AB1108_SOW_Final.pdf

AB 1108 (FACTS Act) Compliant — Gov. Code § 27491.56 Page 1

COUNTY OF NAPA

Board of Supervisors/CEO Office

SCOPE OF WORK

Independent Medical Examination Services for In-Custody Deaths

Issued Pursuant to California Government Code Section 27491.56

AB 1108, Forensic Accountability, Custodial Transparency, and Safety (FACTS) Act of 2025

SECTION 1 — PURPOSE AND LEGAL AUTHORITY

The County of Napa (“County”) issues this Scope of Work (“SOW”) as a component of its

Request for Proposals (“RFP”) for Independent Medical Examination Services for In-Custody

Deaths. This SOW establishes the minimum service requirements, independence standards, personnel qualifications, and deliverables that any Proposer must meet to be considered responsive.

Napa County operates a combined Sheriff-Coroner’s Office. Effective January 1, 2027, California Government Code Section 27491.56 — enacted by AB 1108, the FACTS Act of 2025

— prohibits a combined Sheriff-Coroner from determining the circumstances, manner, and cause of death for any in-custody death. In compliance with Government Code Section

27491.56(a)(2), the County seeks to contract with a qualified Third-Party Medical Examination

Provider that is:

• Separate and independent from the Napa County Sheriff-Coroner’s Office;

• Qualified to determine the circumstances, manner, and cause of death for all in-custody deaths as defined in Penal Code Section 10008; and

• Staffed by physicians meeting the qualifications described in Government Code Section 24010.

STATUTORY

CITATION

Gov. Code § 27491.56(a): “In any county where the offices of the sheriff and the coroner are combined, the sheriff-coroner shall not determine the circumstances, manner, and cause of death … for any in-custody death, but shall instead do one of the following: … (2) Contract with a third-party medical examination provider that is separate and independent from the office of the sheriff-coroner and meets the physician qualification requirements described in Section 24010.”

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SECTION 2 — DEFINITIONS

For purposes of this Scope of Work, the following definitions apply:

“In-Custody Death”

As defined in Penal Code Section 10008: the death of a person who is detained, under arrest, or in the process of being arrested; is en route to be incarcerated; or is incarcerated at a municipal or county jail, state prison, state-run or contracted boot camp prison, any state or local contract facility, or other local or state correctional facility, including any juvenile facility. Also includes deaths occurring in medical facilities while the decedent is in law-enforcement custody.

“Independent Medical Examination”

A complete forensic medical investigation — including scene review, external examination, forensic autopsy, toxicological analysis, and all related documentation — conducted and determined entirely by the Contractor, exercising independent professional judgment free from direction, interference, or undue influence by the Napa County Sheriff-Coroner’s Office or any other Napa County law enforcement personnel.

“Contractor” or “Provider”

A third-party medical examination provider, which may be another California county with a coroner’s office that operates independently from its sheriff, a county Office of Medical Examiner established pursuant to Government Code Section 24010, or a private forensic pathology entity meeting all requirements of this SOW.

“Forensic Pathologist”

A licensed physician and surgeon who is duly qualified as a specialist in pathology in accordance with Government Code Section 24010, and who is board-certified in forensic pathology by the American Board of Pathology.

SECTION 3 — SCOPE OF SERVICES

3.1 Covered Cases

The Contractor shall provide Independent Medical Examination Services for all in-custody deaths occurring within Napa County for which the Napa County Sheriff-Coroner holds investigative jurisdiction under Government Code Section 27491. This includes but is not limited to deaths occurring in:

• The Napa County Department of Corrections (main adult detention facility);

• Any contract or temporary holding facility operating under the jurisdiction of the Napa County Sheriff;

• Law enforcement vehicles or during transport while in the custody of any law enforcement agency personnel;

• Medical facilities, where the decedent was in law enforcement custody at the time of death, including the Napa State Hospital; and

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• Any other circumstances meeting the statutory definition of an in-custody death under Penal Code Section 10008.

3.2 Core Services Required

The Contractor shall provide the following services for each covered case:

A. Death Scene Coordination and Review

• Review all available scene documentation, law enforcement reports, crime scene photographs, videos, laboratory tests and other records related to a death made available pursuant to Government Code Section 27522(g) prior to completing the investigation;

• The decedent will be transferred with a secured chain of custody to the Napa County Sheriff-Coroner’s facility. Contractor shall assume custody at the facility when they are ready to conduct the independent examination, consistent with Government Code Section 27491.55; and

• Document the receipt of all case materials and establish chain-of-custody protocols independent of law enforcement.

