REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 29, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contract with Canyon Ridge Hospital, Inc. dba Canyon Ridge Hospital for Fee-For-Service Acute Psychiatric Inpatient Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 4 to Contract No. 20-1240 with Canyon Ridge Hospital, Inc. dba Canyon Ridge Hospital for the provision of Fee-For-Service Acute Psychiatric Inpatient services, updating contract language to include additional eligibility for reimbursement for services, with no change to the aggregate amount of $37,077,921, or the contract period of December 15, 2020, through June 30, 2025.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The aggregate total of $37,077,921 for Fee-For-Service (FFS) Acute Psychiatric Inpatient services is funded by 1991 Realignment funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2024-25 budget.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to County residents experiencing severe mental illness (SMI) and/or SUD. DBH entered into a contract with the Department of Health Care Services (DHCS) as a Mental Health Plan (MHP) established under Assembly Bill 757 (AB 757) in January 1995. As an MHP, DBH is responsible for providing access to high-quality specialty mental health services for Medi-Cal beneficiaries in the most cost-effective manner possible. In 1957, California passed legislation creating the Short-Doyle Program (SD), wherein counties were required to ensure delivery of mental health services utilizing a system of county operated and contract providers. AB 757 allowed for the phased implementation of managed mental health care for Medi-Cal beneficiaries through SD Medi-Cal and FFS contracts with MHPs and standardized the requirements for all MHPs that participate in the Medi-Cal Specialty Mental Health Service Consolidation Program. As a result of the contract with the State and pursuant to AB 757 and related regulations, DBH must contract with area hospitals to provide acute psychiatric services to Medi-Cal eligible residents.
Senate Bill 43 (SB 43), passed October 10, 2023, expanded the criteria for involuntary mental health holds under the Lanterman-Petris-Short (LPS) Act to include individuals experiencing grave disability (GD) due to a severe SUD. Counties were given the option to defer implementation until January 1, 2026. San Bernardino County elected to implement SB 43 as of April 1, 2025 on December 17, 2024 (Item No. 27). Historically, involuntary treatment under the LPS Act has been limited to individuals with SMI, leaving a significant gap in services for those with SUD-driven grave disability. DBH is taking steps to align with this new legislation by launching a pilot program in partnership with Canyon Ridge Hospital (CRH) to enable reimbursement under the existing provisions of this contract for individuals detained under the new SB 43 criteria. This initiative will allow emergency departments to coordinate transfers for patients who meet the new GD standard due to SUD, ensuring they receive immediate stabilization and appropriate care. Similar language is being included in other FFS hospital contracts in the upcoming renewal, effective July 1, 2025.
On December 15, 2020 (Item No. 27), the Board of Supervisors (Board) approved non-competitive contracts for FFS hospitals in an aggregate amount not to exceed $20,891,667 for the period of December 15, 2020, through June 30, 2025, for Contract No. 20-1239 with Aurora Charter Oak Hospital (ACOH Contract); Contract No. 20-1240 with CRH; Contract No. 20-1241 with Community Hospital of San Bernardino (CHSB); Contract No. 20-1242 with Loma Linda University Behavioral Medicine Center (LLUBMC); Contract No. 20-1243 with Vista Behavioral Hospital, LLC dba Pacific Grove Hospital (PGH); and Contract No. 20-1244 with Redlands Community Hospital (RCH).
On October 4, 2022 (Item No. 15), the Board approved Amendment No. 1 to the CRH, CHSB, LLUBMC, and RCH Contracts, to update the negotiated bed day rates, with no change to the combined aggregate amount of $20,891,667, with no change to the contract period of December 15, 2020, through June 30, 2025.
On November 14, 2023 (Item No. 22), the Board approved Amendment No. 1 to the ACOH Contract and PGH Contract, Amendment No. 2 to the CRH Contract, CHSB Contract, and LLUBMC Contract to update standard contract language and negotiated bed day rates, increasing the combined aggregate contract amount by $6,721,908 from $20,891,667 to $27,613,575, with no change to the contract period of December 15, 2020, through June 30, 2025.
On December 17, 2024 (Item No. 25), the Board approved Amendment No. 2 to the ACOH Contract and PGH Contract, Amendment No. 3 to CRH Contract and LLUMC Contract, increasing the total aggregate amount by $9,464,346 from $27,613,575 to $37,077,921, with no change to the contract period of December 15, 2020, through June 30, 2025.
Approval of this item will allow CRH to accept approximately 5 individuals detained under the new SB 43 criteria. Until DHCS establishes direct reimbursement guidelines, care for patients with GD due to severe SUD will be reimbursed under this contract. With two months remaining in the contract period as of the amendment’s effective date, this ensures DBH can appropriately accept and fund individuals meeting the new criteria effective April 1, 2025.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Michael Shin, Administrative Manager, 388-0899) on March 19, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 20, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on April 10, 2025, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on April 14, 2025.