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
Non-Financial Mental Health Plan Contract with the California Department of Health Care Services for the Provision of Specialty Mental Health Services
End
RECOMMENDATION(S)
Recommendation
1. Approve non-financial Mental Health Plan Contract (State Agreement No. 25-50146) with the California Department of Health Care Services, for the provision of Specialty Mental Health Services and reimbursement of expenditures, for the period of July 1, 2025, through December 31, 2026.
2. Authorize the Director of the Department of Behavioral Health, as the County Mental Health Director, to execute the Mental Health Plan Contract and any subsequent non-substantive amendments, as required by the California Department of Health Care Services, for the period of July 1, 2025 through December 31, 2026, on behalf of the County, subject to County Counsel review.
3. Direct the Director of the Department of Behavioral Health to transmit the Mental Health Plan Contract and any subsequent non-substantive amendments to the Clerk of the Board of Supervisors within 30 days of execution.
(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 Services 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 Mental Health Plan (MHP) Contract (State Agreement No. 25-50146) with the California Department of Health Care Services (DHCS) outlines the terms and conditions to receive Federal Financial Participation (FFP) reimbursement of expenditures for eligible Specialty Mental Health Services (SMHS) provided to eligible Medi-Cal beneficiaries. Adequate appropriation and revenue have been included in the Department of Behavioral Health (DBH) 2025-26 budget and will be included in the 2026-27 recommended budget.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder treatment services to County residents who are experiencing severe and persistent mental illness, substance use, and other addictions. DBH accomplishes this through a continuum of care of County operated clinics, fee-for-service providers, and contracted service providers. In accordance with Title 9, Section 1810.226 of the California Code of Regulations, an MHP is an entity that enters into a contract with DHCS to directly provide or arrange and pay for SMHS to Medi-Cal beneficiaries in a county. An MHP may be a county, counties acting jointly, or another governmental or non-governmental entity.
DBH has been the administrator of the MHP for the County since 1998. Due to changes in the delivery of services, requirements and regulations, the MHP contract is updated as necessary by DHCS, then submitted to the Board of Supervisors (Board) for approval. The provision of the MHP contract allows DBH to provide SMHS to eligible members of the community, submit claims for reimbursement of services rendered by the County-operated clinics and fee-for-service and contracted service providers, ensure network adequacy, and meet and demonstrate compliance with all MHP requirements and mandates.
As the MHP Administrator, DBH is required to contract with DHCS for SMHS. This MHP contract is in accordance with California Welfare and Institutions Code (WIC) Sections 14680 through 14727. WIC Section 14712 directs DHCS to implement and administer Managed Mental Health Care for Medi-Cal eligible residents of California through contracts with MHPs. DBH agrees to continue to operate the MHP for the County and to adhere to DHCS’ contractual requirements.
During 2024-25, DBH served 41,550 unduplicated clients of which 33,031 were Medi-Cal beneficiaries. The number of clients served is expected to continue to increase in future fiscal years in alignment with historical service data, as well as with the revision of the asset limits for certain Non-Modified Adjusted Gross Income Medi-Cal populations.
On April 11, 2025, DBH received notification of Cancellation of SMHS Contract No. 22-1094 previously approved by the Board on November 15, 2022 (Item No. 23) (State Agreement No. 22-20127) from DHCS, terminating the active contract effective June 30, 2025, for the purposes of initiating a new SMHS contract (State Agreement No. 25-50146), for the period of July 1, 2025 through December 31, 2026.
On July 3, 2025, DBH received the new State Agreement No. 25-50146 from DHCS. A retroactive effective date of July 1, 2025 is necessary to avoid interruptions in service delivery, maintain compliance with state and federal regulations, and ensure the continued provision of timely and equitable behavioral health services for the residents of the County. This item is being presented at this time as this is the first date available following the required extensive program, fiscal, administrative, and legal reviews.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Diana Barajas, Acting Contracts Supervisor, 388-0862) on July 22, 2025; County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on July 31, 2025; and County Finance and Administration (Allegra Pajot, Administrative Analyst, 388-0218) on August 4, 2025.