REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 8, 2025
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. 2 to non-financial Contract No. 21-743 (State Agreement No. 21-10106), with the California Department of Health Care Services, which outlines quality assurance, scope of work, program standards, budget requirements, and accountability measures for local mental health and substance use block grant funds and substance use disorder programs, extending the term by one year, for the new total contract period of July 1, 2021, through June 30, 2026.
(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
This item does not impact Discretionary General Funding (Net County Cost). The Mandated County Performance contract (Contract) with the California Department of Health Care Services (DHCS) 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. This responsibility includes being the administrator of the Managed Care Medi-Cal Mental Health Plan (MHP) for the County.
DBH is mandated to enter a Contract with DHCS for the delivery of mental health services to the residents of the county, funded with 1991 and 2011 Realignment Funds. 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 known as Mental Health Block Grant (MHBG), Crisis Counseling Assistance and Training Program, Children's System of Care, Substance Use Treatment and Prevention Block Grant funds (SUBG), 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, scope of work and program standards, budget requirements, and accountability measures for local mental health and SUBG-funded SUD programs.
DBH is the local MHP responsible for providing certain mental health services, including Tier III Specialty Mental Health Services to County residents. 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, utilizing MHSA funding, DBH provides outreach, supportive services, and community education to those who are unserved, underserved or inappropriately served. These services include 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 the MHSA, LPS, PATH and MHBG programs, and oversees the County provision of community mental health services provided by 1991 and 2011 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 No. 21-743 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 from DHCS. On April 23, 2024 (Item No. 22), the Board approved Amendment No. 1 to the non-financial mandated Contract No. 21-743 with DHCS, extending the term for 12 months, for the total contract period of July 1, 2021, through June 30, 2025.
On March 7, 2025, DBH received Amendment No. 2 to the mandated Contract from DHCS which extends the term for an additional year, through June 30, 2026. Pursuant to Welfare and Institutions (W&I) Code 5650(a), DHCS requires each County Governing Body or Board to approve and sign the Mandated County Performance Contract.
Pursuant to 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. 2 to Contract No. 21-743 (State Agreement No 21-10106) was reviewed by the BHC at the meeting held on April 3, 2025.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Michael Shin, Contracts Manager, 388-0889) on March 24, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 25, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on March 25, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on March 25, 2025.