REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 13, 2026
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Fee-For-Service Acute Psychiatric Inpatient Hospital Service Contracts
End
RECOMMENDATION(S)
Recommendation
Approve contracts with the following Fee-for-Service for Acute Psychiatric Inpatient Hospital Service providers, for services rendered from May 2024 through June 2025, in an aggregate not-to-exceed amount of $1,148,739:
1. Aurora Charter Oak Hospital, in the amount of $139,832
2. Canyon Ridge Hospital, Inc. dba Canyon Ridge Hospital, in the amount of $545,600
3. Community Hospital of San Bernardino, in the amount of $123,200
4. Loma Linda University Medical Center, in the amount of $28,600
5. Vista Behavioral Hospital, LLC dba Pacific Grove Hospital, in the amount of $311,507
(Presenter: Jennifer Alsina, Assistant Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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 payments in an aggregate amount not to exceed $1,148,739 to reimburse Fee-for-Service Acute Psychiatric Inpatient Hospital Service (FFS) providers will be funded by 1991 Realignment funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2025-26 budget.
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. In 1995, DBH entered a contract with the California Department of Health Care Services (DHCS) as a Mental Health Plan (MHP) established under Assembly Bill 757 (AB 757), which made DBH responsible for providing access to high quality, specialty mental health services for Medi-Cal beneficiaries in the most cost-effective manner possible.
AB 757 allowed for the phased implementation of managed mental health care for Medi-Cal beneficiaries through Short-Doyle Medi-Cal and FFS contracts with MHPs and standardized the requirements for all MHPs that participate in the Medi-Cal Specialty Mental Health Service Consolidation Program. As a result of the contract with DHCS and pursuant to AB 757 and related regulations, DBH must contract with area hospitals to provide psychiatric inpatient hospital services to Medi-Cal-eligible residents.
DBH strives to compensate contracted service providers within the original contract period for inpatient psychiatric services provided. However, the lengthy nature of the review and approval process for these services can interfere with this objective. Inpatient psychiatric hospitalizations are invoiced following patient discharge; these services are subject to significant review and authorization requirements. Therefore, services provided for hospitalizations beginning prior to the FFS providers previous contract end date of June 30, 2025, and continuing into the next contract period were unable to be attributed to the appropriate fiscal year prior to the contract end date.
DBH fiscal personnel notified DBH program administration on July 1, 2025 that there were not enough funds to process payments for services rendered through June 30, 2025. Due to the standard billing and review timelines associated with these services, payments often continue up to a year after contract expiration. The delayed submission and the required review period resulted in DBH exceeding the limits of the contract ending June 30, 2025. This item is being presented at this time as this is the first date available following the required program, fiscal, administrative, and legal reviews.
These reconciliation contracts with each provider will collectively resolve any outstanding amounts owed by the County for those services rendered on or prior to June 30, 2025. The public benefits from the County’s continuing relationship with area hospitals for the County to maintain its ongoing commitment to providing psychiatric inpatient hospital services to Medi-Cal eligible residents.
DBH is working to leverage software tools between the concurrent review vendor and existing infrastructure to develop reports that allow for the projection of expenditures based on authorized bed days, prior to submission of invoices. Additionally, DBH is analyzing existing expenditures to better liabilities to service providers prior to contract expiration, with the intend to present contract amendments to the Board as needed.
On December 15, 2020 (Item No. 27), the Board of Supervisors (Board) approved non-competitive contracts for FFS hospitals in an aggregate amount not to exceed $20,891,667 for the period of December 15, 2020, through June 30, 2025. The Board approved Contract No. 20-1239 with Aurora Charter Oak Hospital (ACOH), Contract No. 20-1240 with Canyon Ridge Hospital, Inc. dba Canyon Ridge Hospital (CRH), Contract No. 20-1241 with Community Hospital of San Bernardino (CHSB), Contract No. 20-1242 with Loma Linda University Medical Center (LLUMC), Contract No. 20-1243 with Visa Behavioral Hospital, LLC dba Pacific Grove Hospital (PGH), and Contract No. 20-1244 with Redlands Community Hospital (RCH).
On October 4, 2022 (Item No. 15), the Board approved Amendment No. 1 to Contract No. 20-1240 with CRH, Contract No. 20-1241 with CHSB, Contract No. 20-1242 with LLUMC, and Contract No. 20-1244 with RCH, to update the negotiated bed day rates, with no change to the combined aggregate amount of $20,891,667, or the contract period of December 15, 2020, through June 30, 2025.
On November 14, 2023 (Item No. 22), the Board approved Amendment No. 1 to Contract No. 20-1239 with ACOH and Contract No. 20-1243 with PGH, Amendment No. 2 to the Contract No. 20-1240 with CRH, Contract No. 20-1241 with CHSB, and Contract No. 20-1242 LLUMC, to update the standard contract language and negotiated bed day rates, increasing the combined aggregate contract amount by $6,721,908 from $20,891,667 to $27,613,575, with no change to the contract period of December 15, 2020, through June 30, 2025.
On December 17, 2024 (Item No. 25), the Board approved Amendment No. 2 to the Contract No. 20-1239 with ACOH and Contract No. 20-1243 with PGH, Amendment No. 3 to Contract No. 20-1240 with CRH, Contract No. 20-1241 with CHSB, and Contract No. 20-1242 with LLUMC, increasing the combined aggregate contract amount by $9,464,346 from $27,613,575 to $37,077,921, with no change to the contract period of December 15, 2020, through June 30, 2025.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on December 10, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on November 25, 2025; and County Finance and Administration (Paul Garcia, Administrative Analyst, 386-8392) on December 19, 2025.