REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 10, 2025
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contract for General Mental Health Outpatient Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 21-692, with South Coast Children’s Society, Inc. dba South Coast Community Services for the provision of General Mental Health outpatient services, increasing the total contract amount by $3,069,103, from $9,260,000 to $12,329,103, and extending the contract for an additional year, for a total contract period of October 1, 2021, through September 30, 2026.
(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
This item does not impact Discretionary General Funding (Net County Cost). The contract increase of $3,069,103 will be 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’s (DBH) 2024-25 budget and will be included in future recommended budgets.
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. General Mental Health (GMH) outpatient services are designed to assist an individual’s reduction of mental disability 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 (DHCS). GMH Contract providers 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 a Tier III level of care and children who are experiencing serious mental and emotional difficulties resulting in significant impairment in daily living activities. Adults who require a Tier III level of care have a mental illness and/or SUD with a severe, persistent impairment in one or more functions: health, self-care, housing, employment, education, legal, money management, and/or interpersonal/social. The mental health services include assessments, evaluations, therapy, rehabilitation, medication support, crisis intervention, and case management.
Children who qualify for GMH outpatient services are seriously emotionally disturbed. Examples 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 signification deterioration in an important area of life functioning, or the probability that the child will not progress developmentally and as individually appropriate.
Approval of Amendment No. 2 to Contract No. 21-692 (Contract) will allow South Coast Children’s Society, Inc. dba South Coast Community Services (SCCS) to restore three critical clinician positions, psychiatrist hours, and direct support services - clinical supervision and staffing licensed psychiatric technicians - reduced by significant increases in health insurance and competitive salary costs. Amendment No. 2 will also allow GMH services to continue while a procurement is conducted for a new contract for GMH services beginning in October 2026. DBH GMH outpatient services will serve approximately 640 individuals over the additional year of the contract at an estimated cost of $4,795 per individual.
On September 21, 2021 (Item No. 9), as a result of a formal procurement, the Board of Supervisors (Board) approved the Contract with SCCS to provide GMH outpatient services in the total amount of $6,945,000, for the period of October 1, 2021, through September 30, 2024.
On September 10, 2024 (Item No. 21), the Board approved Amendment No. 1 to the Contract with SCCS adding Executive Order N-6-22 - Russia Sanctions, and Campaign Contribution Disclosure (Senate Bill 1439), increasing the total contract amount by $2,315,000 from $6,945,000 to $9,260,000, and extending the contract term one year, for a total contract period of October 1, 2021, through September 30, 2025.
DBH will also implement monitoring mechanisms to regularly review 1) client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) 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 (DHCS) billing requirements; and 3) 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 (Michael Shin, Administrative Manager, 388-0899) on April 22, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 13, 2025; Finance (Paul Garcia, Administrative Analyst, 386-8392) on May 21, 2025; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0332) on May 22, 2025.