B. External Examination

• Conduct a complete and documented external examination of the decedent;

• Photograph and document all injuries, marks, and physical findings; and

• Document all personal effects and clothing in accordance with established forensic standards.

C. Forensic Autopsy

• Perform a complete forensic autopsy for each in-custody death in accordance with professional standards established by the National Association of Medical Examiners

(NAME);

• All autopsies shall be conducted by, or under the direct supervision of, a licensed Forensic Pathologist meeting the qualifications in Section 4 of this SOW;

• Collect and submit appropriate biological samples for toxicological, histological, and other specialized analyses as indicated; and

• Retain all biological evidence, tissue samples, and specimens in accordance with applicable law and professional standards.

D. Independent Determination of Manner, Circumstances, and Cause of Death

This is the core statutory obligation of the Contractor under Government Code Section

27491.56. The Contractor shall:

• Independently determine and certify the circumstances, manner, and cause of death for each covered case;

• Exercise independent professional judgment in making all such determinations, free from direction, pressure, or influence from the Napa County Sheriff-Coroner’s Office, any other Napa County law enforcement entity, or the County’s administrative leadership;

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• Not alter or amend any determination of manner, circumstances, or cause of death at the direction of law enforcement or County administrative personnel;

• Document the factual and medical basis for all determinations in the written autopsy report; and

• Execute and file the death certificate in compliance with California Health and Safety Code requirements.

INDEPENDENCE

REQUIREMENT

Gov. Code § 27491.56: “A private third party medical examination provider shall operate independently from the office of the sheriff-coroner in conducting the medical examination process, including but not limited to, exercising professional judgment to make determinations of the circumstances, manner, and cause of death.”

E. Toxicology and Ancillary Testing

• Order, coordinate, and interpret toxicological analyses necessary to support cause-of-death determinations;

• Utilize a certified toxicology laboratory independent of Napa County law enforcement;

and

• Retain all toxicology reports as part of the permanent case file.

F. Documentation and Reporting

• Prepare a complete written autopsy report for each case, to be delivered to the Napa County Coroner’s Office within thirty (30) calendar days of completion of the autopsy, absent extraordinary circumstances documented in writing;

• Autopsy reports shall include: case identification, decedent information, summary of available history and circumstances, external and internal examination findings, toxicological findings, photographic documentation, and the forensic pathologist’s independent opinion as to manner, circumstances, and cause of death;

• Maintain complete and secure case records for a minimum of ten (10) years; and

• Provide copies of all reports and records to the County upon request within five (5) business days.

G. Coordination with Legal Proceedings

• Provide the forensic pathologist or a qualified designee to testify as an expert witness in any legal proceeding, including criminal trials, civil actions, or coroner’s inquests, as required by the County or by court order;

• Respond to subpoenas and discovery requests in a timely manner; and

• Cooperate with the Napa County District Attorney’s Office, public defenders, and other authorized parties in the review and interpretation of case findings.

H. Autopsy Suite Access Compliance

The Contractor shall enforce the following access requirements, consistent with Government

Code Section 27522:

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• Only individuals directly involved in the investigation of the decedent’s death shall be permitted in the autopsy suite;

• Napa County Sheriff-Coroner personnel or law enforcement personnel who were directly involved in the death of the individual in custody shall not be permitted in the autopsy suite or involved in any portion of the postmortem examination; and

• All persons in the autopsy suite shall be informed of bloodborne pathogen risks and required to wear personal protective equipment in accordance with Title 8, California Code of Regulations, Section 5193.

SECTION 4 — MINIMUM QUALIFICATIONS

To be deemed responsive, the Proposer must demonstrate that all forensic pathologists performing services under this contract meet the following minimum qualifications, as required by Government Code Sections 27491.56(a)(2) and 24010:

4.1 Physician Licensure

• Current, valid, and unrestricted California Physician and Surgeon license issued by the Medical Board of California; and

• Good standing with the Medical Board of California, with no pending formal disciplinary action, license suspension, or revocation.

