Date:
Tuesday, September 15, 2026 17
To: Board of Supervisors
Title
Improving Care and Achieving Cost Savings by Insourcing Nursing Services at South Region Public Health Center and Polinsky Children's Center (Districts: All)
End
Overview
On November 18, 2025 (21), the Board of Supervisors (Board) established the Ad Hoc Subcommittee on Fiscal Transparency and Accountability (Subcommittee) to review County of San Diego (County) contracts with the goal of reducing costs, enhancing revenue, and improving service delivery quality.
One key responsibility of the Subcommittee is to assess whether certain contracted services could be performed more efficiently or cost-effectively by County staff. In support of this effort, the Health and Human Services Agency (HHSA) conducted a comprehensive review of all service contracts, focusing on identifying opportunities to transition services currently performed by contracted providers to a model where the services are provided directly by County staff.
As a result of the assessment, HHSA identified two service contracts with strong potential for insourcing. Both contracts are primarily for nursing services provided in County facilities. Transitioning these services in-house is expected to raise the standard of care for the children and residents these programs serve, placing clinical staff under direct County oversight, training, and accountability, while strengthening continuity of care for vulnerable populations. This transition also brings added fiscal benefits, generating cost savings and operational efficiency by right-sizing service needs, leveraging existing County positions, and enabling the County to bill Medi-Cal and other payers for eligible services, creating new revenue opportunities to offset costs.
To ensure meaningful public engagement throughout this process and to understand the needs and priorities of the community, three Subcommittee meetings were held on March 18, 2026, April 13, 2026, ...
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