Title
Sheriff's Office recommending the Board:
1) Make findings in accordance with County Ordinance 3.13.030(b) that the California Advancing and Innovation Medi-Cal (CalAIM) planning, billing and staffing services provided by the California Forensic Medical Group, Inc. (CFMG) are in the best interest of the public and that there are specialty skills, qualifications, and equipment not expressly identified in County classifications involved in the performance of the work;
2) Make findings in accordance with Procurement Policy C-17 Section 3.4.2.f to exempt Agreement for Services 10233 from the competitive bidding process because the continuity of providers will provide efficiency or critical knowledge, and other providers cannot provide similar efficiencies or critical knowledge;
3) Approve and authorize the Chair to sign Agreement 10233 with CFMG, to provide CalAIM planning, billing and staffing services with an initial term effective upon execution through December 31, 2029, with automatic one-year renewals, in the monthly amount of $78,934 plus 8% of the total sum of monies collected from Medi-Cal for the initial term; and
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 10233, contingent upon approval by County Counsel and Risk Management, which do not increase compensation or the term of the Agreement.
FUNDING: Inmate Trust Fund and Medi-Cal Revenue.
Body
DISCUSSION / BACKGROUND
The CalAIM Initiative is a statewide effort to improve health outcomes, reduce health disparities, and create a more coordinated system of care for Medi-Cal beneficiaries, including justice-involved individuals. As part of CalAIM implementation, counties are expanding access to services for incarcerated individuals prior to release and strengthening coordination of behavioral health, medical, and community-based services.
To support these efforts, the Sheriff's Office is seeking approval to add staffing necessary to implement and administer CalAIM-related services within the jail setting. One of the proposed positions will focus on providing or coordinating Substance Use Disorder (SUD) treatment services for incarcerated individuals, helping address treatment needs, support recovery planning, and improve continuity of care upon release. This position will play an important role in connecting eligible individuals to appropriate treatment interventions and reentry resources.
In addition, the proposed staffing will support Medi-Cal billing, documentation, and administrative processes associated with CalAIM-covered services. Since CalAIM implementation includes reimbursement opportunities for eligible services provided to justice-involved individuals, adequate staffing is needed to ensure services are documented appropriately, billing requirements are met, and the County is positioned to maximize available Medi-Cal funding. These functions are critical to maintaining compliance with CalAIM requirements and supporting the long-term sustainability of the program.
Approval of this staffing request will strengthen the County's ability to provide timely and appropriate care to incarcerated individuals, support treatment and reentry outcomes, and ensure the Sheriff's Office can effectively implement CalAIM program requirements while pursuing available reimbursement for eligible services. Additionally, approval is being sought at this time to formalize and ratify actions already taken to begin implementing CalAIM-related services and associated staffing needs. Retroactive approval will allow the County to align these efforts to ensure eligibility for reimbursement and maintain compliance with CalAIM program requirements moving forward.
Given that CFMG is the County’s current provider of Jail Medical Services, staff are recommending this Agreement be exempt from competitive bidding in accordance with Procurement Policy C-17 Section 3.4.2, Sole Source/Single Source due to the procurement being for services where the continuity of providers will provide efficiency or critical knowledge, and other providers of the goods cannot provide similar efficiencies or critical knowledge.
ALTERNATIVES
The Board could choose not to approve this, but it would limit the Sheriff's Office's ability to fully implement CalAIM services, reduce capacity to provide SUD treatment support to eligible incarcerated individuals, and hinder the County's ability to complete Medi-Cal billing and reimbursement activities associated with the program.
PRIOR BOARD ACTION
Legistar file 25-0618 - April 22, 2025 - The Board approved Agreement 9411 with CFMG, to provide California Advancing and Innovation Medi-Cal planning and implementation consulting services for the term of three years upon execution and with an amount not to exceed $350,000.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel and Risk Management have reviewed and approved the Agreement.
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
The Agreement will be paid by the Inmate Trust Fund and Medi-Cal revenue. There will be no impact to Net County Cost.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Please return a fully executed Agreement to the Sheriff’s Office for processing.
STRATEGIC PLAN COMPONENT
N/A
CONTACT
Undersheriff Eric Palmberg