REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 19, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendments to Contracts for General Mental Health Outpatient Services
End
RECOMMENDATION(S)
Recommendation
Approve amendments to the following contracts for the provision of General Mental Health outpatient services, increasing the total aggregate contract amount by $1,968,873, from $7,875,492 to $9,844,365, updating standard contract language, and extending the contract terms by one year, for a total contract period of October 1, 2021, to September 30, 2026:
1. Amendment No. 3 to Contract No. 21-690 with Citrus Counseling Services, Inc. dba Family Service Agency of San Bernardino, increasing the contract amount by $625,000, from $2,500,000 to $3,125,000.
2. Amendment No. 2 to Contract No. 21-691 with Lutheran Social Services of Southern California, increasing the contract amount by $720,000, from $2,880,000 to $3,600,000.
3. Amendment No. 2 to Contract No. 21-693 with West End Family Counseling Service reflecting the legal name change and increasing the contract amount by $623,873, from $2,495,492 to $3,119,365.
(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
Approval of this item will not impact Discretionary General Funding (Net County Cost). The recommended increase of $1,968,873 for General Mental Health (GMH) outpatient services is funded by Federal Financial Participation Medi-Cal, and 1991 and 2011 Realignment funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health (DBH) 2025-26 budget and will be included in 2026-27 recommended budget.
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. GMH outpatient services are designed to assist an individual’s reduction of mental disability in order to enhance self-sufficiency through mental health activities that promote learning, self-development, and achievement of personal milestones.
GMH outpatient specialty mental health services are mandated through the Mental Health Plan contract with the State of California Department of Health Care Services. GMH Contract providers Citrus Counseling Services, Inc. dba Family Service Agency of San Bernardino (CCS-FSA), Lutheran Social Services of Southern California (LSS), West End Family Counseling Services (WEFCS), South Coast Children’s Society, Inc. dba South Coast Community Services, and Valley Star Behavioral Health, Inc. augment the capacity of DBH to meet the Federal Center for Medicare and Medicaid Services’ mandates for timeliness and access to services (42 Code of Federal Regulations Parts 431, 432, 438).
GMH outpatient services are provided to indigent or Medi-Cal-eligible adults who require Tier III level of care and children who are experiencing serious mental and emotional difficulties resulting in significant impairment in daily living activities and functioning. Adults who require Tier III level of care have a severe impairment resulting from a mental illness and/or SUD that is persistent in duration and impairs functioning in one or more categories such as health, self-care, housing, employment, education, legal, money management, and/or interpersonal/social. The mental health services include assessments, evaluation, therapy, rehabilitation, medication support, crisis intervention, and case management. DBH GMH outpatient services will serve approximately 1,160 clients at an estimated cost of $1,697 per client.
Children who qualify for GMH outpatient services are seriously emotionally disturbed. Examples of these include minors who have a mental disorder other than primary SUD or developmental disorder, which results in behavior inappropriate to the child’s age according to expected developmental norms. The children that qualify for these services must also meet medical necessity criteria such as significant impairment or probability of significant deterioration in an important area of life functioning, or the probability that the child will not progress developmentally and is individually appropriate.
On September 21, 2021 (Item No. 9), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-690 with Family Service Agency of San Bernardino (FSA), Contract No. 21-691 with LSS, and Contract No. 21-693 with WEFCS, to provide GMH outpatient services in the total combined amount of $5,906,619 for the contract period of October 1, 2021, through September 30, 2024.
On March 26, 2024 (Item No. 24), the Board approved Amendment No. 1 to Contract No. 21-690, assigning the contract from FSA to CCS-FSA, and adding Executive Order N-6-22 - Russia Sanctions, and Campaign Contribution Disclosure (Senate Bill 1439), with no change to the total combined amount of $5,906,619 or the contract period of October 1, 2021, through September 30, 2024.
On September 10, 2024 (Item No. 21) the Board approved Amendment No. 2 to Contract 21-690 with CCS-FSA, Amendment No. 1 to Contract No. 21-691 with LSS, and Amendment No.1 to Contract No. 21-693 with WEFCS adding Contract Exclusivity and Notice of Delays clauses to update standard contract language and add Executive Order N-6-22 - Russia Sanctions and Campaign Contribution Disclosure (SB 1439), increasing the contract amount by $1,968,873 from $5,906,619 to $7,875,492, and extending the contract term one year for a total contract period of October 1, 2021, to September 30, 2025.
The recommended amendments will update the Levine Act - Campaign Contribution Disclosure (formerly referred to as Senate Bill 1439) and increase the total combined contract amount by $1,968,873, from $7,875,492 to $9,844,365, and extend the contract term one year for a total contract period of October 1, 2021, through September 30, 2026. Approval of these amendments will allow CCS-FSA, WEFCS and LSS to continue to provide GMH services through September 30, 2026.
On April 2, 2025, DBH staff were notified that West End Family Counseling Services, Inc.’s legal name changed to West End Family Counseling Service which coincided with upcoming amendments to General Mental Health Outpatient Services. Amendment No. 2 to Contract No. 21-693 is being processed at this time as this is the first Board date available following DBH programmatic, fiscal, administrative, and legal reviews.
DBH will implement monitoring 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 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) 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, Contracts Supervisor,383-3940) on July 15, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 16, 2025; and County Finance and Administration (Allegra Pajot, Administrative Analyst, 388-0218) on August 4, 2025.