REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 25, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendments to Contracts for Comprehensive Treatment Services Student Assistance Program and School-Aged Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve amendments to the following contracts for the provision of Comprehensive Treatment Services Student Assistance Program, and School-Aged Treatment Services, updating standard contract language, increasing the combined contract amount by $20,080,304 from $179,519,836 to $199,600,140, and extending the contract by six months, for a total period of July 1, 2018, through December 31, 2024:
1. Desert/Mountain Children’s Center, Amendment No. 5 to Contract No. 18-382, increasing the total contract amount by $7,249,637 from $78,434,119 to $85,683,756.
2. Lutheran Social Services of Southern California, Amendment No. 2 to Contract No. 18-383, increasing the total contract amount by $179,817, from $2,146,869 to $2,326,686.
3. Mountain Counseling and Training, Amendment No. 4 to Contract No. 18-384, increasing the total contract amount by $555,833, from $4,989,166 to $5,544,999.
4. South Coast Community Service, Amendment No. 6 to Contract No. 18-385, increasing the total contract amount by $6,300,768, from $49,078,956 to $55,379,724.
5. Victor Community Support Services, Inc., Amendment No. 4 to Contract No. 18-386, increasing the total contract amount by $4,072,241, from $31,693,531 to $35,765,772.
6. West End Family Counseling Services, Amendment No. 4 to Contract No. 18-387, increasing the total contract amount by $1,722,008, from $13,177,195 to $14,899,203.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Operate in a Fiscally-Responsible and Business-Like Manner.
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 increase of $20,080,304 for Comprehensive Treatment Services (CTS) Student Assistance Program (SAP) and School-Aged Treatment Services (SATS) is funded by Children and Families Commission for San Bernardino County, Mental Health Services Act Prevention and Early Intervention funds, Federal Financial Participation Medi-Cal, 2011 Realignment, and matching funds, up to $559,799, from the Desert Mountain Special Education Local Planning Area (DMSELPA). 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 San Bernardino County (County) residents experiencing severe mental illness and/or SUD. An integral part of the service delivery system consists of CTS services - the SAP and SATS programs. SAP and SATS are two distinctive programs that collectively represent a large portion of the children’s continuum of care for mental health services; each program is expected to collaborate cohesively with the other, providing these services countywide.
SAP is a school-based approach to providing focused services to students in need of interventions for SUD, mental health, academic, emotional, and/or social issues. The program serves children and youth (grades K-12) and their families who have been exposed to trauma, are experiencing the first onset of serious psychiatric illness, are in stressed families, are at risk for school failure and/or at risk of, or are experiencing, juvenile justice involvement.
SATS provides services to Medi-Cal beneficiaries who are at risk of school failure due to SUD, juvenile justice involvement, mental health, emotional, and social issues. The program serves school-age children and youth (up to the age of 21) that experience significant distress and resulting dysfunction, and thus meet Medi-Cal medical necessity criteria.
DMSELPA, a support services office that serves as a liaison to the desert and mountain local school districts, has a history of partnership with Desert/Mountain Children’s Center (DMCC) to provide Early & Periodic Screening, Diagnosis & Treatment (EPSDT) Medi-Cal specialty mental health services (SMHS) to eligible children and youth in the school, and preventive health care services for children under age 21. DMSELPA will provide a non-federal match for a portion of the costs for EPSDT Medi-Cal SMHS to eligible children and/or youth through DBH contracts with DMCC, up to $599,799, which will allow for an additional $3,998,564 of Medi-Cal funded services to children and youth served by DMCC through the SATS program. This additional funding is included in the contract awarded to DMCC.
DBH requests approval of amendments to the contracts listed in the Recommendation to continue to provide CTS for the SAP and SATS programs. DBH anticipates an estimated 7,116 clients to be served at an estimated cost of $2,822 per client.
DBH will also implement mechanisms to regularly review 1) client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) applicable claims data and claims for reimbursement to ensure integrity 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) provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
On June 26, 2018 (Item No.21), as the result of a formal procurement for the provision of CTS for the SAP, SATS and Children’s Intensive Services (CIS) programs, the Board of Supervisors (Board) approved the following contracts: Contract No. 18-382 with Desert/Mountain Children’s Center (DMCC) in the amount of $68,209,730; Contract No. 18-383 with Lutheran Social Services of Southern California (LSSSC) in the amount of $1,787,235; Contract No. 18-384 with Mountain Counseling and Training (MCT) in the amount of $3,700,000; Contract No. 18-385 with South Coast Community Services (SCCS) in the amount $28,595,745; Contract No. 18-386 with Victor Community Support Services, Inc. (VCSS) in the amount of $16,497,040; Contract No. 18-387 with West End Family Counseling (WEFC) in the amount of $5,586,865, for the combined amount of $124,376,615 for the period of July 1, 2018 through June 30, 2023.
