REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 11, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Standard Agreement Template for Substance Use Disorder and Recovery Services Withdrawal Management and Residential Treatment Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to the standard agreement template for Substance Use Disorder and Recovery Services Withdrawal Management and Residential Treatment Services, increasing the aggregate amount by $70,665,272, from $89,730,320 to $160,395,592, with no change to the total contract period of January 1, 2024, through December 31, 2028.
2. Approve Amendment No. 1 to Agreement No. 23-1364 with Tarzana Treatment Centers, Inc. for the provision of Substance Use Disorder and Recovery Services Withdrawal Management and Residential Treatment services, in the same aggregate increase amount of $70,665,272, from $89,730,320 to $160,395,592, as referenced in Recommendation No. 1, with no change to the total contract period of January 1, 2024, through December 31, 2028.
3. Authorize the Assistant Executive Officer or the Director of the Department of Behavioral Health to execute the amendment to the standard agreement template with the individual Substance Use Disorder and Recovery Services Withdrawal Management and Residential Treatment services providers, including any non-substantive changes, provider legal name changes, and facility location changes to the standard agreement template, on behalf of the County, subject to review by County Counsel.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
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 recommended aggregate increase not to exceed $70,665,272 will be funded by Drug Medi-Cal, Opioid Settlement Funds, and 2011 Realignment. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2024-25 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. DBH provides a full range of SUD services for residents of the county through contracts with community-based organizations and County-operated clinics, with the goal of promoting prevention, intervention, treatment, education, recovery, and resiliency for individuals and families. An integral part of the service delivery system consists of Substance Use Disorder and Recovery Services (SUDRS) Withdrawal Management and Residential Treatment (WM and RT) services.
SUDRS WM and RT services provide 24-hour living support and structure, with available trained personnel providing services ranging from high intensity to low intensity, including clinical services, to address addiction in a therapeutic setting for adults (ages 18 and over), adolescents (ages 12-17), and perinatal patients. DBH anticipates that the increase of $70,665,272 will provide SUDRS WM and RT services to approximately 5,888 additional clients over the remaining contract period at an estimated cost of $12,002 per client. Available SUDRS WM and RT beds will increase from 169 to 303. The increase in available beds will meet the need to expand the capacity to serve additional clients for SUDRS WM and RT services throughout the county.
DBH utilizes a standard agreement template for WM and RT services to maintain a pool of qualified contract SUDRS WM and RT service providers. Recommendation No. 1 will increase the aggregate amount able to be expended pursuant to this template. The following five agencies currently provide SUDRS WM and RT services via this template:
• G and C Swan, Inc.
• Inland Valley Drug and Alcohol Recovery Services, Inc.
• Phoenix House Orange County, Inc.
• Social Science Services, Inc. dba Cedar House Life Change Center
• Veteran’s Alcohol Rehabilitation Program, Inc.
On December 19, 2023 (Item No. 31), as a result of a formal procurement for the provision of SUDRS WM and RT, the Board of Supervisors (Board) approved a standard agreement template in an aggregate amount not to exceed $89,730,320, for the period of January 1, 2024, through December 31, 2028. Additionally, the Board authorized the Assistant Executive Officer or the Director of the DBH to execute the standard agreement template with the individual SUDRS WM and RT services providers, on behalf of the County, subject to review by County Counsel.
Separate from the template referenced in Recommendation No. 1, Recommendation No. 2 will allow DBH to amend Agreement No. 23-1364 with Tarzana Treatment Centers, Inc. (Tarzana), which was approved by the Board on December 19, 2023 (Item No. 31), for the provision of SUDRS WM and RT services. The individual agreement with Tarzana differs in that the fee-for-service payment structure is required due to the specialized population of adolescents and the limited number of clients to be served. The number of adolescent clients treated at the residential level is less than adult clients, therefore, the adolescent population receiving treatment is considered limited. Tarzana serves approximately 25 youth clients annually.
DBH has implemented mechanisms to regularly: 1) review client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) review applicable reimbursement claims and claims data to ensure fidelity and accuracy of service billing and optimization of Medi-Cal reimbursement in alignment with contract terms and Department of Health Care Services billing requirements; and 3) review provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Lisa Rivas-Ordaz, Contract Supervisor, 383-3940) on February 14, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on February 21, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on February 24, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on February 24, 2025.