4.2 Pathology Specialization

• Board certification in Anatomic Pathology or Anatomic and Clinical Pathology by the American Board of Pathology; and

• Board certification in Forensic Pathology by the American Board of Pathology.

4.3 Experience

• A minimum of three (3) years of post-board-certification forensic pathology practice; and

• Demonstrated experience performing forensic autopsies in California, including in cases involving in-custody or law-enforcement-related deaths.

4.4 Organizational Independence

The Proposer and all assigned forensic pathologists must demonstrate organizational independence from the Napa County Sheriff-Coroner’s Office. The following are disqualifying:

• Current employment by, or active service contract with, the Napa County Sheriff- Coroner’s Office or any Napa County law enforcement entity;

• Any financial arrangement, ownership interest, or referral relationship with the Napa County Sheriff-Coroner’s Office that could compromise independent professional judgment; and

• Any prior formal finding by a court, licensing board, or professional body that the Proposer or an assigned pathologist was subject to undue influence by law enforcement in the performance of forensic pathology services.

4.5 Organizational Structure (for Private Entities)

Private forensic pathology entities must additionally demonstrate:

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• Organizational governance and chain of command that insulates forensic pathologists from direction by law enforcement clients on matters of professional judgment;

• Written policies and procedures governing the independence of cause-of-death determinations; and

• A conflict-of-interest policy prohibiting the revision of forensic findings at the direction of law enforcement.

SECTION 5 — INDEPENDENCE AND NON-INTERFERENCE

STANDARDS

Government Code Section 27491.56 requires that the Provider /Contractor operate independently from the office of the sheriff-coroner in conducting the medical examination process. The following standards give operational effect to this requirement.

1. The Contractor shall make all determinations of the circumstances, manner, and cause of death solely on the basis of scientific evidence, medical findings, and professional forensic standards. No such determination shall be subject to review, revision, or override by any Napa County Sheriff-Coroner personnel or law enforcement official.

2. The Contractor shall maintain a written log of all communications with Napa County Sheriff-Coroner personnel related to active cases. The log shall be available for County audit upon request.

3. The Contractor shall immediately notify the County Executive’s Office in writing of any attempt by law enforcement personnel — including personnel of the Napa County Sheriff-Coroner’s Office — to direct, pressure, or otherwise influence a forensic determination.

4. The Contractor shall not hire or subcontract any forensic pathologist who is currently or was within the preceding twenty-four (24) months employed by or under active contract with the Napa County Sheriff-Coroner’s Office.

5. The Contractor’s forensic pathologists shall have direct, unrestricted access to all relevant case materials, including law enforcement reports, video evidence, and laboratory results, as required by Government Code Section 27522(g), without these materials being curated, withheld, or filtered by the Sheriff-Coroner.

6. The Contractor shall maintain professional liability insurance sufficient to provide financial independence from the County, and shall not be financially dependent on Napa County as its sole or primary client.

SECTION 6 — PERFORMANCE AND RESPONSE STANDARDS

Performance Standard Requirement

Initial Notification Response Acknowledge written notification of an in-custody death within two (2) hours of receipt.

Scene or Facility Response Respond to the decedent’s location or receiving facility within four (4) hours of notification, absent exigent circumstances.

Autopsy Commencement Autopsy shall be performed as soon as possible after notification, generally within forty-eight (48) to ninety-six (96) hours after of transfer of the decedent, but in no case beyond

AB 1108 (FACTS Act) Compliant — Gov. Code § 27491.56 Page 7 four working days without the approval of the County Executive Officer or designee based on triage discussion (by phone or in-person). Autopsies shall be conducted Monday through Friday between the hours of 8:00am and 5:00pm, unless specifically requested and/or approved by County Executive Officer or designee.

Preliminary Findings Provide written preliminary cause-of-death findings within twenty four (24) hours of autopsy completion.

Final Autopsy Report Deliver final written autopsy report within thirty (30) calendar days of autopsy completion. Extensions require written notice.

Toxicology Reports Toxicology results to be incorporated into the final report.

Preliminary tox findings communicated to County in writing within twenty-one (21) days of sample submission.

Expert Testimony Availability Forensic pathologist available for testimony with reasonable advance notice, not less than fourteen (14) calendar days except in emergencies.

Records Requests Copies of reports and records provided within five (5) business days of written request from authorized parties.

