DATE: June 20, 2023
TO: Board of Supervisors
SUBMITTED BY: John Zanoni, Sheriff-Coroner-Public Administrator
Kirk Haynes, Chief Probation Officer
SUBJECT: Amendments to Agreement with California Forensic Medical Group, Incorporated
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment VIII to Agreement with California Forensic Medical Group, Incorporated (CFMG) for jail medical services for the Sheriff-Coroner-Public Administrator’s Office detention facilities, extending the term by three months, commencing on July 1, 2023 to September 30, 2023, with an optional 3 month extension, and increasing the maximum by $16,358,514 to a total of $159,009,127; and
2. Approve and authorize the Chairman to execute Amendment I to Service Agreement with CFMG for comprehensive medical and behavioral health care services to youth at the County Probation Department Juvenile Justice Campus, extending the term by three months, commencing on July 1, 2023 to September 30, 2023, with an optional 3 month extension, and increasing the maximum by $1,806,996 to a total of $18,854,547.
REPORT
There is additional Net County Cost associated with the recommended actions. Approval of the recommended actions will allow for CFMG to extend the jail and Juvenile Justice Campus medical and behavioral health care agreements for an additional three months, with an optional three-month extension. Approval of the recommended actions will allow sufficient time to negotiate and develop a new five-year agreement for jail medical services. This item is countywide.
ALTERNATIVE ACTION(S):
There is no practical alternative under the circumstances. If the recommended actions are not approved, the Sheriff’s Office and Probation Department will be without a jail and Juvenile Justice Campus medical and behavioral health care agreement.
FISCAL IMPACT:
There is no additional Net County Cost associated with the recommended actions. The Sheriff’s Office and Probation Department will have sufficient appropriations included in their respective FY 2023-24 budget requests.
Approval of the first recommended action will increase the Sheriff’s agreement maximum by $16,358,514, for a total of $159,009,127. Approval of the second recommended action will increase Probation’s agreement maximum by $1,806,996, for a total of $18,854,547.
DISCUSSION:
On April 3, 2018, the Board approved Agreement No. A-18-169 and A-18-170 with CFMG, to provide medical and behavioral health care services to the adult incarcerated individuals detained in the County Sheriff Adult Detention Facilities identified as North Annex, Main, and South Annex Jails (Jail) as well as youth at the Juvenile Justice Campus.
On April 28, 2020, the Board approved Amendment I to Agreement No. A-18-169-1 with CFMG to allow the Sheriff’s Office to approve pre-payments and accept a 1% discount for the months of May, June, July, and August of 2020.
On August 4, 2020, the Board approved Amendment II to Agreement No. A-18-169-2 with CFMG for additional temporary staffing from July 16, 2020 to December 30, 2020 for medical services to address the need for testing and treatment(s) for jail inmates due to the COVID-19 pandemic and the ongoing spread of COVID-19 in the Jail.
On March 23, 2021, the Board approved Amendment III to Agreement No. A-18-169-3 with CFMG to increase the maximum compensation provided under the Agreement by $5,261,182, to a total of $129,627,204, to pay for an additional six months of COVID-19 testing and treatment(s) for jail inmates due to the COVID-19 pandemic (January 1, 2021, to June 30, 2021), and provide for pharmaceutical costs.
On February 1, 2022, the Board approved Amendment IV to Agreement No. A-22-038 with CFMG to increase the maximum compensation provided under the Agreement by $120,000, to a total of $129,747,205 to pay for a Medication Assisted Treatment (MAT) Care Coordinator to identify Opioid Use Disorder (OUD) inmates upon intake and enroll them in MAT services while incarcerated in the Fresno County Jail.
On March 22, 2022, the Board approved Amendment V to Agreement No. A-22-094 with CFMG to increase the maximum compensation provided under the Agreement by $6,702,382 to a total of $136,449,588 to pay for an additional twelve months (July 1, 2022, to June 30, 2023) of COVID-19 testing and treatment(s) for jail inmates and pay COVID-19 related pharmaceutical and congregate living costs, with no change to the term of July 1, 2018, to June 30, 2023.
On November 29, 2022 the Board approved Amendment VI to Agreement No. A-22-528 with CFMG to increase the maximum compensation provided under the Agreement by $6,147,900 to a total of $142,597,488 to continue to provide COVID-19 testing and treatment through June 30, 2023, provide reimbursement for COVID-19 related pharmaceutical costs in excess of the pharmaceutical cap discussed in Section VI of the Agreement, and allow for the reimbursement of COVID-19 related staffing and treatment of inmates within the congregate living system. Due to the Omicron variant surge, services related to detection and treatment of COVID-19 were not being reduced, and staff estimated there would be an additional cost of $6,147,900 for the remainder of FY 2022-23.
On May 23, 2023 (retroactive to February 1, 2023) the Board approved Amendment VII to Agreement No. A-22-528 with CFMG to increase the maximum compensation provided under the Agreement by $53,125 to a total of $142,650,613 to extend funding to pay for a MAT Care Coordinator to identify OUD inmates upon intake and enroll them in MAT services while incarcerated in the Fresno County Jail.
Approval of the first recommended action will approve an increase to Agreement A-22-528, maximum for CFMG to pay for the additional three-month term with an optional three-month extension for jail medical and behavioral health care services.
Approval of the second recommended action will approve an increase to the agreement, A-18-170, maximum for CFMG to pay for the additional three-month term with an optional three-month extension for comprehensive medical and behavioral health care services to youth at the County Probation Department Juvenile Justice Campus.
Both recommended amendments provide that despite entering into the amendments, the County may still terminate negotiations with CFMG and engage in a competitive request for proposal process, in accordance with the County’s purchasing procedures.
REFERENCE MATERIAL:
BAI #22 May 23, 2023
BAI #25 November 29, 2022
BAI #35 March 22, 2022
BAI #16 February 1, 2022
BAI #23 March 23, 2021
BAI #5, August 4, 2020
BAI #30.1, April 28, 2020
BAI #8.1, April 3, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment VIII to Agreement with CFMG (Jail)
On file with Clerk - Amendment I to Agreement with CFMG (JJC)
CAO ANALYST:
Fine Nai