LaSalle County officials plan new hospital clearance form to limit jail liability

LaSalle County officials said they will begin pressing local hospitals to complete a new medical-clearance form before the jail accepts arrestees released from emergency departments, a change officials said is intended to reduce county liability and repeated re-admissions.

The proposal came Friday during an Insurance and Trust Committee meeting where a county staff member described repeated cases in which hospitals discharged people back to law enforcement quickly — sometimes minutes after arrival — and the jail later discovered the person needed further medical care. “We get a lot of people that sometimes an officer should take them in and they should probably get admitted to choices and the hospital say well they're going to the jail, the jail will be okay to take care of them,” the staff member said.

The county’s risk-management representative said the new form, which is being circulated to other jails in the state, would require hospital clinicians to attest to whether incarceration is medically appropriate and to identify any medical or monitoring needs that the jail could not meet. “The physician has to put their name on it, it has to be signed off by the hospital,” said Jason Reed, an IPMG representative, adding the form “limits the liability not only for the jail and the employees but also the overall taxpayers of LaSalle County.”

County staffers said the change is not intended to shift care away from hospitals but to ensure that clinicians document that an arrestee is medically cleared for jail conditions before the person is returned. The staff member described a case from about two months ago in which a woman initially treated and cleared by the emergency department later became unconscious in a jail safety cell and had to be flown to a regional hospital. “If we would have had this sheet, they would have had to do a more thorough examination of her instead of just cutting her loose,” the staff member said.

Officials acknowledged the hospitals may resist the requirement. Committee members encouraged staff to meet hospital administrators and emergency-room leaders ahead of implementation to explain the form and reduce surprises. “I don't want it to be a surprise to them,” the staff member said, adding the county plans to provide the paperwork in advance and train officers on how to make sure it is completed correctly.

Committee members also discussed operational and evidentiary measures if a clinician refuses to complete the form: documenting the refusal in incident reports and on body-worn camera and, if necessary, seeking care at a different facility. “As a former police officer I wouldn't be leaving the emergency room with that prisoner if the doctor discarded it and wouldn't give it back,” one committee member said, noting alternatives such as escalating to hospital supervisors or transporting the person to another facility if appropriate.

County representatives said they are coordinating with the county sheriff and risk management and will seek feedback from other counties already using the form before finalizing the local approach. Committee members asked that the presenter return with regular updates; the presenter agreed to do so.

The committee did not take formal action Thursday; members instructed staff to continue discussions with hospitals and to report back to the committee on implementation progress.