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Pima County extends NAF Care jail health contract while staff map path to in-house services
Summary
The Board of Supervisors voted 5-0 to extend NAF Care’s correctional health contract through Sept. 30, 2027, while directing staff to prepare monthly transition work and liability analyses to evaluate bringing medical and behavioral-health care in-house.
The Pima County Board of Supervisors voted 5-0 on Sept. 16 to extend a contract with NAF Care Inc. for correctional health services and ordered staff to develop a plan and timeline to evaluate bringing those services back under county control.
The agreement authorizes up to $53,763,925.33 to cover medical and behavioral-health care in county detention facilities through Sept. 30, 2027. Chair Scott moved the item and Supervisor Allen seconded; the motion passed unanimously.
Board members said they support a careful, time‑bound evaluation of a transition to county-operated correctional health rather than an immediate change. Supervisor Hines said she wants an in‑house system, ideally in 12 months, and asked staff to pursue the fastest safe path. Administrator Jan Lehi and department staff said they are preparing a step‑by‑step roadmap and will meet monthly to evaluate liability, staffing and accreditation issues.
Deputy and county staff described the practical obstacles to a rapid transition: current county self‑insurance does not cover correctional medicine, some clinical malpractice claims historically relate to correctional care, and staffing correctional medicine requires retention incentives used by other counties. County staff told the board they had met with Maricopa County counterparts and with risk-management staff and that Navcare (the current contractor) has agreed to participate in a non‑disruptive transition plan should the county decide to move services in‑house.
Supervisor Allen asked whether the contract contains new provisions aimed at reducing risks tied to mortality and serious incidents in the jail. County staff said operational changes over the past two years — for example, altered intake assumptions and closer monitoring for overdoses and suicide risk — have reduced preventable deaths and that staffing stability and operational practices (not new contractual penalties) account for much of the improvement. Staff acknowledged more work is needed to codify practices and the board asked for recommendations and timelines.
Supervisor Cano requested clarity that the board has not yet decided to bring services in‑house, only that it wanted a plan for board consideration. Administrator Lehi confirmed staff will return with recommendations and options, including hybrid models. The contract contains a 120‑day notice provision; staff said Navcare agreed to produce a transition plan within 30 days of notice and a fuller plan within 90 days to minimize service interruption.
The board made no policy decision to transfer operations at this meeting; it approved the contract extension with direction for monthly status updates from staff on liability, accreditation, staffing, and transition feasibility. The item passed 5-0.
Ending — County staff said they will provide monthly briefings on the transition effort, and return with a recommended roadmap for the board to act on if members choose to proceed with partial or full in‑house provision of correctional health.