Availability Be available 24/7 for phone consultation, every day of the year, at no additional cost, except during periods of authorized absence, as arranged under coverage by a subcontracting provider, not to exceed eight (8) weeks (40 days) per year.

Periods of absence require at least fifteen (15) working days written notice before taking an absence utilizing a subcontractor to provide services.

SECTION 7 — DELIVERABLES

The Contractor shall provide the following deliverables to the County for each in-custody death case:

• Case Intake Acknowledgment — written confirmation of case acceptance, assigned forensic pathologist, and anticipated autopsy date;

• Preliminary Findings Memorandum — written summary of preliminary cause-of-death findings within 24 hours of autopsy;

• Final Autopsy Report — complete forensic autopsy report, independently signed by the performing Forensic Pathologist, including all findings, opinions, and supporting documentation;

• Toxicology Report — certified toxicology results from an independent, accredited laboratory;

• Photographic Documentation — complete photographic record of the examination, in a format acceptable for evidentiary use;

• Executed Death Certificate — completed and filed in compliance with California Health and Safety Code Section 102775 and related provisions; and

• Case File — all records, correspondence, chain-of-custody documentation, and supporting materials maintained in a secure, retrievable format for a minimum of ten (10) years.

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SECTION 8 — CONTRACT REQUIREMENTS

8.1 Term

The initial contract term shall be ONE year, commencing no later than January 1, 2027, consistent with the effective date of Government Code Section 27491.56. The County reserves the option to extend the contract for up to [two (2)] additional one-year periods by mutual written agreement

8.2 Insurance

The Contractor shall maintain, at minimum, the following insurance coverage throughout the contract term:

• Professional Liability (Errors and Omissions): minimum $2,000,000 per occurrence / $4,000,000 aggregate;

• Commercial General Liability: minimum $1,000,000 per occurrence / $2,000,000 aggregate;

• Commercial Automobile Insurance (include County limit requirements)

• Workers’ Compensation: as required by California law; and

• The County of Napa shall be named as an additional insured on all liability policies.

8.3 Confidentiality and Records

The Contractor shall treat all case information as confidential and shall not disclose any case records, findings, or decedent information except as required by law or authorized in writing by the County..

8.4 Subcontracting

Any subcontracted forensic pathologist or ancillary service provider must meet all qualification requirements in Section 4 of this SOW. The Contractor shall obtain written County approval prior to subcontracting any primary forensic pathology service. Use of subcontractors does not relieve the Contractor of its independence obligations under Section 5. All subcontracts are required to comply with all provisions of this contract.

8.5 Compliance with Law

The Contractor shall comply with all applicable California statutes, including but not limited to

Government Code Section 27491.56, Government Code Section 27522, Penal Code Section

10008, Health and Safety Code requirements for death certificates, and all applicable regulations governing forensic pathology practice.

8.6 Staffing Model Disclosure

The Contractor shall disclose in its proposal whether it operates as a direct-service forensic pathology provider or as a staffing intermediary that places independent contractor or locum tenens forensic pathologists with clients. If the Contractor operates as a staffing intermediary or placement firm, the following additional requirements apply:

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1. Prior to any individual forensic pathologist rendering services under this agreement, the Contractor shall submit that individual’s curriculum vitae, current California Physician and Surgeon license verification, and board certification documentation to the County for review and written approval. No pathologist shall perform a Napa County case prior to receiving such written approval;

2. The Contractor shall maintain a roster of all pathologists approved to perform Napa County cases and shall notify the County in writing within five (5) business days of any change to that roster; and

3. Regardless of the staffing model employed, the Contractor bears full professional and contractual responsibility for the independence, quality, and timeliness of all forensic pathology services rendered under its agreement with the County. The use of a staffing intermediary structure does not transfer, limit, or otherwise diminish the Contractor’s obligations under Government Code Section 27491.56 or this SOW.

8.7 Pending Case Completion

Upon termination or expiration of the agreement with the County, or upon the departure or removal of any individual forensic pathologist who has performed work on a Napa County case, the Contractor shall ensure continuity of all pending cases as follows:

1. Any case for which an autopsy has been initiated but for which a final autopsy report has not yet been issued — including cases awaiting toxicological, histological, or other ancillary test results — shall be completed by the original performing pathologist or, if unavailable, by a qualified substitute pathologist approved by the County.. The final autopsy report shall be issued under the professional signature of the pathologist who performed the autopsy;

2. The Contractor shall transfer all case files, biological evidence, chain-of-custody documentation, and ancillary test results to the County or to a successor provider designated by the County within thirty (30) calendar days of the termination or expiration date of the agreement with the County; and

3. Compensation for services rendered on pending cases completed after the termination or expiration date shall be governed by the fee schedule in effect at the time the autopsy was performed, prorated to services actually rendered.

