‘This is not the county trying to duck responsibility’: Jail medical care to be outsourced

County leaders say a major overhaul to medical care in County Jail by outsourcing through a private company is about improving the quality of inmate care — not just saving money.

After a series of high-profile deaths in County Jail prompted public scorn, passionate pleas from mourning families, expensive lawsuits and costly elections, San Luis Obispo County supervisors unanimously approved the plan Tuesday.

“It’s not about the fact it’s going to cost less or reduce the significant risk to the county. I have evolved to the idea that we will get better results .... better compassionate treatment of our inmates if we go in this direction,” Supervisor Bruce Gibson said.

Department heads say the goal is to improve the level of medical and mental health services to meet National Standards of Jail Health Care Services and become accredited, something that a private company under the direction of the county’s new chief medical officer could accomplish in about six months, instead of the two years it would likely take the county Health Agency.

The transition in the County Jail on Kansas Street is expected to take about six months and result in the elimination of about 24 jobs and elevated services at a lower cost than if done in-house, according to county department leaders who considered the options.

To increase services to the stated goal would cost about $9 million if done by county staff and $6.3 million or less if contracted out. It will also offer the county some cover when confronted with costly litigation.

Carty Holland, father of deceased County Jail inmate Andrew Holland, told the board he had “mixed feelings” about outsourcing and what the jail really needs culture change.

“We’ve had some real tragedies for a long time. How can we assure that’s not going to happen with the outsourcing team? I know it’s going to cost us less and save the county liability, I get that,” Carty Holland said. “Why doesn’t the county (not) just look at reach the national standard, (but look) to be the best ran jail in the state of California?”

He directly addressed Sheriff Ian Parkinson, who manages the jail, saying “ I think you can do that. You have got to look at the root of the problem.”

In January 2017, Andrew Holland died after being left in a restraint chair for 46 straight hours when jail staff determined he posed a safety risk to himself and others.

Since their son’s death, Sharon and Carty Holland became the public faces of a movement to advocate for better treatment of inmates in County Jail, and financially supported an unsuccessful effort to de-seat then-two-term Parkinson and District Attorney Dan Dow.

During all of this, the Health Agency and the Sheriff’s Office promoted changes they’ve made to the system, pointing to the hiring of the jail’s chief medical officer, extensive policy changes, a new medical facility at the jail and plans for a mental-health unit as examples.

Supervisors addressed the concerns of county responsibility and public perception.

“How can we assure the public that this is not the county trying to duck responsibility?” Supervisor Adam Hill asked of the county leaders who recommended outsourcing.

County Counsel Rita Neal said the company would have insurance and indemnification contracts, but outsourcing “will never get us out, nor should it, of the responsibility we have for our inmates.”

“Outsourcing is not the end all solution. There may be some sad outcomes because of the nature of the population the jail serves. We’re just not going to be able to prevent that,” Neal said.

Gibson said he was initially skeptical of the plan.

“We need to demonstrate there is a benefit to inmates and the overall system of care,” Gibson said. “I have my concerns about the profit motive in any kind of medical care.”

Chairman John Peschong agreed, saying “dollar savings cannot be the primary motivator.”

In response to these concerns, Parkinson called outsourcing “a significant change in county business” and something that he first brought up nearly five years ago, when sheriffs across the state began to see larger jail populations with higher medical needs after realignment transferred the responsibility of housing some inmates from state prison to county jail.

All surrounding counties outsource their medical and mental health services, and have done so for at least five years.

“We saw a difference between inmates sentenced one year and 12 years. That’s a whole different level of care,” Parkinson said, adding that he “didn’t take over this job to be in charge of health care.”

“Responsibility, I gladly take; that has never been a concern for me,” Parkinson said. “Security and safety of everybody has got to be number one.”

County staff plan to begin negotiating a contract with a company that has not yet been publicly identified.

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