Supervisors weigh $20.4M Medi-Cal gap pilot, $5M sheriff biometric system and no-bid jail work

San Diego County supervisors will be asked Tuesday to spend $20.4 million, mostly from county reserves, on a one-year pilot that would pay for free primary care and benefits outreach for residents expected to lose Medi-Cal under new federal work requirements. The same agenda includes a $5 million Sheriff's Office request for a new biometric identification system and a $10.9 million no-bid change order for work at the San Diego Central Jail.

According to the staff report, $17.6 million of the Safety Net Bridge pilot would come from one-time use of the county's Unlocked Reserves set aside for safety net services. Another $2.15 million would come from one-time social services administrative revenue and $675,000 from existing county funds for staff time.

The plan includes $12.4 million for primary care providers to offer no-cost visits and same-day prescriptions, $6.6 million for Medi-Cal and CalFresh navigation, mostly through nonprofit contracts, and $750,000 for health fairs. About $25.1 million would remain in the safety net reserve.

County staff estimate that starting in March 2027, 68,761 of the 309,939 local Medi-Cal recipients subject to new work and community engagement requirements in the federal law known as H.R. 1 could lose coverage. Staff say the pilot would keep those residents connected to care.

A separate item would loosen rules for County Medical Services, the county's indigent care program. It would end property liens and credit checks. It would also direct staff to keep studying larger expansions, including coverage for people who fail Medi-Cal work requirements and for residents affected by immigration-based Medi-Cal limits. Staff say any expansion would return to the board for funding.

The biometric request is on the consent agenda, where items pass on a single vote unless a supervisor pulls them. Sheriff Kelly Martinez asks the board to authorize a competitive solicitation for an Automated Biometric Identification System. The contract would run five years, with five one-year options and a possible six-month extension.

The system would replace the county's fingerprint identification system, in service since December 2011, which the board letter calls obsolete. The county runs the regional link to Cal-ID, the state Department of Justice fingerprint network, and uses it to identify people booked into jail and to match prints left at crime scenes.

The board approved shopping for a replacement fingerprint system in April 2025. The sheriff's letter says staff then switched to a broader biometric platform because the state and other agencies are moving that way. Such platforms can compare fingerprints, facial images or iris scans. The letter says the county's system "is limited to fingerprints and palm prints" and that "no expansion is planned at this time." It also says the system "retains the capability to enable other modalities should future policy or operational needs require it." The letter does not describe a privacy policy or say whether adding facial recognition would need a new board vote.

No vendor has been chosen. The $5 million would come from the Sheriff Fingerprint ID Trust Fund, which collects a $2 fee on each vehicle registered in the county, not from the general fund. Ongoing license and maintenance costs are estimated at about $1.2 million a year from the same fund.

Another consent item would add one school resource officer for Vista middle schools under the city's law enforcement contract with the Sheriff's Office. First-year costs total $336,945, including $181,595 for salary and benefits and $94,498 for a patrol vehicle. Vista pays those costs. State law bars the county from charging cities for general overhead, so the Sheriff's Office budget would cover the deputy's indirect costs. The letter does not give that amount. The sheriff says the deputy would focus on cannabis and vaping prevention.

The board will also consider an ADT Inc. donation, valued at $41,080, of software that sends alarm-company calls directly into sheriff's dispatch.

The Central Jail item would add $10.86 million in kitchen, ventilation, plumbing and bathroom work to Balfour Beatty Construction's existing contract without competitive bidding, bringing it to $39.38 million. Staff say a second contractor would disrupt jail operations and could put warranties at risk.

Martinez also asks the board to drop a condition, set in March, that the county not be responsible for cost overruns under a new contract with United HealthCare Services, known as AmeriChoice, to process jail inmates' outside medical claims. The sheriff says AmeriChoice does not provide care and would not accept that risk, and that delays could cost the county state reimbursement that became available Oct. 1.

The board adopted the county's $9.16 billion budget on a 5-0 vote June 25. The Sheriff's Office budget rose from $1.375 billion to $1.435 billion, about 4.4%. Authorized positions went from 4,710 to 4,712, with detention staffing down from 2,395 to 2,387. The Public Defender's office grew from 547 to 576 positions.

The same day, the board voted 3-2 to put a half-cent countywide sales tax on the Nov. 3 ballot. It would raise an estimated $400 million to $450 million a year. Supervisors Terra Lawson-Remer, Monica Montgomery Steppe and Paloma Aguirre voted yes. Joel Anderson and Jim Desmond voted no.

The sheriff and county staff, not individual supervisors, brought the items above. Lawson-Remer, the board chair, added a late item to cover taxes on up to $20,000 in moving expenses for County Counsel Damon Brown. Aguirre and Anderson co-sponsored an item on county purchasing contracts.