County staff told the board on Aug. 12 that the jail medical-services contract will be amended to shift staffing and reduce costs while maintaining clinical coverage.

Nate (county jail staff) explained the recommended amendment would reduce the psychiatric nurse-practitioner position from 1.2 full-time-equivalent (FTE) to 0.5 FTE and add a 1.0-FTE mental-health professional (social worker or nurse) to handle follow-up tasks and screenings. The amendment also lets the contractor substitute two hours of nurse-practitioner/physician-assistant time for one hour of a psychiatrist or physician when needed. The county estimated a contract cost savings of about $41,460.66 over the life of the contract.

“Nobody is losing clinical access,” Nate said. He told the board the psychiatric NP currently averages 14 to 15 hours of direct patient contact weekly and spends substantial time on paperwork and non-clinical follow-ups; shifting some duties to a mental-health professional would increase time available for direct clinical work.

Board members pressed staff about how inmate population affects monthly charges. Michelle, the county finance director, and Nate explained the base contract rate is calculated on 250 inmates; when average daily population exceeds 250, the county pays additional per-diem charges for each day above that threshold. Nate said the contractor contacts and provides at least two medical touches in the first 10 days for each admitted inmate and accepts liability for hospital and external medical runs once a person is accepted under the contract.

The board approved the resolution to amend the contract by unanimous roll call.

Why it matters: The amendment is intended to preserve or expand direct clinical patient time while reducing contract costs. Board members sought clarity on per-diem billing and the interplay between population and invoices.

What’s next: County staff will implement the staffing changes under the amended contract and continue monitoring inmate population and monthly billing.