Correctional health manager says 24-hour prescribers and increased on-site care now available at Wakom County facilities

Rachel McGarity, the countycorrectional health services manager, told the Incarceration Prevention and Reduction Task Force on April 20 that a December operational change to a single contracted provider has expanded clinical access inside Wakom County detention facilities.

"We now have 24-hour a day on-call prescribers, providers available," McGarity said, describing a shift she said will allow staff to get medications ordered and address acute issues any time someone is booked into custody.

McGarity said on-site provider presence also increased: what had been twice-weekly coverage is now three times weekly, or four times if the county counts its second facility, the work center. Nursing coverage has moved toward near-24-hour staffing with "three nurses during the day and three nurses at night," she said, while acknowledging some overnight vacancies remain as the county finishes the transition to Correctional Healthcare Partners.

The changes aim to shorten delays between booking and first clinical contact, McGarity said, and to reduce lapses in medication access that previously left some people waiting until the next day for a provider. She described a revised re-entry process in which the CHP re-entry team provides in-custody support and hands off post-release follow-up to community partners; the county also added a discharge-coordinator position to enroll people in Medicaid and arrange outpatient appointments.

"Our discharge coordinator is nonclinical," McGarity said in response to questions from public defenders and task force members, noting the coordinator focuses on health-related needs and coordination rather than delivering clinical care. McGarity named Lifeline and Northwest Youth Services as behavioral health partners who perform some in-facility assessments; she also said providers such as Seymar and Unity Care accept new behavioral health referrals that can help ensure continuity after release.

Task force members pressed McGarity on whether people who are discharged will have firm appointments and immediate access to community providers. McGarity said behavioral health appointments are typically scheduled, while some substance-use services operate with open-access models. She said the county aims for "warm handoffs" so that people are not left to self-navigate referrals alone.

While praising the operational changes, McGarity and task force members acknowledged persistent staffing and operational challenges. Chief Corrections Deputy Caleb Ericson, who joined the discussion, urged that intake areas be redesigned to protect privacy and encourage honest screening. McGarity agreed, saying the county's booking flow is "clunky" and that more private, health-focused screening space would improve early identification of urgent needs.

The presentation closed with an invitation for task force members to follow up directly with McGarity for deeper technical questions and to continue coordinating on design choices for the planned facility.