San Luis Obispo County supervisors vote to outsource jail health services

Posted at 7:55 PM, Sep 18, 2018
and last updated 2018-09-18 22:55:47-04

The San Luis Obispo County Board of Supervisors on Tuesday unanimously gave the green light to outsource jail medical and mental health services.

The board was presented with two options:

  1. Grow what many call a broken county-run jail healthcare system
  2. Hire a private company that specializes in health care for inmates.

Supervisors chose the latter.

The healthcare change comes after several inmates died in jail. That includes the high-profile death of Andrew Holland.

Sharon Holland, Andrew’s mother, said for change to happen, the culture at the jail must change.

"I was very impressed and think that this is possibly the way to go. We are just concerned that they jail becomes better,” Holland said.

The chief medical officer outlined the pros and cons for each option:

Pro Con
Expanding County model
  • County employees
  • No contract
  • Invested in community
  • Familiar with population
  • Challenges are known
  • Need to build infrastructure
  • Longer time to accreditation
  • Exceeds budget
  • Difficult staff recruitment and retention
  • Policies need development
  • Established infrastructure and policies
  • Guaranteed shift coverage
  • Faster accreditation
  • Less risk
  • Within budget 
  • Standard in other counties
  • Reduction of County FTE
  • Difficult to predict contract increases
  • Need oversight
  • Difficult to reverse course 

Growing the county’s health care system would invest in the community and county workers but exceeds the board of supervisor’s budget.

On the other hand, outsourcing would stay within the budget and create a sound infrastructure but would be difficult to reverse course. 

Supervisor Bruce Gibson asked for all county health workers to be on the same page when it comes to defining roles.

"On one hand, we have a simple system,” Gibson said. “On the other, we have a more complex system in having a chief medical officer, a chief health officer, behavioral health specialists all working on behalf of the county and the inmates and those roles to me should be crystal clear.”

The newly-hired chief medical officer, Dr. Christy Mulkerin, is hopeful the county is moving in the right direction.

"Tomorrow is to start working with staff in regards to where they want to start working in their next position,” said Dr. Mulkerin. “Do they want to start with the jail and the contractor or do they want to take a different job with the county?"

Twenty-four county employees could lose their jobs but according to the report, some staff members will be offered positions with the new contractor.

The next step is writing up a contract.

The county health department has identified the company they want to hire but is keeping that name confidential for now.

The report looked at jail healthcare across the state. Out of the 26 California counties similar to the size of SLO County, 21 outsourced jail healthcare.