REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 25, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services
End
RECOMMENDATION(S)
Recommendation
1. Approve amendments to contracts with the following agencies, effective July 1, 2025, for the provision of Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services, increasing the aggregate amount by $800,000 for clients referred by the Department of Children and Family Services in 2025-26:
a. Inland Behavioral and Health Services, Inc., Amendment No. 3 to Contract No. 22-472, with no change to the contract period of July 1, 2022, through June 30, 2027.
b. Social Science Services, Inc. dba Cedar House Life Change Center, Amendment No. 3 to Contract No. 22-475, with no change to the contract period of July 1, 2022, through June 30, 2027.
c. CLARE|MATRIX, Amendment No. 2 to Contract No. 23-601, with no change to the contract period of July 1, 2023, through June 30, 2027.
2. Approve Amendment No. 4 to Contract No. 22-471 with High Desert Child, Adolescent and Family Services Center, Inc., for the provision of Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services, increasing the total contract amount by $796,563, from $3,101,210 to $3,897,773, in addition to the same increase in the aggregate amount by $800,000, as referenced in Recommendation No. 1, for clients referred by the Department of Children and Family Services in 2025-26, with no change to the contract period of July 1, 2022 through June 30, 2027.
3. Approve Amendment No. 4 to Contract No. 22-473 with Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services, increasing the total contract amount by $1,092,787, from $5,764,693 to $6,857,480, in addition to the same increase in the aggregate amount by $800,000, as referenced in Recommendation No. 1, for clients referred by the Department of Children and Family Services in 2025-26, with no change to the contract period of July 1, 2022 through June 30, 2027.
(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 will not result in the use of additional Discretional General Funding (Net County Cost). The recommended increases of $796,563 and $1,092,787 to the contracts in Recommendation Nos. 2 and 3 respectively, totaling $1,889,350, are funded by 2011 Realignment; Drug Medi-Cal; and Substance Use Prevention, Treatment and Recovery Services Block Grant. The recommended aggregate increase of $800,000 for clients referred by the Department of Children and Family Services (CFS), which is separate from the increase to the total amounts of $796,563 and $1,092,787 for the contracts with High Desert Child, Adolescent, and Family Services Center, Inc. (HDCAFS), and Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services (IVRS), will be funded through a memorandum of understanding with CFS. Adequate appropriation and revenue will be included in DBH’s 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. SUD Early Intervention, Outpatient Treatment, Intensive Outpatient Treatment, and Recovery Services (EI-OT-IOT-RS) provide a full range of SUD prevention/treatment services and education for residents in the county.
Early Intervention services are intended for youth (ages 12 through 17) and young adults (ages 18 through 20) to identify and address potential substance use before it develops into more serious conditions. These services often involve screening, assessment, brief counseling, or psychoeducation to help clients understand the risks of substance abuse and develop health coping skills.
Outpatient Treatment (OT) is designed for clients with SUDs; it provides counseling, therapy, and supportive services without requiring clients to live at a treatment facility. Services typically include individual, group, and family therapy, as well as medication management and psychoeducation.
Intensive OT is a more structured and time-intensive form of outpatient care, designed for clients with moderate to severe SUDs or co-occurring mental health issues. Clients participate in multiple treatment sessions per week, which may include individual, group, and family therapy, as well as case management and other support services.
Recovery Services provide those who have completed treatment with a place to seek support, allowing clients to reconnect with a former treatment episode is not warranted. These services may include peer support, self-help groups, case management, and ongoing counseling or therapy with the goal of maintaining abstinence and preventing relapse.
On June 28, 2022 (Item No. 35), as the result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 22-471 with HDCAFSC in the amount of $2,290,745, Contract No. 22-472 with Inland Behavioral and Health Services, Inc. (IBHS) in the amount of $1,685,950, Contract No. 22-473 with IVRS in the amount of $4,769,000, and Contract No. 22-475 with Social Science Services, Inc. dba Cedar House Life Change Center (Cedar House) in the amount of $1,530,295, to provide EI-OT-IOT-RS for a combined contract total of $10,275,990 for the period of July 1, 2022 through June 30, 2027.
On May 23, 2023 (Item No. 25), the Board approved Amendment No. 1 to Contract No. 22-471 with HDCAFSC, Contract No. 22-472 with IBHS, Contract No. 22-475 with Cedar House, and Contract No. 22-473 with IVRS, adding an aggregate amount of $1,600,000 for clients referred by CFS with no change to the contract period of July 1, 2022, through June 30, 2027. The amendment with IVRS also included an increase of the total contract amount of $57,000, from $4,769,000 to $4,826,000, with no change to the contract period of July 1, 2022, through June 30, 2027.
On June 27, 2023 (Item No. 41), as a result of a formal procurement, the Board approved Contract No. 23-601 with CLARE|MATRIX in the amount of $1,520,000, in addition to the aggregate amount of $800,000, for clients referred by CFS for 2023-24, for the contract period of July 1, 2023, through June 30, 2027.
On May 7, 2024 (Item No. 21), the Board approved Amendment No. 2 to Contract No. 22-471 with HDCAFSC, increasing the total contract amount by $810,465, from $2,290,745 to $3,101,210, with no change to the contract period of July 1, 2022, through June 30, 2027. Additionally, the Board approved Amendment No. 2 to Contract No. 22-473 with IVRS, increasing the total contract amount by $938,693, from $4,826,000 to $5,764,693, with no change to the contract period of July 1, 2022, through June 30, 2027.
On June 11, 2024 (Item No. 36), the Board approved Amendment No. 3 to Contract No. 22-471, with HDCAFSC, Amendment No. 2 to Contract 22-472, with IBHS, Amendment No. 3 to Contract 22-473, with IVRS, Amendment No. 2 to Contract No. 22-475, with Cedar House, and Amendment No. 1 to Contract No. 23-601, with CLARE|MATRIX, adding an aggregate amount by $800,000 for clients referred by CFS for 2024-25 for the contract period of July 1, 2024 through June 30, 2025, add Campaign Contribution Disclosure Senate Bill (SB 1439) language, and add Executive Order N-6-22 - Russia Sanctions language, with no change to the contract periods for HDCAFSC, IBHS, IVRS, Cedar House of July 1, 2022, through June 30, 2027, and CLARE|MATRIX of July 1, 2023 through June 30, 2027.
Approval of $800,000 in additional aggregate funding is to be used by all EI-OT-IOT-RS providers on a first-come, first-served basis for clients referred by CFS in 2025-26. Approval of the contract amendments will allow DBH to extend services to an estimated 679 CFS referred clients annually at an average cost of $1,178 per client for all services.
Approval of Recommendation No. 2 and No. 3 contract amendments for HDCAFSC and IVRS will increase the total contract amount by $1,889,350 from $8,865,903 to $10,755,253, in addition to the increase in the aggregate amount by $800,000 for clients referred by CFS in 2025-26. The recommended increase of $1,889,350 will allow HDCAFSC and IVRS to expand EI-OT-IOT-RS services to the Colton, San Bernardino, and Yucca Valley regions. Approval of the contract amendments for HDCAFSC and IVRS will allow DBH to address the departure of a provider in Colton and continue to provide services in the Colton, San Bernardino and Yucca Valley regions. Approval of the contract amendments for HDCAFSC and IVRS will allow DBH to provide services to an estimated 1,617 additional clients at an average cost of $1,178 per client for the contract term.
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 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) 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 (Michael Shin, Contracts Supervisor, 388-0899) on February 26, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 4, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on March 10, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on March 11, 2025.