Santa Clara Doctors Stop Contracting Out

A battle between doctors in Santa Clara County and County administrators ended with a big victory for UAPD.  After weeks of protest, the County agreed not to replace doctors at their corrections facilities with outside contractors as originally planned.  The County instead raised the differential for those jobs to 25%.  With that differential in place, positions that had remained vacant for years quickly filled.  A UAPD doctor was also given a seat on the Blue Ribbon Commission that was created to investigate and improve conditions in the jails.

Back in September, UAPD received notice that Traditions Behavioral Health and representatives of the County of Santa Clara had signed an agreement to immediately hire outside contractors to provide psychiatric services to the Main Jail, Elmwood Correctional Facility, and Elmwood Correctional Center for Women.  At about the same time, two doctors currently employed in the Main Jail were told that starting in October, custodial health services will be performed by TBH contractors rather public employees.

UAPD launched a comprehensive campaign to urge the County Supervisors to reject that agreement, and a large number of Santa Clara doctors have joined the fight.  The County’s attempt to replace regular positions with contractors posed a direct threat to all Santa Clara doctor jobs and the services they provide to the community.

First Actions

On September 15th , UAPD President Dr. Stuart Bussey and UAPD staff joined county-employees Dr. Heather Colbert, Dr. Divya Reddy, and Dr. Farah Khan at the Supervisors meeting.  Together they urged the Supervisors to vote down the contract when it comes before them on the 29th.  The doctors warned the Supervisors and the public that using outside contractors rather than dedicated, experienced County psychiatrists would seriously diminish the quality of care provided to the County’s mentally ill inmates.  That same day the Supervisors were approving the plan to investigate conditions in the jail in the wake of the murder of Michael Tyree, a mentally ill inmate killed by guards in late August.  The doctors asked the Supervisors to consider how the use of contract doctors would make inmates like Tyree even more vulnerable.

On top of the quality of care issues, the plan to contract out County psychiatry jobs was also outrageously expensive.  According to the contract, Santa Clara County would pay $258 per hour for 7 full-time psychiatrist positions, far more than what it would cost to recruit and retain enough permanent County workers to fully staff Custodial Health.

On September 18th, UAPD staff and Santa Clara doctors met with County management to present the Union plan for filling Custodial Health vacancies without relying on expensive contractors.   They said they would offer a response within a week, but as of October 5th, they have not responded, despite UAPD’s repeated demands that they do so.

Petitions, Emails, and Visits to the County Supervisors

Santa Clara doctors started by written messages and signing petitions aimed at educating all five County Supervisors about the drawbacks of the contracting out plan.  The message:

  • County doctors provide better care at a lower cost than Traditions contractors do
  • Offering a compensation package on par with what other Counties offer for similar work would solve the recruitment problem in the department.

A large number of County doctors also accompanied UAPD staff and UAPD President Dr. Stuart Bussey on one-on-one visits with the County supervisors.  Based on feedback from some of the Supervisors, the doctors refined the Union plan to address the recruitment and retention problem that the County has ignored for years.  While that plan was being communicated to the Supervisors, it was not clear whether they or County management would listen to the strong arguments the doctors are making.

Other Actions

UAPD fought the contracting out of County positions in other ways.  UAPD leadership has reached out to political allies in the region, to ask them to remind the County that public employees, not contractors, are best suited to provide care to mentally ill inmates.  We also spoke to reporters and released the Traditions Behavior Health contract to the media, so the public was able to learn just how expensive and ill advised it is.  UAPD staff also worked with other Santa Clara unions, because contracting out is the sort of union-busting behavior that will eventually affect other bargaining units if left unchecked.


On October 14th, the UAPD team sat with County Executive Jeff Smith and negotiated a deal that will help fill UAPD positions during custody mental health’s emergent physician shortage.

This agreement secures the following:

  • Immediately increases the Custody differential to 25%. The County is working on the method to make this differential PERSable.
  • Reserves a seat for a UAPD member on the Blue Ribbon Commission.
  • Guarantees meet and confers with the County to reevaluate contractor positions and assure that any created positions become UAPD represented employees.

You can read the full text of the side letter here.