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County asks for $1.02M to cover jail medical and food contract overruns as inmate needs surge
Summary
County staff requested an additional $880,000 for inmate off‑site medical costs and $140,000 for jail food services after average daily population rose and off‑site medical events per inmate increased. NavCare and sheriff’s staff cited rising patient acuity, safekeeper expenses, and single high‑cost hospitalizations as the main drivers.
Precise County staff told commissioners on May 4 they need to appropriate $1.02 million in FY26 fund balance to cover contract shortfalls for inmate medical services and jail food. The county asked for $880,000 to address NavCare off‑site medical overages and $140,000 for Aramark food‑service overages, citing higher average daily population (ADP), growing medical acuity among inmates and rising community health costs.
The county’s presentation showed off‑site medical invoices have risen sharply year‑over‑year; staff reported average monthly medical invoices increased by roughly 151% compared with last year and local off‑site costs increased by more than 110%. NavCare Chief Operating Officer Byron Harrison said both the number of inmates and the number of off‑site events per inmate have grown: “We have three more months left [in the year]…there were 67 off‑site visits per ADP in 2024 compared to 87 off‑site visits per ADP in 2026,” he said.
Harrison and county staff identified several compounding drivers: a higher ADP (staff cited a roughly 13% increase since 2024), longer lengths of stay tied to court delays, higher patient acuity (chronic care patients rose from 1,232 to 1,961 in first‑quarter comparisons), and increased safekeeper costs for inmates housed by the state’s safekeeper program. County staff noted that a few very high‑cost, long hospitalizations can materially change annual projections — one recent extended hospitalization generated nearly a $300,000 bill before contractual adjustments.
NavCare outlined cost‑control strategies already in use: on‑site nursing 24/7 with mid‑level providers on weekday daytime shifts, StatCare telemedicine, a virtual emergency‑department service (roughly $120 per encounter) to triage potential transports, utilization review through corporate specialty clinicians, and Medicaid/ACA enrollment assistance when feasible. Commissioners asked for more data on safekeeper utilization and for continued coordination with the judicial system and courts about pretrial strategies that affect ADP.
County staff said the requested appropriation is necessary to remain compliant with statutory obligations to provide medical care and three meals per day to inmates and to avoid legal and financial risk. The board will consider the budget ordinance amendments on the consent/regular agenda.
