REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 10, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for General Mental Health Outpatient Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendments to the following contracts for the provision of General Mental Health outpatient services, updating standard contract language, increasing the total contract amount by $4,283,873, from $12,851,619 to $17,135,492, and extending the contract term one year for a total contract period of October 1, 2021, to September 30, 2025:
1. Amendment No. 2 to Contract No. 21-690 with Citrus Counseling Services, Inc. dba Family Service Agency of San Bernardino, increasing the contract amount by $625,000 from $1,875,000 to $2,500,000.
2. Amendment No. 1 to Contract No. 21-691 with Lutheran Social Services of Southern California, increasing the contract amount by $720,000 from $2,160,000 to $2,880,000.
3. Amendment No. 1 to Contract No. 21-692 with South Coast Children’s Society, Inc. dba South Coast Community Services, increasing the contract amount by $2,315,000 from $6,945,000 to $9,260,000.
4. Amendment No. 1 to Contract No. 21-693 with West End Family Counseling Service, increasing the contract amount by $623,873 from $1,871,619 to $2,495,492.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Operate in a Fiscally-Responsible and Business-Like Manner
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The recommended increase of $4,283,873 for General Mental Health (GMH) outpatient services is 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 the 2025-26 recommended budget.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to c residents experiencing severe mental illness and/or SUD. GMH outpatient services are designed to assist an individual’s reduction of mental disability in order 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. 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 Tier III level of care and children who are experiencing serious mental and emotional difficulties resulting in significant impairment in daily living activities and functioning. The mental health services include assessments, evaluations, therapy, rehabilitation, medication support, crisis intervention, and case management. DBH GMH outpatient services will serve approximately 1,800 individuals at an estimated cost of $2,379 per individual.
Adults who require Tier III level of care have a severe impairment resulting from a mental illness and/or SUD that is persistent in duration and impairs functioning in one or more categories such as health, self-care, housing, employment, education, legal, money management, and/or interpersonal/social.
Children who qualify for GMH outpatient services are seriously emotionally disturbed. Examples of these 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. These children must also meet medical necessity criteria such as significant impairment or probability of significant deterioration in an important area of life functioning, or the probability that the child will not progress developmentally and as individually appropriate.
On September 21, 2021 (Item No. 9), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-690 with Family Service Agency of San Bernardino (FSA), Contract No. 21-691 with Lutheran Social Services of Southern California (LSS), Contract No. 21-692 with South Coast Children’s Society, Inc. dba South Coast Community Services (SCCS), Contract No. 21-693 with West End Family Counseling Service (WEFCS), to provide GMH outpatient services in the total combined amount of $12,851,619, for the period of October 1, 2021 to September 30, 2024.
On March 26, 2024 (Item No. 24), the Board approved Amendment No. 1 to Contract No. 21-690 with FSA assigning the contract from Family Service Agency of San Bernardino to Citrus Counseling Services, Inc. dba Family Service Agency of San Bernardino (CCS FSA), and adding Executive Order N-6-22 - Russia Sanctions, and Campaign Contribution Disclosure (Senate Bill [SB] 1439), with no change to the contract amount of $1,875,000 or the contract period of October 1, 2021, through September 30, 2024.
Amendments to the contracts in Recommendation No.1 will add Contract Exclusivity and Notice of Delays clauses to update standard contract language and add Executive Order N-6-22 - Russia Sanctions and Campaign Contribution Disclosure (SB 1439) to the LSS, SCCS and WEFCS contracts.
DBH will 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; 2) review 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 Department of Health Care Services billing requirements; and 3) review 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 (Ellayna Hoatson, Contract Supervisor, 388-0858) on July 16, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on August 8, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on August 20, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on August 24, 2024.