The Santa Barbara County Board of Supervisors recently decided to allow the Sheriff’s Office to negotiate a new shorter-term contract with the current jail health care provider, despite voicing concerns about the company’s money troubles and ability to offer quality care.
“Performance is the best indication of future results,” 4th District Supervisor Bob Nelson told the Sun. “The Sheriff’s Department has not done a great job holding Wellpath accountable.”
Since 2017, the Sheriff’s Office has contracted with California Forensic Medical Group (CFMG), often referred to by the name of its umbrella company, Wellpath. In April 2024, the Santa Barbara County grand jury uncovered systemic issues with the health care provider, including persistent staffing vacancies, lack of 24/7 mental health care, insufficient financial oversight of contract-mandated credits for staffing shortages, and significant delays in annual reporting.
At the Jan. 14 Board of Supervisors meeting, the Sheriff’s Office presented an overview of the more than $1 million in credits the county has received since April 2023 for unfilled Wellpath positions. Nelson said that the continual need for reimbursements makes him wary of the company’s ability to comply with a new contract.
“I was the one who had to bring it to their attention and make a big deal about it that we were continuing to pay them for work that they weren’t doing, and for me, that’s pretty offensive,” Nelson told the Sun. “Not only are they not staffing these positions, but they’re cashing the check every month. I don’t think we can really talk about Wellpath’s performance until we make sure that they actually have bodies in the positions.”
Sheriff Bill Brown said that blame for staffing credit and accountability issues in the past belongs to both the Sheriff’s Office and Wellpath, but they have resolved those issues. As part of the presentation to the board, he explained why Wellpath was the most qualified vendor from which they received a proposal.
“Services must be delivered under intense scrutiny and amidst a myriad of legal and health considerations while providing care to an incarcerated population of patients,” Brown told the board. “Correctional health care is, as I said, very specialized in nature, and it must be provided while balancing cost with quality of care. It is for these reasons that we believe the county should continue to contract with Wellpath for our correctional health care services.”
According to Brown, the Sheriff’s Office has worked closely with the Public Health Department and Behavioral Wellness over the past few years to modify the monitoring of Wellpath’s contract. In an email to the Sun, he said that Public Health added two new positions—a correctional health quality care improvement manager and a chief correctional health medical advisor—to ensure better contract compliance.
“These two positions were onboarded in October 2024 and December 2024 and are assisting with contract monitoring to help improve all aspects of care,” he wrote. “They are advisory to the sheriff, reporting regularly to Sheriff’s Office staff, and they help recommend adjustments to policies, procedures, and workflows to increase efficiencies, adherence to the contract, and, ultimately, to improve care.”
Following the presentation given by the Sheriff’s Office, Public Health Director Mouhanad Hammami, presented a rough estimate of what the costs and staffing needs would be in the event that the Public Health Department needed to take over and provide correctional health care.
Hammami told the Sun that while the Public Health Department could manage to take over if needed, it would not be their first choice. Two of the main challenges he noted include difficulty competing with private-sector salaries due to government limits, as well as the logistical and financial burden of running extra 24/7 clinics without the cost efficiencies and centralized operations of a national company.
“From past experience, there are many county-run operations that opted to outsource care because it is the economy of scale,” Hammami said. “When you go with a national company, then you are cutting a lot of your overhead and a lot of the admin costs, so it is more cost-efficient to outsource jail health care than to run it yourself.”
First District Supervisor Roy Lee suggested a potential hybrid situation, where Public Health and Wellpath work together to provide care at the county jails. But according to Sheriff Brown, it would be difficult to “parse out portions of health and mental health care within a closed system.”
Second District Supervisor Laura Capps raised concerns about Wellpath filing for bankruptcy in November 2024, noting that it adds to her hesitation about proceeding with a new contract. Brown explained that the contract would specifically be with CFMG, not Wellpath and that CFMG is not a part of the bankruptcy proceedings.
As a result of the concerns regarding Wellpath’s past performance and the current bankruptcy proceedings, the board unanimously agreed that while the Sheriff’s Office can continue with contract negotiations with the company, the final contract should be for less than five years.
The Sheriff’s Office began negotiations on Jan. 15 and will present a new contract to the Board of Supervisors sometime before Wellpath’s current contract ends on March 31. In his email response to the Sun, Brown noted that they are focused on continuing to “provide quality health care and improve care” for those in custody.
“On balance, and contrary to some of the criticism that has been leveled against these two companies,” Brown wrote, “Wellpath and CFMG have done a good job of providing health and mental health care for inmates in the Santa Barbara County jail system.”
Staff writer Emma Montalbano can be reached at emontalbano@newtimesslo.com.
This article appears in Jan 23 – Feb 2, 2025.