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Commission approves interlocal with sheriff to use indigent trust funds for inmate medical care
Summary
The board approved an interlocal agreement with the sheriff’s office to use indigent trust funds to pay for inmate medical services (10/1/24–9/30/27, annual not‑to‑exceed ~$15.7M), reducing county general‑fund expenditures; vote passed 6–1 after questions about reserves and statutory limits.
The Hillsborough County Board of County Commissioners on Aug. 20 approved an interlocal agreement with the Hillsborough County Sheriff’s Office to use the county’s indigent health‑care trust funds to pay inmate medical services, shifting the expense away from general‑fund dollars.
Kevin Wagner, director of the county’s Health Care Services Department, told commissioners the program aims to provide continuity of care — allowing inmates who qualify for the county health plan to have medical services covered while incarcerated and continued access to medications upon release. Wagner said the county currently funds inmate medical care with approximately $45 million of general‑fund support and that the proposed agreement would be in effect from Oct. 1, 2024, through Sept. 30, 2027, with a 15.7 million annual not‑to‑exceed amount incorporated into the FY25 and proposed FY26 budgets.
Commissioners pressed staff on eligibility rules and statutory authority. Wagner said indigent‑care eligibility is generally limited to county residents with incomes at or below 175% of the poverty level; he also stated the county’s Medicare contribution (the so‑called Medicare gap) would be about $29 million in FY26 and that indigent‑care fund reserves were approximately $493 million as of May 2025. One commissioner cited attorney‑general opinions that raise questions about using surtax proceeds for certain medically poor purposes; the county attorney noted recent statutory amendments that allow counties to repeal or reduce the surtax under certain conditions.
Commissioner Gwen Myers moved approval and Commissioner Cohen seconded; the motion passed 6–1 after a recorded vote. Commissioners asked staff to ensure only eligible individuals who would otherwise qualify for the county plan receive coverage under the program and requested follow‑up briefings on reserve use and statutory compliance.
What’s next: staff will implement the interlocal agreement with the sheriff’s office, monitor eligibility and report back on the program and any impacts to the indigent‑care trust fund.
