To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan 707-565-4774; Ryan DeHart, 707-565-6623
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Medical Support for Disaster Shelters Contract Award
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute an agreement with IEM International, Inc. to provide medical support services in evacuation shelters during times of disaster within Sonoma County, for a three-year term beginning September 1, 2025 with the option to extend for up to two (2) additional one-year periods, in an amount not to exceed $300,000 annually, subject to annual appropriations and satisfactory contractor performance, and review and approval as to form by counsel.
B) Authorize the Director of Health Services, or designee, to execute an agreement with LIFEwest Northern California to provide medical support services at disaster shelters within Sonoma County, for a three-year term beginning September 1, 2025 with the option to extend for up to two (2) additional one-year periods, in an amount not to exceed $300,000 annually, subject to annual appropriations and satisfactory contractor performance, subject to review and approval as to form by counsel.
C) Authorize the Director of Health Services, or designee, to execute minor amendments to the scope of services during local disasters, subject to County Counsel approval.
end
Executive Summary:
To secure timely and reliable medical support during emergencies, the Department of Health Services (hereinafter "DHS" or "the Department") is recommending the award of contracts to IEM International, Inc., a national emergency management firm with over 40 years of experience, and LIFEwest Northern California, a local provider with a proven track record in disaster response. Both vendors offer rapid deployment, culturally competent care, and scalable medical support tailored to Sonoma County's diverse needs during disasters.
These services are critical during natural disasters such as wildfires, floods, and earthquakes, when general population shelters are activated to house displaced residents.
The Department will activate the agreements as needed in coordination with the Department of Health Services Director, with compensation tied to actual services rendered. While activation is not guaranteed, these contracts provide a scalable contingency resource, enabling rapid deployment of qualified medical personnel when disaster shelters are activated.
Discussion:
Sonoma County faces frequent and severe natural disasters, including wildfires, earthquakes, and floods. During such events, temporary evacuation shelters are activated to house displaced residents. To ensure the availability of reliable medical care within these shelters, DHS issued a Request for Proposals (RFP) for qualified vendors to manage and staff shelter-based medical teams. This initiative aligns with FEMA's Emergency Support Function 8 (ESF-8) Public Health and Medical Services and the California Department of Public Health's Medical Health Operational Coordination Program.
This initiative fulfills the County's responsibilities under the Federal Emergency Management Agency's (FEMA) Emergency Support Function 8 (ESF 8) and the California Department of Public Health's Medical Health Operational Area Coordination Program (MHOAC).
Procurement Process
On May 28, 2025, the Department issued an RFP to identify qualified vendors capable of rapidly deploying medical teams within 12 hours of activation to support general population shelters during emergency events. The requested scope of work included providing up to 14 days of medical services (with possible extensions), coordinating with the County's Emergency Operations Center (EOC), the Department of Health Services' Department Operations Center (DOC), and public health partners, and delivering culturally and linguistically appropriate care in accordance with County and State guidelines.
Selected vendors are expected to deliver care across three service tiers, from basic triage to higher-acuity care for individuals with chronic conditions, while furnishing all necessary equipment, personnel, and supplies. They must also comply with regulatory requirements such as HIPAA, maintain thorough documentation, and submit daily reports and after-action documentation to support reimbursement. Additionally, vendors are required to participate in planning, training, and exercises during non-emergency periods to ensure readiness.
The RFP was broadly distributed to registered and interested entities. By the submission deadline, the Department received two proposals, both of which were evaluated based on qualifications and experience, demonstrated capacity to fulfill the scope of services, cost effectiveness, quality of past work (as confirmed through references), and willingness to accept County contract terms.
Following this comprehensive evaluation, the Department recommends awarding contracts to both IEM International, Inc. and LIFEwest Northern California for a term of three years with two (2) one-year options to extend for amounts not to exceed $300,000 annually.
IEM International, Inc.
IEM International, Inc is a privately held, woman- and minority-owned company incorporated in Delaware and headquartered in North Carolina. With over 40 years of experience supporting government, military, and private sector clients, IEM specializes in disaster management, risk mitigation, and emergency preparedness. IEM brings a skilled team to support disaster shelter medical operations in Sonoma County. The team will provide credentialed medical personnel, pharmacy support, equipment, and logistical resources. IEM's approach includes integration with DHS DOC and shelter managers, readiness training, scalable staffing, rapid deployment, and strict quality and confidentiality standards - ensuring responsive, comprehensive support during emergencies.
LIFEwest Northern California
LIFEwest Northern California is a locally based organization with extensive experience in emergency response, large-scale event medical management, and disaster shelter operations. LIFEwest has supported Sonoma County during past emergencies and is uniquely positioned to provide compassionate, culturally competent, and ADA-compliant medical services across all contracted shelter sites. The organization is committed to equity in access and outcomes, offering bilingual staffing and coordinated care for vulnerable populations.
LIFEwest's proposed program features rapid deployment of modular medical teams. Guided by credentialed clinicians, strong internal controls, and a clear chain of command, LIFEwest offers a responsive, compliant, and collaborative solution to meet Sonoma County's shelter-based medical needs.
Contract Terms and Activation
The initial contract term is three years, with two optional one-year extensions. Services will be activated only during declared emergencies at the direction of the DHS Director or County Health Officer. Compensation will be based on job classification rates and actual services rendered, not to exceed contract limits without further Board approval.
While activation is not guaranteed, these contracts provide a scalable contingency resource, enabling rapid deployment of qualified medical personnel when disaster shelters are activated.
Strategic Plan:
This item directly supports the County's Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County's most vulnerable.
Objective: Objective 2: Identify gaps in the Safety Net system of services and identify areas where departments can address those gaps directly, and seek guidance from the Board when additional resources and/or policy direction is needed.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On January, 7, 2025, the Board authorized the Director of Health Services, or designee, to execute an agreement with Advocacy Home Nursing dba Fox Home Health for a period of three years from the effective date to perform infectious disease testing and vaccine administration during outbreak events, for an annual not-to-exceed amount of $250,000 and total not-to-exceed amount of $750,000, subject to review and approval as to form by counsel; authorized the Director of Health Services, or designee, to execute an agreement with Longview International Technology Solutions, Inc. for a period of three years from the effective date, to perform infectious disease testing and vaccine administration during outbreak events, for an annual not-to-exceed amount of $250,000 and total not-to-exceed amount of $750,000; and authorized the Director of Health Services, or designee, to execute modifications to the agreements in this Board Item which do not significantly change the scopes of service and/or to increase the total not-to-exceed amount in order to address increased service needs, subject to available funding and review and approval by County Counsel.
FISCAL SUMMARY
Expenditures
FY25-26 Adopted
FY26-27 Projected
FY27-28 Projected
Budgeted Expenses
$600,000
$600,000
Additional Appropriation Requested
$,600,000
Total Expenditures
$600,000
$600,000
$600,000
Funding Sources
General Fund/WA GF
State/Federal
Fees/Other
Use of Fund Balance
$600,000
$600,000
$600,000
General Fund Contingencies
Total Sources
$600,000
$600,000
$600,000
Narrative Explanation of Fiscal Impacts:
Should these contracts be activated based on specified needs during future emergencies, funding from account 22050500 will be utilized. Should additional appropriations be required based on the scale of emergencies, the Department will return to the Board.
Staffing Impacts:
Position Title (Payroll Classification)
Monthly Salary Range (A-I Step)
Additions (Number)
Deletions (Number)
Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1 - Sample Agreement
Related Items "On File" with the Clerk of the Board:
N/A