Commissioners, judge and staff debate funding source for proposed juvenile medical provider

Okanogan County staff presented a proposal to contract with a part‑time physician assistant to provide medical screenings, medication continuity and behavioral‑health triage for youths held in the county detention facility and for juvenile referrals.

Public health and juvenile staff said the PA would provide initial well‑child and mental‑health assessments in detention, help determine fitness for inpatient treatment and coordinate referrals. County human‑resources and risk‑management staff said a part‑time contract had been drafted and a candidate identified; the PA would also occasionally backfill medical duties at the jail.

Several commissioners and Judge Grama raised legal and budget questions about whether proceeds from the county’s voter‑approved therapeutic‑court sales tax (Fund 1.43) could be used to pay the position. Commissioners questioned whether the PA’s time and duties would be sufficiently tied to “therapeutic court programs and services” as defined by statute and the sales‑tax ordinance; Judge Grama and staff discussed the overlap between diversion, juvenile supervision and mental‑health services.

No formal vote to fund the PA from the therapeutic‑court fund was recorded. Commissioners asked staff to obtain written guidance from county counsel (Esther) and to produce a short accounting method (for example, a time‑tracking percentage for juvenile behavioral‑health work) that could support partial reimbursement from Fund 1.43 if legally appropriate. Staff also noted the county has funds available in the general budget but wanted to avoid committing those funds prematurely without clarifying any restricted grant or dedicated‑fund rules.

Why it matters: The county is weighing how to pay for a medical provider whose duties straddle public‑health, detention medical care and behavioral‑health triage for at‑risk youth. Using a dedicated therapeutic‑court sales tax to cover some of the work could be lawful, but commissioners and the juvenile judge asked for counsel’s written interpretation and a mechanism to document how much of the PA’s work would meet the sales‑tax restrictions before committing the funds.

Next steps: Staff will consult county counsel, quantify the share of PA time likely to qualify under the therapeutic‑court statute, and return to the board with options for funding and a proposed accounting method.