San Mateo County supervisors are poised to renew a contract with a San Jose facility for prisoners with serious mental illnesses, spending as much as $1.7 million over the next two years on up to two spots in the institution.

Officials say the expense is necessary because they must provide medical care to people in their jail, and there aren't many options for treating inmates who have a major illness. But when supervisors vote on the no-bid contract at their Tuesday meeting, it will come just days after they decided to pull $49 million out of reserves and make $27.3 million in cuts to balance next year's budget.

Jean Fraser, head of the county Health System, said given the specialized nature of the care, the cost isn't excessive. "It's not expensive compared to what a hospital stay costs in most hospitals," she said.

Since 1997, San Mateo County has had a contract with Santa Clara County for prisoners suffering from severe mental illness. The San Mateo County jail isn't equipped to deal with inmates with disorders such as schizophrenia or major depression. The facility in San Jose's main jail provides 24-hour guards and medical staff, individual cells and court hearings for administering forced medication.


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According to a staff report from Fraser and the head of Correctional Health Services, Nomalee Tilman, "Santa Clara County is the only provider of this service in the Bay Area." As a result, they have requested a waiver from the county rule that requires bidding before awarding the contract.

In interviews, however, Fraser and Supervisor Adrienne Tissier said San Francisco also has a facility that handles seriously ill prisoners. But officials there either don't have the space or refuse to rent it out. "We have asked, and they are not interested," Fraser said.

Supervisor Carole Groom said she has no qualms with a no-bid contract as long there are no other similar facilities in the area. Even though the care is highly specialized, the county is required to provide it.

"We are obligated to take care of people who are in our jail -- that is a state law," Groom said. She added supervisors weighed a proposal two years ago to keep the inmates locally, but decided it was too expensive.

The cost of the contract is supposed to come down in the upcoming fiscal year. Over the past two years, the county paid for two beds instead of one.

Next year's price tag breaks down to $1,425 per day, for a total of $1.04 million over two years. However, if the county needs another bed, the cost would be $1,500 per day, or $547,500 for a year. There is another roughly $74,400 in the contract for extra medical expenses.

"I think it's extremely costly, but do we have a choice?" Tissier asked. "I don't think so."

The Board of Supervisors meets at 9 a.m. Tuesday at 400 County Center in Redwood City.

Contact Joshua Melvin at 650-348-4335.