County discusses telemedicine contract to reduce jail emergency-room visits, no action taken

County officials and the sheriff's office discussed a proposed inmate medical services contract that would provide telemedicine, on-site lab work and mobile x-ray to reduce emergency-room transports and county liability. The court did not vote on the proposal; members asked staff to return with written proposals and precise budget figures for a follow-up meeting.

The proposal described by sheriff’s staff and the county’s chief deputy would place custody nurses on a contractor’s payroll, allow telehealth consultations when nurses are uncertain about care decisions, and provide on-site lab draws and mobile x-ray services. County staff said the vendor would assume medical liability under the contract and that the arrangement could reduce overtime and deputy time spent accompanying inmates to off-site care.

Chief Deputy Robert Waldrop explained the telemedicine element in the meeting: "So they do the telehealth... so that way, they're able to observe the inmate and say, 'okay, this'll be okay, but tomorrow they need to go see the doctor,'" Waldrop said, describing how remote clinicians could triage care and limit unnecessary emergency-room transports.

Staff told the court the current local physician capacity is limited; one local provider has about two openings per month while the jail serves more than 100 inmates, making same-day in-person care difficult. The contract under discussion includes prescription management to lower drug costs, lab work performed on-site (with contractor-supplied technicians or training of local staff), and a mobile x-ray unit that could perform imaging at the jail rather than transporting inmates.

County staff acknowledged the vendor’s proposed annual price exceeds the current budget but said net savings could accrue from reduced emergency-room bills, fewer deputy hours spent on transports, and removal of fringe-benefit cost for nurses who would move to the contractor's payroll. The auditor and sheriff’s office were asked to run detailed numbers comparing the county’s current outlays (including inmate ER costs, deputy hours and nurse payroll) to the contractor’s proposal.

Ending: The court agreed to place the item on the next meeting agenda as an action item after staff provide the written proposal and reconciled budget figures. No contract was authorized at this meeting.