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Sheriff outlines rising medical contract costs; committee to explore in-house or contractor options
Summary
Sheriff's office reported steep proposed increases from Advanced Correctional Healthcare and presented in-house alternative using a nurse practitioner at an estimated $70,000 plus a part-time nurse; the committee asked staff to evaluate liability, payroll/contract structure (1099 vs. employee), and insurance implications and reconvene soon.
Sheriff Clay reported that contracted jail medical services from Advanced Correctional Healthcare (ACH) have increased dramatically in recent years and that ACH proposed a 38.8% fee increase at short notice before the new fiscal year.
Clay said the county's average daily jail population has fallen from roughly 55 to about the low 30s, which prompted him to ask ACH to reduce nursing hours from the contract's 32 hours to 20 hours. ACH provided a reduced-price offer but still sought a material rate increase.
Clay and committee members discussed alternatives. Clay said Rock Island County and other jurisdictions have faced similar increases. He reported that Ogle County and Whiteside County operate in-house medical services and that a local nurse practitioner (Marla Van Bickel, named in discussion) indicated willingness to work for the county at approximately a $70,000 annual salary (quoted with "no benefits" in the discussion). The sheriff said one existing nurse currently paid through ACH is willing to be hired by the county, which could yield initial first-year savings of about $20,000 compared with the proposed ACH increase.
Committee members raised liability and insurance concerns and suggested several options to evaluate: in-house county employment, contracting the NP as a 1099 independent contractor, housing the medical staff within the health department, and confirming liability coverage through the county's insurer (SERMA). Jeremy (county administration) and legal/staff said they would explore the insurance and payroll implications, including whether a part-time employee would trigger IMRF or other payroll obligations. Clay said the ACH contract had an original end date of Nov. 30 and is currently month-to-month while the county explores options; Clay said he could begin an in-house model quickly (the NP could start Feb. 24 in his timeline).
Ending: The committee asked staff to analyze costs, liability and payroll implications, including 1099 vs. employee options, and to return with recommendations. No contract termination or immediate procurement decision was made at the meeting.
