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SLO County to outsource jail health care 

San Luis Obispo County is turning to the private sector in a bid to improve medical and mental health services to its jail inmates.

The SLO County Board of Supervisors voted unanimously on Sept. 18 to move forward with plans to outsource health services at the SLO County Jail. The vote allows county staff to begin contract negotiations with an undisclosed vendor to provide those services in the jail instead of staff from the county's Sheriff's Office and Health Agency.

"This is a significant change in county business," SLO County Sheriff Ian Parkinson told the board. "It is simply going to give us the ability to deliver more for inmates and more for their transition back to the community."

click to enlarge CARE BEHIND BARS The SLO County Jail will seek an outside contractor to provide medical and mental health services to inmates. The decision comes after the jail opened up a new medical clinic to treat inmates. - FILE PHOTO BY CHRIS MCGUINNESS
  • File Photo By Chris Mcguinness
  • CARE BEHIND BARS The SLO County Jail will seek an outside contractor to provide medical and mental health services to inmates. The decision comes after the jail opened up a new medical clinic to treat inmates.

The recommendation to contract those services was made by an executive committee after studying the pros and cons of outsourcing health services at the jail as opposed to continuing them though the county. SLO County Chief Jail Medical Officer Dr. Christy Mulkerin said that hiring an outside contractor would allow the jail to bring its inmate care up to levels that meet national standards more quickly, as well as help address problems with staffing, recruitment, and retention of medical personnel at the jail.

"SLO has not had a robust county health care system that can support a jail health care system," she said.

Contracting a private company will also be cheaper, according to county staff. They estimated that outsourcing jail health care would cost up to $6.3 million, while keeping it in-house would cost about $9 million. A staff report also stated that outsourcing the jail's health services would result in the loss of jobs for some of the 24 county employees who currently provide care to inmates at the jail, including correctional nurses. The board approved spending an additional $250,000 on a retention incentive program to minimize disruption in staff during the transition.

"This is a program that can achieve better results and better patient health care at a lesser cost to the county and lessen our liability," said 4th District Supervisor Lynn Compton. "I don't see a downside."

The decision to contract out jail health services is one of several reforms that the county has tried to implement after a spate of inmate deaths raised public outcry and sparked a civil rights investigation by the FBI. Since 2000, 21 inmates have died in the jail. The families of some of those deceased inmates have claimed that some of those deaths were the result of inadequate medical or mental health treatment. Carty Holland, whose son Andrew died in the jail in 2017, told the board that he had "mixed emotions" about the move to privatize inmate care. As a result of the death, the county paid a $5 million settlement to the Holland family.

"We've had some real tragedies for a long time," Holland said. "How can we assure that's not going to happen with the outsourcing team?"

Mulkerin, members of the board, and other county staff agreed that outsourcing was not a cure-all for the jail's problems, but characterized the decision as just one of several steps the county was taking to improve inmate care.

"I think its important to remember that it does not absolve the county of any responsibility of taking care of its community members," Mulkerin said.

Just which company will end up providing health care services at the jail remains unknown. County Counsel Rita Neal said that multiple companies responded to a request for proposal released in March. A selection committee has already identified a top candidate, but both she and Mulkerin declined to divulge the company's name, citing the pending contract negotiations. Neal said it could be "several months" before county staff would return to the board with a contract for approval. Mulkerin estimated that it would take about six months for the county to fully implement a contractor at the jail. Δ

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