Title
Sheriff's Office and Probation Department recommending the Board:
1) Make findings that the provision of health services in the County detention facilities by licensed healthcare professionals trained in correctional medicine provided by Contractor are in the public's best interest and that there are specialty skills and qualifications not expressly identified in County classifications involved in the performance of the work in accordance with El Dorado County Ordinance Code, Chapter 3.13.030(B);
2) Make findings in accordance with Procurement Policy C-17 Section 3.4(3) exempting the competitive bidding process, with Purchasing Agent concurrence, because “competitive bidding would produce no economic benefit to the County” and may result in the lack of continuity in appropriate mandated correctional medical care to detained adults and children in detention facilities in the County of El Dorado;
3) Approve and authorize the Chair to sign retroactive Agreement 8953 with California Forensic Medical Group, Incorporated in the amount of $45,000,000 for medical services for the jail and juvenile detention facilities, for the retroactive term of July 1, 2024 through December 31, 2029; and
4) Authorize the Purchasing Agent to approve any amendments that do not change the amount or the term of the agreement, contingent upon County Counsel approval.
FUNDING: General Fund (91%) and Community Corrections Partnership funds (9%).
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DISCUSSION / BACKGROUND
The El Dorado County Sheriff’s Office and Probation Department require a new contract with CFMG to provide essential medical services for individuals housed in county jails and juvenile detention facilities. The proposed agreement, valued at $45 million over five and a half years, ensures continued access to medical care in compliance with state and federal requirements and includes increases for labor, pharmaceuticals, and regulatory compliance.
The County has a legal and ethical obligation to provide medical services to incarcerated individuals. This contract ensures uninterrupted healthcare services, including emergency care, chronic disease management, mental health support, and medication administration. Pursuant to California Penal Code Section 4011 and California Code of Regulations Title 15, jail and juvenile detention facilities are required to meet specific standards to provide adequate care. The County is responsible for the provision of health care for detained adults and children. These services have been provided via contracts with CFMG since 2005 when County Public Health determined that the provision of medical care to the facilities was more cost effective and better provided by a vendor who specialized in these services.
When originally considered, CFMG was the only active Contractor in California providing licensed healthcare professionals trained in correctional medical care for the provision of healthcare services in County detention facilities. Under Procurement Policy C-17 Section 3.4(3), effective October 20, 2022, and with concurrence from the County Procurement and Contracts Division, it was recommended that competitive bidding “would produce no economic benefit to the County.” Additionally, the potential financial impact from the lack of appropriate, mandated medical care to individuals incarcerated in County jails or the juvenile detention facility outweighed any benefits from conducting the competitive solicitation process. Since that time, other providers of correctional medical services in California have entered the market but the continuity of service has value that currently outweighs seeking another option for medical care. CFMG did declare Chapter 11 bankruptcy in November 2024 in order to re-organize the business. The County recognizes this presents a risk for the County therefore will be pursuing a Request for Proposal (RFP) for medical services for individuals housed in county jails and juvenile detention facilities. Due to the complexity of preparing and evaluating a RFP, this agreement is recommended for a term of five and a half years to allow time to prepare and process an RFP. The agreement includes termination language in the event that another vendor is selected through the RFP.
CFMG faces ongoing staffing shortages, which have affected their ability to deliver fully on their contractual service levels; therefore, language has been added to Agreement 8953 that provides for the County to seek financial remedy if at any time staffing levels fall below the delivery agreement.
CFMG has in good faith been providing services to the County without a contract since July 1, 2024. Given the nature and complexity of this agreement, delays occurred both by the vendor and the County to ensure legal and regulatory compliance. The renewal of the medical services contract with CFMG is critical for ensuring that each facility remains compliant with regulatory and legal mandates and provides high-quality, comprehensive healthcare services to its inmate and juvenile populations. This will ensure operational continuity and most importantly, protect the health and safety of inmates.
Services provided to the South Lake Tahoe Juvenile Treatment Center are subject to a term of July 1, 2024 through December 31, 2027 with an option to extend the term for one additional two year period.
ALTERNATIVES
No viable alternative recommendations are available without seeking an RFP which would cause further delay. The County jails remain under a Federal Court Decree (York Vs El Dorado County 12/15/1993) to provide correctional medical care 24 hours per day, 7 days per week. Disapproval of Agreement for Services 8953 may result in a gap in correctional medical care in the County of El Dorado and the inability to meet standards pursuant to the California Penal Code Section 4011 and California Code of Regulations Title 15.
PRIOR BOARD ACTION
12/18/2018 Legistar item 18-1793
11/05/2019 Legistar item 19-1576
12/13/2022 Legistar item 22-1449
12/12/2023 Legistar item 23-2162
02/27/2024 Legistar item 24-0305
OTHER DEPARTMENT / AGENCY INVOLVEMENT
County Counsel and Risk Management
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
There is no increase to net county cost for FY 2024-25, the funds are included in each department's FY 2024-25 budget and will be included in future budget requests.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Return one signed Agreement to Sheriff’s Office for distribution.
STRATEGIC PLAN COMPONENT
N/A
CONTACT
Undersheriff Bryan Golmitz
Chief Probation Officer Brian Richart