To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Extension #23-861-3 with Alvarez & Marsal Healthcare Industry Group, LLC
☐Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract Extension #23-861-3 with Alvarez & Marsal Healthcare Industry Group, LLC, a limited liability company, to amend Contract #23-861 (as amended by #23-861-1 and #23-861-2), to extend the termination date from June 30, 2026 to September 30, 2026, to continue providing interim leadership support for essential operational functions within the Health Services Department, including activities aligned with the Chief Operating Officer (COO), with no change in the original payment limit of $8,057,336.
FISCAL IMPACT:
Approval of this Contract Extension will not result in any additional funds. The original contract with a total amount not to exceed $8,057,336 is funded 40% by Hospital Enterprise Fund I and 60% Contra Costa Health Plan Enterprise Fund II.
BACKGROUND:
On September 10, 2024, the Board of Supervisors approved Contract #23-861 with Alvarez & Marsal Healthcare Industry Group, LLC, in an amount not to exceed $6,139,200 to provide interim CFO services, including management of all day-to-day financial operations for the Health Services Department, for the period October 1, 2024 through September 30, 2025. This contract contains special provisions related to indemnification and liability, as follows:
a. The County shall indemnify the Alvarez & Marsal employees acting as officers (Brian Buchanan and Ceci Arriera) to the same extent as the most favorable indemnification it extends to County employees.
b. The County agrees to indemnify and hold harmless each Alvarez & Marsal, its affiliates and their respective shareholders, members, managers, employees, agents, representatives and subcontractors against any and all losses, claims, damages, liabilities, penalties, obligations and expenses, including the costs for counsel or others in investigating, preparing or defending any action or claim, whether or not in connection with litigation in which any Indemnified Party is a party, or enforcing the contract (including these indemnity provisions). This indemnification obligation applies to actions or claims incurred, caused by, relating to, based upon or arising out of (directly or indirectly) Alvarez & Marsal’s performance or nonperformance under the Contract, except for such actions or claims that result primarily and directly from Alvarez & Marsal’s gross negligence or willful misconduct, as determined by a final court judgment.
c. The County acknowledges that Alvarez & Marsal may utilize the services of third-party service providers to assist in performing certain services. Under this contract, the County agrees that no Contractor affiliate, subcontractor, nor their respective partners, principals or employees who perform work under the contract will have any liability to County in connection with the services or this contract.
d. The contract limits Alvarez & Marsal’s total liability to the fees Alvarez & Marsal receives under the contract. Alvarez & Marsal will also not be liable for any special, consequential, incidental or exemplary damages or loss, or any lost profits, savings, or business opportunity.
e. The contract also requires the County to maintain public officials’ errors and omissions liability insurance for Contractor’s personnel performing CFO Duties and Deputy CFO Duties services. Such insurance coverage will be primary coverage to any insurance available to these personnel by Alvarez & Marsal.
f. Lastly, under the contract’s Business Associate Addendum (BAA), Alvarez & Marsal has no obligation to save, hold harmless, or indemnify the County in the event there is a privacy breach or unauthorized access, use, or disclosure of protected health information by Alvarez & Marsal. The County will be responsible for any penalty or fine assessed against County arising from Alvarez & Marsal’s failure to comply with the BAA.
On September 16, 2025, the Board of Supervisors approved Contract Extension #23-861-1 with Alvarez & Marsal Healthcare Industry Group, LLC, to continue to provide temporary CFO/COO roles and continue the recruitment efforts for a permanent CFO through January 31, 2026.
On January 13, 2026, the Board of Supervisors approved Contract Amendment/Extension #23-861-2 with Alvarez & Marsal Healthcare Industry Group, LLC, to increase the payment limited by $1,918,136 to a new amount not to exceed $8,057,336 and extended the term through June 30, 2026 to continue providing temporary CFO/COO role and continue the recruitment efforts for a permanent CFO.
Approval of Contract Extension #23‑861‑3 will allow Alvarez & Marsal to continue providing interim executive and operational support, including functions aligned with the COO role, through September 30, 2026. This short extension will help maintain continuity and stability in critical operational areas within the Health Services Department and will be achieved without increasing the total contract amount.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract Extension is not approved, CCHS will lose essential interim executive support during a key period, potentially disrupting operational stability and oversight needed to support hospital, health plan, and systemwide functions.