REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 16, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Non-Financial Affiliation Agreement with Kaiser Foundation Hospitals, Southern California Permanente Medical Group for Clinical and Instructional Training
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2 to non-financial Affiliation Agreement No. 24-555 with Kaiser Foundation Hospitals, Southern California Permanente Medical Group, for the provision of clinical and instructional training to psychiatry residents and/or fellows, updating contract language to include an additional training facility, with no change to the contract period of July 1, 2024 through June 30, 2029.
2. Authorize the Director of the Department of Behavioral Health to electronically sign and submit any subsequent non-substantive amendments to the non-financial Affiliation Agreement No. 24-555 on behalf of the County, subject to County Counsel review.
3. Direct the Director of the Department of Behavioral Health to transmit any non-substantive amendments in relation to the non-financial Affiliation Agreement No. 24-555 to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Gayani DeSilva, Medical Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Create, Maintain and Grow Jobs and Economic Value in the County.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost) as the recommended amendment to the Affiliation Agreement is non-financial in nature.
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. As the Mental Health Plan for the County, DBH is required to maintain a qualified network of psychiatric care providers to ensure timely access to mental health services.
DBH has experienced the effects of the nationwide shortage of psychiatrists and qualified individuals who provide services in the County’s public mental health workforce. For over 17 years, DBH’s Workforce Education and Training component of the Mental Health Services Act Three-Year Program and Expenditure Plan has included increasing the number of psychiatrists in the public mental health field as a goal.
To address this shortage, DBH proposed an Affiliation Agreement with Kaiser Foundation Hospitals, Southern California Permanente Medical Group (Kaiser Permanente) to allow psychiatry residents and/or fellows (Residents) to perform rotations at DBH-operated mental health facilities. The objective of recruiting Residents into DBH’s system of care is to offer a beneficial educational opportunity for them due to the volume and variety of patients at DBH.
DBH has been providing clinical and instructional training to Kaiser Permanente Residents through a non-financial Affiliation Agreement since 2016. This affiliation agreement has proven to be successful, allowing Residents to gain a richness of diversity in training settings and see a broad cross-section of child, adolescent, adult, and older adult DBH clients from many different ethnic, cultural, and socio-economic backgrounds. Kaiser Permanente Residents provided services to 331 unduplicated clients during 2022-23 and an estimated 331 unduplicated clients during 2023-24.
On June 25, 2024 (Item No. 38), the Board of Supervisors (Board) approved non-financial Affiliation Agreement No. 24-555 with Kaiser Permanente, to provide clinical and instructional training to Residents, for the period of July 1, 2024 through June 30, 2029.
On June 18, 2025 (Item No. 22), the Board approved non-financial Affiliation Agreement Amendment No. 1 to Agreement No. 24-555 with Kaiser Permanente, for the provision of clinical and instructional training to psychiatry residents and/or fellows, updating contract language to include training facilities, with no change to the contract period of July 1, 2024 through June 30, 2029.
Approval of the item further amends the Affiliation Agreement No. 24-555 to include training at an additional DBH facility located within the city of San Bernardino, which allows DBH to enhance its partnership with Kaiser Permanente to provide clinical and instructional training to Residents.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Diana Barajas, Acting Administrative Supervisor I, 388-0862) on November 3, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on November 12, 2025; and County Finance and Administration (Paul Garcia, Administrative Analyst, 386-8392) on November 24, 2025.