REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
January 9, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Non-Financial Operational Understanding with the San Bernardino City Unified School District for Specialty Mental Health Services
End
RECOMMENDATION(S)
Recommendation
1. Approve non-financial Operational Understanding with the San Bernardino City Unified School District, including non-standard terms, for specialty mental health services to Medi-Cal eligible recipients, for the period of July 1, 2023 through June 30, 2028.
2. Authorize the Director of the Department of Behavioral Health, to execute and submit all Fingerprint and Criminal Background Check Certification documents related to the Operational Understanding to the San Bernardino City Unified School District, for the period of July 1, 2023 through June 30, 2028, on behalf of the County, subject to review by County Counsel.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health, and Social Services Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies.
FINANCIAL IMPACT
Approval of this item will not impact Discretionary General Funding (Net County Cost) as the Operational Understanding (OU) is non-financial in nature.
BACKGROUND INFORMATION
An integral part of the Department of Behavioral Health’s (DBH) service delivery system includes County-operated and contracted facilities for the delivery of a variety of mental health treatment services, including specialized services for in a school setting. DBH has provided specialty mental health services (SMHS) to children and youth via the San Bernardino City Unified School District (SBCUSD) OU since 2003. SMHS include Early Periodic Screening, Diagnosis and Treatment (EPSDT) Medi-Cal services, which are a federally mandated Medicaid option for children and young adults aged 0-21 years. The intent of this mandate is to ensure that all children and young adults covered by Medi-Cal are given the opportunity to obtain a screening for mental health disorders, and are provided with treatment to address, correct, and improve mental health functioning, for the enhancement of learning and self-sufficiency.
The recommended OU with SBCUSD will allow DBH to continue to provide EPSDT services to Medi-Cal eligible children, youth, and their families at schools within the SBCUSD. DBH provides SMHS throughout the entire calendar year as students may be seen both during and outside the traditional school year.
While DBH provides these services to any school district that requests them, SBCUSD requires a formal agreement to be in place to deliver services. DBH anticipates approximately 875 children, youth, and families will receive SMHS annually during the term of the recommended OU, subject to available resources, personnel, and funding.
The recommended OU includes terms that differ from the standard San Bernardino County (County) contract and omits certain County standard contract terms. The non-standard and missing terms include the following:
1. The OU does not prohibit SBCUSD from assigning the OU without the County’s prior approval.
• The County standard contract requires that the County must approve any assignment of a contract.
• Potential Impact: SBCUSD could assign the OU without the County’s knowledge to a third party or business.
2. There is no stated venue in the OU.
• County Policy 11-05 requires the venue for disputes be in the Superior Court of California, County of San Bernardino, San Bernardino District.
• Potential Impact: SBCUSD is located in San Bernardino County and therefore any legal dispute would generally be required to be filed in the courts in the County, however, the OU could be assigned to a third party without the County’s consent, which may result in any legal disputes with the new entity having venue in a different court, resulting in additional expenses to the County.
3. The OU does not require SBCUSD to indemnify the County, as required by County Policies 11-05 and 11-07.
• The County standard contract requires that the contractor agrees to indemnify, defend, and hold the County harmless from third party claims arising out of the acts, errors, or omissions of any person.
• Potential Impact: SBCUSD is not required to defend, indemnify or hold the County harmless from any claims, including indemnification for claims arising from SBCUSD’s negligent or intentional acts, which could lead to additional expenses for the County.
4. The OU does not require SBCUSD to meet the County’s insurance standards as required pursuant to County Policies 11-05, 11-07 and 11-07SP.
• County policy requires contracts to carry appropriate insurance at limits and under conditions determined by the County’s Risk Management Department and as set forth in County policy and the County standard contract.
• Potential Impact: The County has no assurance that SBCUSD will be financially responsible for claims that may arise under the OU, which could result in expenses to the County as part of this non-financial OU.
Approval of this item will authorize the Director of DBH to execute and submit all fingerprint and criminal background check certification documents related to the OU on an annual basis. The fingerprint and criminal background check certification documents certify that DBH employees providing SMHS have been screened according to the laws and regulations related to providing services to children and youth on campus.
This item is presented at this time due to an SBCUSD administrative error. During the process of DBH program, administrative, and legal reviews, including required additional leadership approval, DBH discovered that SBCUSD had not submitted the OU to its Board for approval. Following this discovery, the next SBCUSD Board meeting date to consider the OU for approval was December 12, 2023. EPSDT services were briefly interrupted while DBH made arrangements to meet with the children in the homes with the parents present in order to continue to receive services.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on December 13, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on December 14, 2023; Risk Management (Victor Tordesillas, Director, 386-8623) on October 5, 2023; Finance (Paul Garcia, Administrative Analyst, 386-8392) on December 19, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on December 19, 2023.