Pitt commissioners grapple over jail medical service

The Pitt County Board of Commissioners has directed Sheriff Paula Dance to produce contract revisions negotiated with the detention center’s health care provider and to produce a request for other proposals to provide the services.

Commissioners voted unanimously to make the request after a contentious discussion with sheriff’s officials on Monday. The debate was a continuation of an issue raised in July when commissioners approved a sheriff’s office request to seek proposals to replace Wellpath.

The company wanted a 22 percent increase in a $3.2 million contract to provide health care services to detention center inmates. Dance told commissioners last month that the request to seek other proposals was a negotiating tactic. She said Monday that Wellpath would agree to provide services for closer to the 5 percent increase as outlined in the contract that expires June 30.

During the public comment period, Dr. Mark Cervi, a physician who provided jail health services from 2001-2021, said Dance should have adhered to the board’s authorization to issue an RFP rather than continue negotiations with Wellpath.

Detention Center Chief Lim Capehart told the board that his agency decided to stick with Wellpath rather than issue an RFP because the sheriff’s office is satisfied with the quality of care provided by Wellpath.

In response to criticism about that care, he said that a nurse practitioner began work on Monday and that a medical director was hired Aug. 12 to work on-site 16 hours a week.

He also said a backlog of sick calls was the result of a “less than favorable” Wellpath employee who “happens to be a really close friend of the previous medical provider.”

In response to questioning by Commissioner Tom Coulson, Capehart said the sheriff’s office did not intend to issue an RFP. Coulson told him it was necessary.

Dance then took the microphone to state that two services — medical and food services — do not require RFPs under general statutes. She said authorization of an RFP was only requested as a “bargaining tool” when WellPath proposed its 22 percent cost increase.

Commissioner Chris Nunnally asked why it would be a bad idea to issue an RFP as Wellpath approaches the end of its contract, calling the eight-month period between now and June 30 a short amount of time to turn around the request.

Dance said she was willing to develop the request but is pleased with the current service. Nunnally said the process felt rushed when a new provider was selected in 2021, but Dance said her team could turn around an RFP in a 90-day window.

Dance also offered what she called a hypothetical. She said if the board overruled her decision to enlist Wellpath, the jail could call county EMS teams to administer medical treatment. Coulson said commissioners are trying to ensure health care is provided for inmates and not making threats.

“But what you’re saying is that, ‘Oh, if I don’t want somebody (new) I’ll just call the rescue squad and we’ll run the bill up to $20 million a year because I can do that, because general statutes say I can do that.’ That’s not working with the local board,” Coulson said.

Dance disagreed and said she was merely outlining state law.

Pitt County Manager Janis Gallagher said funds for up to a 5 percent increase for Wellpath were included in the 2024-25 budget cycle. That does not mean that the county must provide the increase, she said.

The sheriff’s office does have the authority to hire the jail’s medical service provider, but the county has the authority to budget for it.

The board voted unanimously that the sheriff’s office provide its contract with Wellpath and an RFP for services effective July 1, 2025, at its Oct. 21 meeting.