Frederick County, MD: Feasibility Study

Evergreen was hired by Frederick County to examine the feasibility of outsourcing medical services for the County’s Detention Center. Evergreen completed the following tasks: clarified all components of “medical services” (primary care, mental health, pharmacy, emergency response) and identified resources the County would need to provide if services were insourced; gathered baseline data on the existing medical services agreement, including cost, staffing, scope, performance, compliance, and operational challenges; evaluated contractor performance against NCCHC, ACA, and state standards; designed a comparable staffing plan using County employees, detailing positions, coverage, supervision, and support infrastructure; estimated all personnel and operational costs in collaboration with HR and Finance; created a three to five year comparison of outsourced versus in-house models, analyzing total costs, service quality, flexibility, and operational control; review liability, accreditation, licensure, and compliance impacts of each model in consultation with County legal counsel; conduct interviews with Detention Center leadership, HR, Finance, Legal, and staff, and benchmarked similar counties that have changed models; summarized key trade-offs (cost, quality, liability, control, and staffing) and identified barriers or hybrid options if appropriate; and provided a comprehensive written report outlining data, analysis, stakeholder feedback, and evidence-based recommendations, including implementation considerations and transition planning.