REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
November 17, 2026
FROM
JOSHUA DUGAS, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Non-Financial Participation Agreement with the California Mental Health Services Authority for the Medi-Cal Peer Specialist Certification Program
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to non-financial Participation Agreement No. 24-1126 (California Mental Health Services Authority Agreement No. 5357-MEDICALPEERSCERTIFICIATION-2024-SANBERNARDINO-PA) with the California Mental Health Services Authority, for the Medi-Cal Peer Support Specialist Certification Program, extending the term an additional year, for the total agreement period of November 19, 2024 through November 18, 2027.
(Presenter: Joshua Dugas, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Foster Sustainable Development Through Strategic Partnerships.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost), as the Participation Agreement (Agreement) with the California Mental Health Services Authority (CalMHSA) is non-financial in nature.
BACKGROUND INFORMATION
The Department of Behavioral Health (DBH) is responsible for providing mental health (MH) and substance use disorder (SUD) services to San Bernardino County (County) residents experiencing severe mental illness and/or SUD. The Agreement is governed by CalMHSA, a Joint Powers Authority comprised of California Mental Health Plans, that provides administrative and fiscal services for member counties to maximize resources for the coordination and implementation of statewide or multi-county initiatives. DBH has been a member of CalMHSA since November 2008 and participates in collaborative efforts to develop and fund MH services and education programs on a regional, statewide, and multi-county basis. These efforts include statewide initiatives such as Suicide Prevention and Stigma and Discrimination Reduction Campaigns.
Senate Bill (SB) 803, MH Services: Peer Support Specialist Certification (PSSC), chaptered in 2020, authorized the California Department of Health Care Services (DHCS) to seek federal approval to add peer support specialists as a Medi-Cal provider type. SB 803 recognizes the important role that peer support specialists play within California’s behavioral health systems and their longstanding contributions to prevention, early intervention, treatment, and recovery services for individuals experiencing MH and/or SUD conditions. Peer support specialists draw upon their lived experience, including as individuals with personal experience of MH and/or SUD conditions, or as the parents, caregivers, and family members of individuals with these conditions. Their firsthand understanding enables them to connect with individuals receiving services, support recovery, and assist in identifying services and resources that align with an individual’s recovery needs.
SB 803 also directed DHCS to develop statewide standards for the Medi-Cal PSSC program that may be implemented by counties or county-contracted entities that elect to provide peer support specialist certification services. CalMHSA subsequently received approval from DHCS to implement and administer the PSSC program on behalf of its member counties.
Since the execution of this Agreement, 393 County residents have become Certified Medi-Cal Peer Support Specialists, and an additional 201 County residents have completed the Supervision for Peer Workers course to enhance their ability to support individuals receiving MH and SUD services. These trained County residents contribute to prevention, early intervention, treatment, and recovery efforts by providing peer-based support to individuals experiencing MH and/or SUD conditions.
On November 19, 2024 (Item No. 15), the Board of Supervisors (Board) approved the non-financial Participation Agreement No. 24-1126 (California Mental Health Services Authority Agreement No. 5357-MEDICALPEERSCERTIFICIATION-2024-SANBERNARDINO-PA) with CalMHSA, including non-standard terms, for the Medi-Cal PSSC, for a one-year term beginning on the date of execution by both parties, effective on November 19, 2024 through November 18, 2025.
On September 23, 2025 (Item No. 28), the Board approved Amendment No. 1 to Participation Agreement No. 24-1126 with CalMHSA, for the Medi-Cal PSSC, extending the agreement by an additional year, for a total agreement period of November 19, 2024 through November 18, 2026.
Since DBH does not currently have the infrastructure or staffing to meet the state standards in providing a peer certification program, DBH seeks approval of the amendment to continue the Agreement with CalMHSA in supporting the DHCS approved PSSC program for the County. Approval of the amendment will allow the County to receive additional Medi-Cal reimbursements through PSSC services. It will also allow for continued expansion of DBH clients who receive a peer support service, which is an identified goal in the DHCS Performance Improvement Plan for the County.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on September 21, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on October 27, 2026; and County Finance and Administration (Lizveth Varela, Administrative Analyst III, 387-4883) on October 29, 2026.