REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 20, 2026
FROM
JOSHUA DUGAS, Director, Department of Behavioral Health
SUBJECT
Title
Employment Contract Template for Contract Physicians
End
RECOMMENDATION(S)
Recommendation
1. Approve Contract Template for contract physicians to provide ongoing psychiatric and/or other physician services, in the total combined amount not to exceed $34,223,530, from the date of execution, as defined in the contract template, through July 31, 2031.
2. Authorize the Assistant Executive Officer, Director of the Department of Behavioral Health, Assistant Director of the Department of Behavioral Health, Medical Director of the Department of Behavioral Health, or Assistant Medical Director of the Department of Behavioral Health to execute the contract template with the individual contract physicians, effective from the date of execution, as defined in the contract template, through July 31, 2031, on behalf of the County, subject to County Counsel review.
(Presenter: Joshua Dugas, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Create, Maintain and Grow Employment Opportunities and Economic Value in the County.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The total combined amount for services will not exceed $34,223,530 and will be funded by Federal Financial Participation, Drug Medi-Cal, Mental Health Medi-Cal, 1991 Realignment, and 2011 Realignment funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2026-27 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and/or SUD. As the Mental Health Plan and Drug Medi-Cal Organized Delivery System for San Bernardino County (County), DBH is required to provide a qualified network of psychiatric providers to ensure timely access to mental health services. DBH is mandated by the California Department of Health Care Services to maintain a panel of qualified psychiatrists to provide medication support services, as specified in California Code of Regulations, Title 9, Sections 18.10.225 and 623.
DBH utilizes a combination of regular County positions and contracted specialized medical personnel, including psychiatrists and other physicians for the treatment of adults and children with a mental illness and/or SUD. Due to the ongoing and projected nationwide shortage of qualified physicians and psychiatrists available to provide these services, recruiting and retaining physicians is extremely competitive.
In collaboration with the Human Resources Department, DBH developed a comprehensive recruitment and retention strategy to strengthen hiring outcomes for regular positions. This strategy includes succession planning through mentoring, professional support, County-sponsored training opportunities, and internal DBH training through the department’s Workforce, Education, & Training Unit.
On June 27, 2023 (Item No. 47), the Board of Supervisors approved the employment contract template for contract physicians to provide ongoing psychiatric and/or other physician services. The template has been used since 2007 based on the existing compensation and benefit structure.
To further support recruitment and retention efforts, the previously approved physician’s employment contract template is being replaced to better align contract compensation and benefits with those of comparable County regular positions. This alignment helps address internal equity concerns while creating a smoother transition for contracted physicians who choose to accept regular full-time County employment.
Each executed employment contract may vary based on the individual’s classification, salary range, and authorized work hours. The level of psychiatric and physician services utilized is determined by DBH’s budgeted clinic physician hours. Compensation is based on applicable position classification and scope of services to be provided. The salary grade designations are established by the County’s Professional Unit, Memorandum of Understanding, and the individual contract physician’s level of experience as follows:
|
Contracted Position Classification |
Salary Range |
|
Psychiatrist I/Behavioral Health Physician I |
SG |
|
Psychiatrist II/Behavioral Health Physician II |
P2 |
|
Child Psychiatrist |
CP |
|
Senior Psychiatrist/Behavioral Health Physician III |
P3 |
Approval of the recommended employment contract template will allow psychiatric and/or other physician services to continue through July 31, 2031. Contracts may be terminated with or without cause upon 14 days’ written notice by either party.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on September 16, 2026; County Counsel (Scott Runyan, Principal Assistant County Counsel, 387-5455) on October 15, 2026; Human Resources (Jose Mancilla, Human Resources Employment Division Chief, 387-5560) on September 15, 2026; and County Finance and Administration (Lizveth Varela, Administrative Analyst, 387-4883) on October 15, 2026.