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
Contract with Ramsell Corporation for Pharmacy Benefit Manager Services
End
RECOMMENDATION(S)
Recommendation
Approve contract with Ramsell Corporation, for the provision of Pharmacy Benefit Manager services for countywide prescription management, in an amount not to exceed $750,000, for the contract period of January 1, 2026 through December 31, 2030.
(Presenter: Gayani DeSilva, Medical 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.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The amount not to exceed $750,000 for Pharmacy Benefit Manager (PBM) services will be funded by 1991 Realignment and the Mental/Behavioral Health Services Act funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2025-26 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 San Bernardino County (County) residents experiencing severe mental illness and/or SUD. DBH has provided countywide PBM services through contracted vendors since 2003. The PBM program provides prescription management services for DBH to clients who are unfunded, receive medications not reimbursed under the Medi-Cal program or other third-party insurance, and/or are pending Medi-Cal eligibility. Prescriptions are typically given for a 30-day supply during clients’ monthly appointments. The PBM program allows DBH to gather all unfunded client pharmaceutical data and provide regular monthly reporting of the usage and costs of medications to DBH Administration. This data allows DBH administrators to enhance pharmaceutical practice management by reviewing poly-pharmacy practices, medication efficacies based upon diagnoses, and uses of brand-name versus generic drugs.
Ramsell Corporation (Ramsell) provides prescription management services to eligible county residents through the PBM program. The monthly medication cost per client has averaged, based on medical necessity, from a low of $3.66 for a client with one prescription to a high of $947.25 for a client requiring multiple prescriptions. Upon approval of the recommended contract, DBH anticipates that Ramsell will service approximately 200 clients and issue around 1,300 prescriptions annually.
Since July 1, 2009, Ramsell has effectively provided pharmacy benefit management services to the County’s uninsured and underinsured population. As the County’s current contractor, Ramsell provides:
• A network of pharmacies that geographically covers all of the county, including Needles and Trona.
• Pharmacies that have increased language translation capabilities and extended hours of operation.
• Tracking and coordination of client eligibility.
• A DBH-specific database for tracking cost, usage, and prescribing patterns for unsponsored clients.
• Routine concurrent and retrospective reports on pharmacies, enrolled clients, and physicians' prescribing practices.
• Patient assistance programs with drug manufacturers that provide no-cost drugs with minimal dispensing and administrative fees to eligible clients.
• Requests for prior authorizations for medications.
The recommended contract with Ramsell will allow DBH to continue to provide prescription services to eligible county residents. DBH will monitor contractor performance on a regular basis to ensure performance and compliance standards are met.
PROCUREMENT
Following the implementation of the Affordable Care Act, DBH experienced a significant reduction in expenditures for PBM services as more individuals obtained insurance coverage for prescription medications. Consequently, the contract amount has been reduced by 50%, making the opportunity less financially viable for other potential vendors. This reduction, combined with the highly specialized service requirements, has further limited market interest. In both the initial and most recent procurements, Ramsell was the sole proposer to meet the County’s minimum qualifications. Given these factors, a non-competitive procurement is the most practical and cost-effective approach to ensure continuity of care and service quality for vulnerable populations.
The Purchasing Department supports the non-competitive procurement with Ramsell Corporation to provide prescription management services to eligible uninsured and underinsured County residents due to the specialized credentials and the comprehensive nature of the services provided. Ramsell remains one of the few vendors capable of delivering the full scope of pharmacy benefit management services.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 388-3940) on October 27, 2025; Risk Management (Stephanie Pacheco, Staff Analyst II, 386-8655) on October 31, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on November 14, 2025; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on October 31, 2025; and County Finance and Administration (Paul Garcia, Administrative Analyst, 386-8392) on November 25, 2025.