Unfortunately, there have been a series of deaths in Guilford County jails in recent years – as there have been in jails in other counties across the state. It’s no secret that many inmates don’t arrive in the best of health – some have a history of heavy drug abuse, some are alcoholics, some are malnourished due to a lack of food security and some face other medical issues as well.
It’s inevitable that, from time to time, the conditions in a jail and the medical conditions of the people in jail even lead to death, as anyone who follows the local news knows.
And, just as health costs have been going up for you and me, the same is true of providing health care for inmates in Guilford County’s two jails. Now those costs have gotten to the point where Guilford County Manager Victor Isler, in his new fiscal 2026-2027 budget proposal is recommending that the county add and fund a new Sheriff’s Office position dedicated to overseeing the county’s jail medical services contracts.
The position, which would cost county taxpayers $83,565 a year, is one of 26 new General Fund positions included in Isler’s recommended spending plan for the coming 12 months.
According to the proposed budget, the new employee would be responsible for overseeing the jails’ medical services contract and strengthening the county’s review of inmate medical care costs.
Isler states that the position would focus on “strengthening oversight of care provided for complex and acute medical needs.”
The budget document states that the position would be involved in contract and invoice review and would monitor medical coding associated with inmate medical services.
According to Isler, this is one of those positions that could save the county money in the end: The additional oversight, he states, is expected to improve accountability and generate cost savings for the county over time.
The proposed position comes as the county projects increased costs associated with inmate medical care. In a section of the budget identifying major cost drivers for the coming fiscal year, Isler notes that jail medical services within the Sheriff’s Office require an additional $925,000 in funding for third-party medical treatment and hospitalizations.
The budget specifically lists “jail medical services within the Sheriff’s Office” as requiring increased funding because of those costs.
The recommended budget doesn’t provide a detailed breakdown of the additional medical expenses or explain what portion of the increase is related to hospital visits, specialist care, emergency treatment, or other services. However, the budget does indicate that the county is proposing both additional funding and a dedicated employee to oversee the contracts.
The new jail medical oversight position is one of several additions Isler is recommending across county government this year.
The proposed budget includes new positions in Social Services, Parks and Recreation, Information Technology, the County Attorney’s Office, Public Health, Inspections and the Sheriff’s Office.
Overall, Isler is recommending a General Fund budget of $935.5 million for fiscal year 2026- 2027, which represents a 10.4 percent increase over the fiscal year 2025-2026 budget.
In his budget message, Isler said the recommended spending plan attempts to balance service demands, statutory obligations and fiscal responsibility while continuing to invest in county operations.
The Board of Commissioners will review the proposed budget before adopting a final spending plan in mid-June for the fiscal year beginning July 1. On Thursday, June 4, there will be a public hearing on the proposed budget so the county commissioners can hear a final round of public opinion before approving a budget.
And certainly one area likely to receive attention during budget deliberations is the Sheriff’s Office jail medical operation – where Isler’s proposed budget calls for both additional medical spending and a new employee tasked with monitoring the county’s medical services contracts.
