To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Amendment/Extension #23-877-2 with Aliados Health
Recommendation: Recommendation of the County Administrator
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Amendment/Extension #23-877-2 with Aliados Health, a non-profit corporation, effective November 30, 2026, to increase the payment limit by $633,334, from $1,900,000 to a new total payment limit of $2,533,334 and extend the termination date to March 31, 2027 to continue providing basic primary care medical services to low income, uninsured individuals over age 19 residing in Contra Costa County who are ineligible for Medi-Cal, Covered California, or any other health insurance coverage.
FISCAL IMPACT:
Approval of this amendment will result in additional expenditures of $633,334 in FY 26/27. These costs will be funded 100% by County General Fund.
BACKGROUND:
The County’s Health Services Department administers a program to provide basic primary care medical services to low-income, uninsured adults who do not qualify for Medi-Cal, Covered California, or other health insurance options. This program addresses a persistent gap in the local healthcare safety net, ensuring that vulnerable residents have access to essential medical care through a network of community-based clinics. Aliados Health, a non-profit corporation, serves as the coordinating entity for this network, which includes multiple federally qualified health centers with a longstanding presence in Contra Costa County. These health centers have demonstrated the capacity to deliver high-quality, culturally competent care to diverse populations, including individuals regardless of citizenship or immigration status. The County’s partnership with Aliados Health leverages this expertise to reach uninsured adults who might otherwise forgo necessary medical services.
The original contract with Aliados Health was established following Board approval on April 15, 2025, with subsequent Board actions expanding the program’s scope and funding to meet increasing community need. On December 16, 2025, the Board allocated additional resources and directed the Health Services Department to continue administering the contract, resulting in the current agreement, Contract #23-877-1, which supports care for an estimated 2,800 uninsured residents at nine community clinics.
Aliados Health was selected for this role based on its unique position as a consortium of community-governed health centers, its established infrastructure, and its proven track record of serving the target population. The organization’s member clinics meet federal quality standards and have demonstrated effective collaboration with the County to ensure continuity of care for uninsured adults. The contract is governed by California Government Code sections 26227 and 31000, which authorize counties to provide services that meet the social needs of residents, and was reviewed by Health Services Personnel to ensure compliance with labor relations requirements.
Ongoing contract monitoring is conducted by the Health Services Department to ensure that performance measures and service quality standards are upheld. The proposed amendment increases the payment limit and extends the contract term to ensure uninterrupted access to primary care for uninsured adults while the County continues to evaluate long‑term strategies for addressing healthcare access gaps.
CONSEQUENCE OF NEGATIVE ACTION:
If the contract extension is not approved, access to basic primary care medical services for low-income, uninsured adults who are ineligible for other health coverage in Contra Costa County will be disrupted, resulting in a lapse of care for this vulnerable population.