REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 23, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Non-Financial Mandated County Performance Contract with the California Department of Health Care Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to non-financial mandated County Performance Contract No. 21-743 (State Agreement No. 21-10106), with the California Department of Health Care Services, extending the term for 12 months, for the total contract period of July 1, 2021 through June 30, 2025.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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
Amendment No. 1 (State Agreement No. 21-10106 A1) to County Performance Contract No. 21-743 (State Agreement No. 21-10106) (Contract) with the California Department of Health Care Services (DHCS) is non-financial in nature; therefore, approval of this item does not impact Discretionary General Funding (Net County Cost).
BACKGROUND INFORMATION
The Department of Behavioral Health (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. This responsibility includes being the administrator of the Managed Care Medi-Cal Mental Health Plan (MHP) for the County.
DBH is mandated to enter into a County Performance Contract with DHCS for the delivery of mental health services funded with 1991 and 2011 Realignment Funds to the residents of the County. The Contract specifies the State and Federal codes and regulations required to operate, maintain, and receive reimbursement for programs funded under the Mental Health Services Act (MHSA), Lanterman-Petris-Short (LPS) Act, Projects for Assistance in Transition from Homelessness (PATH), Community Mental Health Services Block Grant (MHBG), Crisis Counseling Assistance and Training Program, Children's System of Care, Substance Use Treatment, Prevention and Recovery Services Block Grant (SUBG) programs, and housing and homeless programs, as well as outlining DHCS’ oversight provisions of the County’s community mental health services pursuant to the Bronzan-McCorquodale Act.
In order to receive funding, DBH must comply with the conditions and requirements outlined in the Contract for quality assurance, the scope of work and program standards, budget requirements, and accountability measures for local mental health and SUBG funded SUD programs.
DBH, as the local MHP, is responsible for providing certain mental health services, including Tier III, Specialty Mental Health Services to clients. Tier levels (I, II, and III) indicate successively higher levels of service intensity with Tier level II services provided to clients requiring significant behavioral health supportive services. DBH contracts with healthcare providers such as Inland Empire Health Plan and Molina Healthcare of California, Inc. in the administration of Medi-Cal behavioral health benefits for individuals experiencing severe and persistent mental illness and suffering from SUD. Additionally, through the use of MHSA funding, DBH provides outreach, supportive services, and community education to those who are unserved, underserved or inappropriately served, which includes prevention and early intervention, crisis services and recovery-based services that are provided through an extensive continuum of care of County operated clinics, fee-for-service providers, and contracted DBH service providers.
DHCS administers MHSA, LPS, PATH and MHBG programs and oversees the County provision of community mental health services provided by realignment funds. DBH, as the County’s MHP, must meet certain conditions and requirements to receive funding for these programs and community mental health services.
On October 5, 2021 (Item No. 18), the Board of Supervisors (Board) approved the non-financial mandated Contract with DHCS, which outlined conditions and requirements for funding for the period of July 1, 2021 through June 30, 2024.
On February 27, 2024, DBH received Amendment No. 1 to the mandated Contract from DHCS which extends the term through June 30, 2025.
Pursuant to Welfare and Institutions (W&I) Code 5604.2, the San Bernardino County Behavioral Health Commission (BHC) is required to review County Performance Contracts prior to the Board’s approval. The BHC is appointed by the Board and provides the Board with recommendations on local mental health and SUD programs that will strengthen and improve services to County residents. Amendment No. 1 to the Contract was reviewed by the BHC at the meeting held on April 4, 2024.
Pursuant to W&I Code 5650(a), DHCS requires each County Governing Body or Board to approve and sign the County Performance Contract. Upon Board approval, DBH will submit Amendment No. 1 to the Contract to DHCS.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by (Ellayna Hoatson, Contracts Supervisor, 388-0858) on March 25, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 27, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on April 8, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on April 8, 2024.