MEDICAL DIRECTOR - DETENTION CENTER - 40011425

Medical Director Detention Center

The Medical Director Detention Center serves as the highest-ranking medical authority within the Durham County Detention Facility. This position provides comprehensive medical leadership, oversight, and direction for all clinical, behavioral health, and substance use disorder services delivered to adults housed in a 736 bed detention environment. The Medical Director ensures that all medical, mental health, and substance use treatment practices are evidence-based, patient-centered, compliant with applicable laws and accredited standards, and aligned with constitutional and statutory requirements for inmate care. The position reports administratively to the Sheriff and receives clinical guidance from the Public Health Director regarding standards of medical practice and system-wide clinical objectives.

Daily medical operations and treatment decisions are delivered by contracted medical and behavioral health vendors; however, the Medical Director provides oversight, ensures compliance and quality assurance, reviews complex or high-risk clinical cases, and directly delivers care when vendor capacity is unavailable. This role is critical to maintaining accreditation through the National Commission on Correctional Health Care (NCCHC), the American Correctional Association (ACA), and compliance with Substance Abuse and Mental Health Services Administration (SAMHSA) regulations for the Sheriff's Medication Assisted and Rehabilitation Treatment (SMART) Program and the Opioid Treatment Program (OTP).

The essential functions listed below are those that represent the majority of the time spent working in this position. Management may assign additional functions related to the type of work of the position as necessary.

• Establishes, implements, and oversees systems to ensure provider competency in primary, urgent, chronic, psychiatric, and emergent care.
• Develops and maintains an ongoing quality improvement program to evaluate, monitor, and enhance clinical effectiveness, patient outcomes, compliance, and service delivery.
• Reviews medical records, clinical documentation, treatment plans, and testing results; identifies performance gaps and implements corrective actions.
• Conducts quarterly reviews of detainee medical grievances and resolves grievance appeals; identifies trends and reports systemic issues to the Sheriff and Public Health Director.
• Reviews monthly, quarterly, and annual vendor reportsincluding billing, cost trends, utilization, and patient outcomesto ensure contract compliance and identify program needs.
• Ensures full compliance with Care NCCHC, ACA, state and federal laws, DHHS audits, SAMHSA regulations, and other governing protocols.
• Oversees development, implementation, and monitoring of required policies, procedures, clinical guidelines, and training necessary for maintaining accreditation.
• Directs quality improvement teams and ensures routine audits, corrective action plans, and follow-up reviews are completed.
• Reviews and updates the Detention Facility Medical Plan annually.
• Provides medical care when vendor capacity is unavailable, including evaluations, treatment decisions, reviewing transfers, and coordinating higher levels of care.
• Reviews all inpatient hospitalizations and all in-custody deaths or suicides to determine whether professional standards of care were met and whether corrective actions are required.
• Collaborates with detention command staff on housing and security-related medical decisions, including pod assignments, cell placement, and safekeeping determinations.
• Coordinates with contracted vendors and specialty providers regarding complex chronic or acute medical cases.
• Supports community reintegration by identifying medical providers and ensuring continuity of care upon release.
• Oversees all clinical components of the SMART MAT program and OTP, ensuring compliance with state/federal regulations, SAMHSA directives, and best practices in addiction treatment.
• Coordinates efforts to obtain and maintain OTP certification and state licensure.
• Develops and revises policies, procedures, and training related to MAT, psychiatric emergencies, specialized medications, infectious disease protocols, and harm-reduction strategies.
• Evaluates and selects community addiction treatment partners and monitors quality of care and treatment outcomes.
• Provides collaborative supervision with detention non-medical staff involved in SUD-related operations.
• Reviews CAP reports, vendor billing, cost trends, and inventory to inform budget planning.
• Recommends operational improvements, new initiatives, and resource needs to the Sheriff and Public Health Director.
• Research and evaluates grant opportunities, Medicaid expansion programs, and demonstration waivers that may enhance services.
• Participates in annual and strategic planning for the Detention Facility's medical operations.
• Directly supervises identified County staff; conducts performance evaluations; develops work plans; identifies training needs and monitors staff performance.
• Evaluates contracted vendor performance and provides recommendations to the Sheriff regarding vendor selection, performance concerns, and contract renewals.
• Participates in interviewing and selecting candidates for positions within the medical services unit.
• Responds to after-hours medical emergencies, complex cases, or critical incidents as needed.
• Serves as clinical authority during detainee deaths, suicides, infectious disease outbreaks, or major medical events.

Knowledge, Skills, and Abilities:

• Comprehensive knowledge of preventive, general, emergency, and correctional medicine.
• Thorough knowledge of medical developments, addiction treatment protocols, MAT/OTP standards, and behavioral health integration.
• Considerable knowledge of federal and state regulations, NCCHC and ACA standards, SAMHSA OTP requirements, HIPAA, and public health laws.
• Ability to interpret and apply clinical regulations, medical policies, and accreditation standards.
• Skill in clinical leadership, teaching, and teambuilding; ability to lead interdisciplinary teams.
• Ability to analyze complex medical and operational data and develop effective strategies.
• Ability to communicate complex medical information clearly, orally and in writing.
• Ability to coordinate care for diverse, underserved, and medically complex populations.
• Ability to represent clinical service needs to County leadership and community partners.
• Proficiency with electronic medical records, jail management systems, and data reporting tools.
• Ability to plan, supervise, and evaluate the work of professional and paraprofessional staff.

Minimum Education and Experience Requirements:

• Graduation from an accredited medical school.
• Licensed to practice medicine in the State of North Carolina (or eligibility for licensure upon hire).
• Five (5) years of experience in health services delivery management, including experience with addiction treatment, chronic disease management, and/or correctional health.
• Experience working with diverse and medically complex populations, including behavioral health and substance use disorder treatment.

Physical Demands:

• Performs sedentary work that involves walking or standing some of the time and involves exerting up to 10 pounds of force on a regular and recurring basis or sustained keyboard operations.

Unavoidable Hazards (Work Environment):

• Bodily fluids and infectious diseases.
• Noxious odors and cleaning chemicals.
• Detainees experiencing psychiatric or medical crises.
• Verbal or physical threats and occasional acts of violence.

Special Certifications and Licenses Requirements:

• Active, unrestricted license with the North Carolina Medical Board.
• DEA license (or eligibility to obtain one) for prescribing controlled substances.
• Valid North Carolina driver's license with acceptable three-year driving history.

Standard Clauses:

• May be required to work nights, weekends, holidays and emergencies (man-made or natural) to meet the business needs of Durham County.

Essential Safety Functions:

• It is the responsibility of each employee to comply with established policies, procedures and safe work practices. Each employee must follow safety training and instructions provided by their supervisor. Each employee must also properly wear and maintain all personal protective equipment required for their job. Finally, each employee must immediately report any unsafe work practices or unsafe conditions as well as any on-the-job injury or illnesses. Every manager/supervisor is responsible for enforcing all safety rules and regulations. In addition, they are responsible for ensuring that a safe work environment is maintained, safe work practices are followed and employees are properly trained.

Americans with Disabilities Act Compliance:

• Durham County is an Equal Opportunity Employer. ADA requires Durham County to provide reasonable accommodations to qualified persons with disabilities. Prospective and current employees are encouraged to discuss ADA accommodations with management.

Background Check Statement:

• This position may be subject to a background check, which could include, but is not limited to, criminal history (employment-related and/or

Durham County Government