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 with Life Generations Healthcare LLC for Institution for Mental Disease Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 23-1087 with Life Generations Healthcare LLC, for the provision of Institution for Mental Disease services, updating the contract language to include additional program sites, with no changes to the aggregate contract amount of $40,904,090 or the contract period of September 26, 2023, through June 30, 2027.
(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.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). Institution for Mental Disease (IMD) services are funded by Local Share. Adequate appropriation and revenue are included in the Department of Behavioral Health’s (DBH) 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
As the Mental Health Plan for the County, DBH is required to provide an adequate network of treatment providers to County beneficiaries through an array of behavioral health services. DBH operates a continuum of care system that consists of County-operated clinics and contracted service providers delivering a variety of mental health treatment services within each geographic region of the county. The highest level of care is state hospitals and acute psychiatric units; the next highest level of care is provided through an IMD facility. IMD facilities provide a program consisting of organized therapeutic activities which promote daily living and social skills to county residents experiencing severe and persistent behavioral health disorders.
IMD facilities are state licensed, locked, skilled nursing facilities that provide specialized treatment services to clients experiencing a severe behavioral health disorder whose functioning level is too challenging to be maintained at a licensed board and care facility, including augmented board and care, or in the community. DBH contracted IMD facilities are responsible for:
• Maintaining state certification as a skilled nursing facility;
• Providing bed days at the Department of Health Care Services specified rate(s);
• Evaluating and accepting referrals from state hospitals, veteran hospitals, county/private facilities, and other facilities or sources deemed appropriate by DBH;
• Providing psychiatric services, treatment, and support staff with specialized training; and
• Providing medication management, crisis intervention, and discharge planning.
On September 26, 2023 (Item No. 24), the Board of Supervisors (Board) approved Contract No. 23-1087 (Contract) with Generations Healthcare in the aggregate amount of $40,904,090, effective September 26, 2023, through June 30, 2027.
On March 26, 2024 (Item No. 23), the Board approved Amendment No. 1 to the Contract which reflected the legal name change from Generations Healthcare to Life Generations Healthcare LLC and included contract language changes for the additional Lakeside location program site, with no change to the aggregate contract amount of $40,904,090 or the contract period of September 26, 2023, through June 30, 2027.
Approval of Amendment No. 2 to the Contract will add Newport Beach and National City as program site locations, with no change to the aggregate contract amount of $40,904,090 or the contract period of September 26, 2023, through June 30, 2027. The inclusion of these two new program sites allows IMD placement for older adults above 65 years of age, placement for clients who have previously been denied at current contracted IMDs, and mitigates the challenges associated with the increase of state hospital referrals.
DBH will also implement mechanisms to regularly 1) review client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; and 2) review provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
DBH did not conduct a formal procurement for these services as there are a limited number of state-licensed IMD facilities willing to provide services to DBH clients. The IMD providers specialize in providing services to persistently mentally ill clients with psychiatric needs, severe medical issues, and a criminal history that other facilities decline to admit. The Purchasing Department continues to support the non-competitive contracts for IMD services with the justification of specialized services.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Lisa Rivas-Ordaz, Contracts Supervisor, 383-3940) on April 21, 2025; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 8, 2025; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on May 9, 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.