Commissioners approve fund‑balance appropriation to cover jail medical shortfall after sheriff’s presentation

The Person County Board of Commissioners on March 17 approved a fund‑balance appropriation (referred to in staff materials as “option 2”) to cover an overage in the detention center’s inmate medical account and to meet remaining contract payments through the end of the fiscal year.

Chief Deputy Mark Massey and jail administrators told the board that the sheriff’s detention medical line has run consistent deficits in recent years because a small number of high‑cost cases, long pretrial stays and an increase in inmates with mental‑health and substance‑abuse needs have driven expenses well above the budgeted amount. Staff said an adopted policy implemented in August 2024 to enroll eligible inmates in private insurance under the Affordable Care Act should lower costs over time but that billing lags mean those savings are not yet fully reflected in account balances.

Massey told commissioners that one inmate’s medical bills in the current fiscal year totaled $296,860.83 and that the county faces multiple large bills and contractual balances with Southern Health Partners, which provides nursing and medical contract management for the jail. In his presentation staff listed a set of figures: $595,765.93 in medical bills owed to Southern Health Partners for service dates from October 2024 into 2025, a remaining Southern Health Partners contract balance of $86,569.75 to cover February–June 2025, and projected additional safekeeping and medical expenses if current trends continue. Staff’s consolidated “finish‑out” figure presented to the board for the fiscal year was $995,857.96; staff also discussed a recommended Option 2 to appropriate approximately $1,000,000 in fund balance to ensure the public‑safety function has sufficient funds available through June 30, 2025.

Massey said the sheriff’s office implemented a new intake process beginning August 2024 to verify insurance eligibility and enroll inmates with a private plan through an outside vendor, Health Plan Freedom. He told the board that the vendor reported about 98% of the county’s inmates are expected to qualify for private coverage or enrollment assistance in the local insurance market; in such cases insurance would cover most costs and the county would be responsible only for any inmate out‑of‑pocket amounts while in custody.

County finance staff told the board that in prior fiscal years the jail medical line was handled through budget amendments and transfers within the public‑safety function, but that the magnitude and timing of bills this year (some for services dating back to 2022) left the county short. Finance staff recommended two options; option 2 was to appropriate approximately $1,000,000 in fund balance to cover the projected shortfall and avoid an audit finding or mid‑year cash shortfall. Finance staff noted any portion of the appropriation not used by year‑end would revert to fund balance.

Commissioners discussed the budget history and the challenges of projecting jail medical costs. Commissioner concerns included whether the county should budget a larger baseline for inmate medical costs next cycle, how safekeeping and juvenile housing can create unpredictable charges, and how long‑term solutions such as continued insurance enrollment or changes to Medicaid policy could shift costs away from counties.

After discussion the board made a motion to approve option 2. The motion passed on the board’s voice vote; the clerk recorded the motion as approved.

Action details: The board approved a fund‑balance appropriation (option 2) to cover the detention center’s medical contract overages and projected remaining medical expenses through June 30, 2025. Staff reported the total finish‑out request presented was $995,857.96; finance recommended appropriating approximately $1,000,000 from fund balance and returning any unused funds at fiscal year end.

Next steps: County staff said they will continue to track billing cycles, report on realized savings from the insurance‑enrollment policy once bills catch up (staff estimated 3–6 months to see clearer effects), and return to the board with budget‑cycle recommendations for FY26 if ongoing increased demand requires baseline adjustments.