance Trust Committee on Aug. 18 that the county is reviewing whether to continue contracting jail medical services or hire its own medical staff, citing contract terms, staffing challenges and potential liability. Edgecomb said the current contractor proposed a 3.1% contract increase under a CPI clause and that the county’s contract allows adjustments between 1% and 5% depending on CPI. "They sent the thing at a 3.1 CPI," Edgecomb said.

The committee was told Edgecomb is gathering cost estimates for an in-house program, including salary ranges he observed for full‑time nurses. He said full‑time nurses on the contractor payroll were paid between $88,000 and $97,000 in base salary and that, when benefits are included, the county would face substantially higher personnel costs if it hired comparable staff directly: "So you're at 450,000 just for 3 of the employees," Edgecomb said, describing a rough calculation for three nursing positions.

Committee members and outside advisers cautioned that an in‑house medical program would change the county’s insurance exposure. A representative for the county’s insurer and claims administrator said the trust’s current retention (a $250,000 self‑insured retention) would be exposed to medical lawsuits if the county employed its own medical personnel, and that was difficult to quantify. "This is one of those services that is much better outsourced, than taking the exposure in just from the liability standpoint," a risk adviser said.

Trust members discussed that, under the current contract’s indemnification language, the contractor (listed in the meeting as Wellpath) currently pays defense costs when the contract is sued for strictly medical negligence claims. Edgecomb said, based on his recollection, that in the last seven to nine years the county was named in two strictly medical suits and that the contractor covered those legal costs: "Because of the indemnification in our contract, even though we were sued in it, Wellpath picks up the bill on our coverage." He said he believed medical suits were a small subset of the county’s overall litigation volume.

Edgecomb also raised operational questions staff will bring back to the committee: whether a county‑run medical program would require a full‑time medical director (not included in the current contract), who would handle hospital bill disputes and collections, and how to handle staffing shortages for mental‑health positions. He reported outreach to Kankakee County, which he believes runs medical in‑house for a larger jail, and said he was attempting to get details on that model.

On funding and offset opportunities Edgecomb said states are pursuing policy changes to allow Medicaid billing for services during the 90 days before an individual’s incarceration ends; he said Illinois is piloting that approach in Cook County first, which could delay any statewide savings for LaSalle County. "We're gonna be able to save you some money because we could put in the waiver for Medicaid to be able to bill through Medicaid for some of their services," he said, but he also cautioned the county will probably be later in line to adopt any such change.

The committee did not approve any immediate change. Edgecomb said he will return to the committee next month with more detailed cost estimates and additional information from the contractor and peer counties. Risk management and insurance advisers said the county should obtain multiyear claims data from the contractor before making a decision and warned that switching to an in‑house model on the timetable discussed could increase errors and claims frequency as the program is stood up.

Edgecomb and committee members also discussed the contractor bidding history: he said the contractor has been the county’s supplier through multiple procurement cycles and, at the last bid (effective Dec. 1, 2021), was the only bidder. Edgecomb said he will pursue an RFP specialist to help structure future solicitations and that Wellpath has agreed to provide more account‑level information to the county.

The committee’s discussion was recorded as a staff briefing and information request rather than a motion or vote to change providers. Edgecomb said he will report back with more precise cost comparisons and liability input from the county’s insurance trust staff.