Memorandum
Date: March 17, 2026
To: The Honorable Lake County Board of Supervisors
From: Susan Parker, County Administrative Officer
Stephen L. Carter, Jr., Assistant County Administrative Officer
Matthew Rothstein, Chief Deputy County Administrative Officer
Subject: Adopt Memorandum of Understanding (MOU) with the Golden State Finance Authority (GSFA) to provide cost reimbursement for participation in a regional Jail Medical Care Feasibility Study focused on evaluating long-term, sustainable alternatives for jail medical service delivery, and Authorize the Chair to sign
Executive Summary:
On September 18, 2025, County Administration signed and submitted a letter of formal request to be included in the Feasibility Study on long-term alternative for Jail Medical Care Request for Proposal. The Administrative Office met with Health Services, the Sheriff's Office, and Behavioral Health before submitting the letter of formal request.
Counties throughout California are increasingly challenged by the rising cost and complexity of providing legally required medical care to individuals housed in county jails. Many face persistent staffing shortages, escalating contract and litigation costs, and increasing difficulty maintaining compliance with state and national care standards. These challenges are particularly pronounced in rural and mid-sized counties, where limited scale, geographic constraints, and workforce availability create additional barriers to service delivery.
Publicly available data and county experience indicate that contract costs for jail medical services have increased significantly from one contract period to the next, often alongside expanded regulatory requirements and heightened expectations for specialty and behavioral health care. At the same time, chronic workforce shortages have contributed to increased reliance on contract-based service models and temporary staffing arrangements, which can create operational instability and additio...
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