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St. Lucie County says inmate medical reforms and new provider have cut hospital send-outs and saved millions
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Summary
County staff told commissioners that a 2024 law and new jail medical provider have reduced outside hospital visits, cut HIV medication costs and produced multi‑million dollar savings; officials described a new discharge-planner position to help reduce recidivism.
St. Lucie County officials updated the Board of County Commissioners on initiatives to rein in rising inmate medical costs and improve care inside the county jail.
County staff said the county pursued three strategies: support for state legislation to cap provider payments, taking greater operational control of inmate medical services, and a local partnership to lower HIV medication costs. "One of the initiatives was to pursue legislation to cap payments to inmate medical providers that would be limited to 110% of the Medicare reimbursement amount," Special Projects Manager Alice Sennott told the board, referring to House Bill 1023.
The nut graf: county presenters said the combined steps have significantly reduced outside hospital trips and produced measurable savings. Sennott said House Bill 1023, which was signed into law May 16, 2024, saved St. Lucie County about $3,000,000 in fiscal 2024 and about $1,800,000 so far in fiscal 2025; staff estimated additional savings of roughly $500,000 tied to the HIV medication initiative.
County staff provided more detail on how the savings were achieved and on operational changes. The county recently contracted with a new medical provider, NAF Care, which staff said can treat more conditions inside the jail and so reduces emergency-room send-outs. "With our new medical provider, we are also seeing better patient care in the jail and quicker turnaround for inmate sick calls," Rick Carmona, Special Projects Assistant Manager, said. Staff reported reductions in hospital spending ranging from about 60% to 75% depending on the outside provider.
Staff also described a new discharge-planner position added as part of the provider change. The discharge planner focuses on inmates who are homeless or have substance‑use histories and coordinates "warm handoffs" to community partners for housing, counseling and job assistance; staff said roughly 35–40 inmates have received placement help since the new provider began and that none of those known to staff had returned to jail so far. Frank Mander, director for criminal justice, said the position aims to reduce recidivism by connecting released people to services so they do not return to jail for medical care or basic needs.
Commissioners praised the work and emphasized the partnership with state legislators. Commissioner remarks singled out Representative Dana Trabulsy for helping to pass HB 1023. Commissioners also asked about long‑term results and whether the savings will persist; staff cautioned that medical claims may take two to six months to post and said a fuller accounting for fiscal 2025 will be available later in the year.
County staff did not propose a board vote on further policy changes at the meeting, and no formal action was taken.