8.8 Travel Expenses

All travel expenses incurred by the Contractor or its forensic pathologists in connection with services rendered under its agreement with the County— including transportation, lodging, and per diem — should be included within the per-case fees set forth in the Contractor’s fee schedule and shall not be separately billed to or reimbursed by the County, unless an exception is explicitly negotiated in writing and approved by the County prior to the travel being incurred.

The County shall not be liable for any travel-related invoices submitted absent such prior written approval.

8.9 Conversion Fee Prohibition

The County of Napa shall not be liable for any placement fee, conversion fee, finder’s fee, or similar charge arising from the County’s decision to directly employ or independently contract with any individual who has performed services relating to the services outlined in this SOW.

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Any provision in the Contractor’s proposal or in any resulting agreement purporting to impose such a fee is void and unenforceable as contrary to California public contracting law and public policy. Proposers shall not include conversion or placement fee provisions in their proposals;

inclusion of such a provision shall render a proposal non-responsive.

8.10 Governing Law and Jurisdiction

Theagreement shall be governed exclusively by the laws of the State of California, without regard to conflict-of-law principles. Any legal action or proceeding arising out of or relating to the agreement must be brought exclusively in the Superior Court of the State of California, County of Napa. The Contractor expressly consents to the jurisdiction of said court and waives any objection to venue in Napa County. Any provision in a Contractor’s proposal designating the law of another state or a venue outside California as governing shall be deemed void, and acceptance of such a proposal shall constitute the Contractor’s agreement to this Section 8.10 notwithstanding any contrary terms in the proposal. The parties further acknowledge that the County of Napa, as a California county, does not waive and cannot waive its right to a jury trial by contract, and any such waiver purported to be agreed to in a proposal or agreement is void and of no legal effect.

SECTION 9 — PROPOSAL REQUIREMENTS

Proposals responding to this RFP must include the following to be considered responsive to this

Scope of Work:

1. Organizational Description — describe the Proposer’s legal structure, governance, and how the organization is structured to operate independently of law enforcement clients;

2. Independence Attestation — a signed statement attesting that neither the Proposer nor any assigned forensic pathologist is currently employed by or under contract with the Napa County Sheriff-Coroner’s Office;

3. Forensic Pathologist Credentials — for each pathologist assigned to Napa County cases: current California medical license number, board certification documentation, CV, and attestation of compliance with Section 4 qualifications;

4. Experience and Case Volume — description of experience performing forensic autopsies in California, including the number of in-custody or law-enforcement-related autopsies performed annually in the past three (3) years;

5. Facilities Description — identification of the autopsy facility or facilities to be used, including accreditation status and location;

6. Policies and Procedures — copies of written policies governing independence of forensic determinations, conflict-of-interest, and autopsy suite access controls;

7. References — a minimum of three (3) written professional references from California counties or government entities for which the Proposer has performed in-custody or law-enforcement-related forensic autopsy services; and

8. Fee Schedule — itemized pricing per case type, including autopsy, toxicology, scene response, expert testimony, and any additional services.

9. Staffing Model Statement — a written disclosure identifying whether the Proposer operates as a direct forensic pathology service provider or as a staffing intermediary/placement firm. If a staffing intermediary, the Proposer shall describe its candidate vetting process, its mechanism for ensuring continuity of assigned

AB 1108 (FACTS Act) Compliant — Gov. Code § 27491.56 Page 11 pathologists across cases, and its process for presenting and obtaining County approval of individual pathologist candidates prior to case assignment; and

10. Governing Law Attestation — a signed statement confirming that the Proposer agrees this agreement and any resulting contract shall be governed by California law, with exclusive venue in Napa County Superior Court, and that the Proposer’s proposal contains no conversion fee, placement fee, or finder’s fee provision, and no jury trial waiver.

QUESTIONS REGARDING THIS SCOPE OF WORK

Direct all inquiries to:

Captian John (Brian) Kenner

John.kenner@countyofnapa.org