REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
April 21, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Agreements for Fee-For-Service Psychiatric Inpatient Hospital Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No.1 to the following agreements for the provision of Fee-For-Service Psychiatric Inpatient Hospital Services, increasing the combined aggregate amount by $28,644,555, from $60,869,390 to $89,513,945:
a. Aurora Charter Oak Hospital, Agreement No. 25-512, with no change to the period of July 1, 2025, through June 30, 2030.
b. Canyon Ridge Hospital, Inc. dba Canyon Ridge Hospital, Agreement No. 25-513, with no change to the period of July 1, 2025, through June 30, 2030.
c. Community Hospital of San Bernardino, Agreement No. 25-511, with no change to the period of July 1, 2025, through June 30, 2030.
d. Loma Linda University Medical Center, Agreement No. 25-857, with no change to the period of July 1, 2025, through June 30, 2030.
e. View Behavioral Health-Colton II, LLC dba View Behavioral Health Colton Children’s, Agreement No. 25-858, updating the contractor’s name, removing a facility address, and updating agreement provisions with no change to the period of November 4, 2025, through June 30, 2030.
f. Vista Behavioral Hospital, LLC dba Pacific Grove Hospital, Agreement No. 26-67, with no change to the period of July 1, 2025, through June 30, 2030.
2. Approve agreements with the following agencies for the provision of Fee-For-Service Psychiatric Inpatient Hospital Services, incorporating the agreement into the existing aggregate funding pool for Fee-For-Service Psychiatric Inpatient Hospital Services, in an amount not to exceed $89,513,945:
a. Indio Behavioral Hospital, LLC DBA Coachella Valley Behavioral Health for the period of July 1, 2025, through June 30, 2030.
b. View Behavioral Health-Colton, LLC dba View Behavioral Health Colton Adult for the period of April 21, 2026, through June 30, 2030.
(Presenter: Joshua Dugas, Acting Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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 total aggregate amount not to exceed $89,513,945 will be funded by existing ongoing 1991 Realignment 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 county residents experiencing severe mental illness (SMI) and/or SUD, including youth with serious emotional disturbance. DBH operates under a contract with the California Department of Health Care Services (DHCS) as a Mental Health Plan (MHP), established pursuant to Chapter 633, Statutes of 1994 (Assembly Bill 757 [AB 757]) since January 1995. As an MHP, DBH is responsible for ensuring access to high quality specialty mental health services for Medi-Cal beneficiaries in the most cost-effective manner.
AB 757 authorized the phased implementation of managed mental health care for Medi-Cal beneficiaries through the Short-Doyle Medi-Cal (SD/MC) financing system and Fee-For-Service (FFS) agreements with MHPs, and standardized requirements for all MHPs participating in the Medi-Cal Specialty Mental Health Service Consolidation Program. The SD/MC system serves as California’s primary funding mechanism for community-based mental health services for Medi-Cal beneficiaries. Pursuant to its agreement with the State, AB 757, and other applicable regulations, DBH is required to maintain agreements with area hospitals, including General Acute Care Hospitals and Acute Psychiatric Hospitals, to provide psychiatric inpatient hospital services to Medi-Cal eligible residents and uninsured individuals.
FFS hospitals provide psychiatric inpatient and indigent care services to individuals with SMI who require an appropriate level of care. County residents who are Medi-Cal members or uninsured qualify for these services when they are a danger to themselves or to others or are gravely disabled due to a mental health condition requiring psychiatric hospitalization.
The hospitals identified in the recommendations have agreed to accept patients for the provision of FFS psychiatric inpatient hospital services, determine Medi-Cal eligibility, and bill Medi-Cal directly as appropriate. For indigent individuals not eligible for Medi-Cal, services will be provided through the County’s health care safety net system, with reimbursement administered by DBH, when applicable.
On June 18, 2025 (Item No. 30), the Board of Supervisors (Board) approved Agreement No. 25-511 with Community Hospital of San Bernardino, Agreement No. 25-512 with Aurora Charter Oak Hospital, and Agreement No. 25-513 with Canyon Ridge Hospital, Inc. dba Canyon Ridge Hospital for the period of July 1, 2025 through June 30, 2030, incorporating these agreements into the existing aggregate funding pool for FFS psychiatric inpatient hospital services in the amount not to exceed $60,869,390.
On November 4, 2025 (Item No. 12), the Board approved Agreement No. 25-857 with Loma Linda University Medical Center for the period of July 1, 2025, through June 30, 2030, and Agreement No. 25-858 with View Behavioral Health, LLC, for the period of November 4, 2025, through June 30, 2030, incorporating these agreements into the existing aggregate funding pool for FFS psychiatric inpatient hospital services, in the amount not to exceed $60,869,390.
On January 27, 2026 (Item No. 20), the Board approved Agreement No. 26-67 with Vista Behavioral Health, LLC dba Pacific Grove Hospital for the period of July 1, 2025, through June 30, 2030, incorporating the agreement into the existing aggregate funding pool for FFS psychiatric inpatient hospital services in the amount not to exceed $60,869,390.
Based on the aggregate funding pool for FFS Psychiatric Inpatient Hospital Services, in an amount not to exceed $89,513,945, the following is anticipated:
• 16,275 bed days per year
• Average per-bed-day cost of $1,100
Recommendation No. 1 is necessary because current service utilization has already exceeded prior budget levels and is projected to continue growing due to operational changes that have improved DBH’s ability to promptly identify needs and authorize necessary services. Additionally, the County currently does not have a Psychiatric Health Facility, creating a gap in the continuum of care. The expansion efforts reflected in this item are intended to address this gap and ensure County residents have access to vital inpatient services closer to home. As a result, higher allocations are necessary to meet reimbursement obligations across the agreement term.
On February 9, 2026, DBH was notified that View Behavioral Health, LLC applied for licensure with DHCS under the name View Behavioral Health-Colton II, LLC dba View Behavioral Health Colton Children’s. The recommended amendment to Agreement No. 25-858 will update the contractor name and hospital classification, remove one facility address, and remove the Adults and Older Adults categories from the populations served, as View Behavioral Health-Colton, LLC dba View Behavioral Health Colton Adult, will assume responsibility for that facility and population.
Pursuant to Behavioral Health Information Notice 24-008, the County of Responsibility for a Medi-Cal member has financial responsibility for Specialty Mental Health Services. Therefore, if a County Medi-Cal member receives services at a hospital in another county, including a hospital that does not currently hold an agreement with the County, DBH is required to reimburse the hospital.
DBH is requesting retroactive approval of the agreement to add Coachella Valley Behavioral Health (CVBH) to the existing pool of FFS hospital service providers due to extensive operational, administrative, and legal reviews required prior to Board presentation. Hospitals outside of the County are reimbursed through purchase orders, however, CVBH’S close proximity to the County has resulted in them providing services to many eligible County residents, and total payments have exceeded the Purchasing Department’s (Purchasing) $200,000 limit allowed under County Policy 11-04. Approval at this time will have no impact on DBH services, as services have been provided without interruption.
PROCUREMENT
Purchasing supports the non-competitive procurement of psychiatric inpatient hospital services due to the specialized credentials required, limited provider options in the desert region, and in accordance with State mandates. As the County’s designated MHP, DBH is required under Title 9 of California Code of Regulations to contract with a range of FFS hospitals that provide psychiatric inpatient hospital services.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on March 25, 2026; County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on March 26, 2026; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on April 8, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on April 6, 2026.