On September 10, 2019 (Item No. 24), the Board approved amendments to the following contracts to meet the increased needs for school-based services: Amendment No. 1 to Contract No. 18-384 with MCT, increasing the total contract amount by $700,000, from $3,700,000 to $4,400,000; Contract No. 18-385 with SCCS, increasing the total contract amount by $9,981,324, from $28,595,745 to $38,577,069; Contract No. 18-386 with VCSS, increasing the total contract amount by $8,518,676, from $16,497,040 to $25,015,716; and Contract No. 18-387 with WEFC, increasing the total contract amount by $4,800,000, from $5,586,865 to $10,386,865, updating standard contract language, and with no change to the contract period of July 1, 2018 through June 30, 2023.
On September 29, 2020 (Item No. 20), the Board approved amendments to the following contracts: Amendment No. 1 to Contract No. 18-382 with DMCC, decreasing the total contract amount by $5,225,000, from $68,209,730 to $62,984,730. The Board also approved Amendment No. 2 to the following: MCT, decreasing the total contract amount by $522,500, from $4,400,000 to $3,877,500; SCCS, decreasing the total contract amount by $4,950,000, from $38,577,069 to $33,627,069; VCSS, decreasing the total contract amount by $1,466,666, from $25,015,716 to $23,549,050; and WEFC, decreasing the total contract amount by $653,686, from $10,386,865 to $9,733,179. These amendments decreased the total contract amounts by $12,817,852, changing the total amount from $146,589,380 to $133,771,528, with no change to the contract period of July 1, 2018, through June 30, 2023.
The decreases to the contracts approved on September 29, 2020 (BAI #20), were executed in response to the economic impact of the COVID-19 pandemic. DBH recommended the contracts providing CIS be amended to decrease the total contract amount by $12,817,852 to eliminate the CIS component as of October 1, 2020. The $12,817,852 in funding for the discontinued CIS program became available for other programs within DBH as needed, which included over 70 programs providing Specialty Mental Health and SUD. The entire $12,817,852 of redirected funds were expended.
On June 8, 2021 (Item No. 33), the Board approved an amendment to contracts with providers for the provision of Specialty Mental Health Services to remove the County Contract Rate Provisions, effective March 1, 2020, and authorized the DBH Director to execute these amendments. As a result, on September 5, 2021, the DBH Director, as authorized by the Board, executed Amendment No. 2 to the DMCC Contract, removing the County Contract Rate provisions via the standardized contract template Amendment. On September 13, 2021, the DBH Director, as authorized by the Board, executed Amendment No. 3 to the SCCS Contract, removing the County Contract Rate provisions via the standardized contract template amendment.
On April 26, 2022 (Item No. 20), the Board approved the amendments to the following contracts for the expansion of services: Amendment No. 3 with DMCC, increasing the total contract amount by $950,117, from $62,984,730 to $63,934,847; Amendment No. 4 with SCCS, increasing the total contract amount by $2,850,352, from $33,627,069 to $36,477,421. These amendments increased the contract amounts by $3,800,469, increasing the total amount from $96,611,799 to $100,412,268, with no change to the contract of July 1, 2018, through June 30, 2023.
On June 27, 2023 (Item No. 46), the Board approved the amendments to the following contracts: Amendment No. 4 to Contract No. 18-382 with DMCC, increasing the total contract amount by $14,499,272 from $63,934,847 to $78,434,119; Amendment No. 1 to Contract No. 18-383 with LSSSC, increasing the total contract amount by $359,634 from $1,787,235 to $2,146,869; Amendment No. 3 to Contract No. 18-384 with MCT, increasing the total contract amount by $1,111,666 from $3,877,500 to $4,989,166; Amendment No. 5 with SCCS, increasing the total contract amount by $12,601,535, from $36,477,421 to $49,078,956; Amendment No. 3 to Contract No. 18-386 with VCSS, increasing the total contract amount by $8,144,481, from $23,549,050 to $31,693,531, and Amendment No. 3 to Contract No. 18-387 with WEFCS, increasing the total contract amount by $40,160,604, from $139,359,232 to $179,519,836, and extending the contract term through June 30, 2024.
PROCUREMENT
DBH is recommending extending the contracts with DMCC, LSSSC, MCT, SCCS, VCSS and WEFC for an additional six months to continue to provide CTS program services to the County. A new procurement for the provision of CTS SAP SATS will be conducted and concluded in 2024-25, for services to begin effective January 1, 2025.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Ellayna Hoatson, Contract Supervisor, 388-0858) on June 10, 2024; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on June 13, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on June 10, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on June 13, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on June 13, 2024.