New Contract for County Jail Medical Services

Written by Neil Farrell

Neil has been a journalist covering the Estero Bay Area for over 27 years. He’s won numerous journalism awards in several different categories over his career.

February 16, 2024

County Supervisors recently approved a 5-year new contract worth $10.5 million a year, for medical services at its three main jails — the Men’s and Women’s Jails and the Honor Farm. Photo Courtesy SLO County

County Supervisors in January approved a new contract for medical services at the County Jail system, extending an existing contract with a contracted firm.

County Sheriff, Ian Parkinson, asked for approval of the contract for a 5-year period with California Forensic Medical Group or Wellpath, “to continue providing comprehensive health care services to incarcerated persons in custody at the County of San Luis Obispo Jail,” reads the Sheriff’s report to Supervisors.

Wellpath’s contract comes after the County went out for bids last August, according to Sheriff Parkinson. The contract, which runs from Feb. 1, 2024 to Jan. 31, 2027, is for over $10.5 million a year, according to the report. The contract length is 3 years, plus two additional 1-year extensions, or 5-years total. The contract also has a 3% a year inflation increase built in.

“The services outlined in the contract,” the Sheriff said, “include medical, behavioral health, and dental care, and are consistent with the national standards of correctional health care as defined by the National Commission on Correctional Health Care [NCCHC]. The contract also includes services for the Jail Based Competency Treatment [JBCT] Program, which is reimbursable by the Department of State Hospitals and is a net neutral cost to the County.”

Outsourcing medical services to inmates started back in 2018, after some high-profile deaths at the Men’s Jail, some of which were due to health problems, as well as citizen concerns and a critical Grand Jury report. So with the public, and especially voters clamoring for better health and mental health care for the incarcerated, the County turned to Wellpath starting in February 2019; and it’s a path that’s’ worked well.

“Under the current Wellpath site leadership,” Sheriff Parkinson said, “the Jail received NCCHC accreditation in October 2022 and continues to remain in compliance with NCCHC standards.”

That first 3-year contract (with two extra years), was amended six times by the County, Sheriff Parkinson said, adding the JBCT Program, and to increase the amount due to high inflation (from 3.6% in 2020 to 4.8% in 2023). Last April the sixth amendment increased the staffing levels. 

It’s a big job and growing because of demand, governmental requirements and changing industry standards.

“The increasing physical and mental health needs of the incarcerated population,” the Sheriff said, “along with ongoing and new mandates, which require increased services in the Jail, have led to increased costs and the need for additional staffing. In order to continue to meet the County’s obligations to provide comprehensive health care services to individuals in custody, the staffing matrix in the new contract has been increased to 40.8 FTE [full time equivalent], which is an increase of 7.0 FTE from the current contract.”

The new hires will include: a Nursing Supervisor, Substance Abuse Counselor, Discharge Planner, Certified Medical Assistant, Licensed Psychiatric Technicians, “and additional monthly hours for the Psychiatrist and Psychiatric Nurse Practitioner/Physician Assistant,” the Sheriff said.

He said the new contract will increase psychiatric care and substance abuse treatment in the jails.

As part of that medical treatment for drug addicts, the Jail is also trying for a grant — along with the Behavioral Health Department — to be able to use injectable treatments to combat opioid addiction, to supplement the treatments available to help those addicted to heroin, methamphetamines and fentanyl.

The JBCT Program is aimed at mentally ill inmates who committed felonies and are “deemed incompetent to stand trial,” the Sheriff said. “Having a JBCT program at the Jail improves care for mentally ill offenders, as they will be offered treatment right away, rather than having to wait for a State Hospital bed to become available, which can often take three months or longer.”

That’s part of the story that happened to Andrew Holland, an Atascadero man who in 2017, while awaiting transfer to the County’s Psychiatric Health Facility, was strapped into a restraint chair at the County Jail and left for nearly 2 days, before he died. The County and Holland’s Family reached a $5 million settlement in his death, money that was used in part to challenge Sheriff Parkinson and District Attorney Dan Dow in the next election (both won re-election).

The Sheriff’s Department and Wellpath are also working on a new program, the “California Advancing and Innovating Medi-Cal” or CalAIM, which must be implemented no later than Sept. 30, 2026, according to the Sheriff.

According to the Department of Health Care Services, CalAIM is a long-term commitment to transform Medi-Cal, making the program more equitable, coordinated and person-centered to help people maximize their health and life trajectory.” (See: www.dhcs.ca.gov/CalAIM for information.)

Once the two sides figure out what resources — operational and administrative — the CalAIM Program will need, Sheriff Parkinson said they would likely come back to Supervisors to amend this new Wellpath contract. But there’s a funding source for that too.

“CalAIM efforts in the Jail,” Sheriff Parkinson said, “will be funded through Providing Access and Transforming Health [PATH] Justice-Involved grants.”

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