REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 18, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Standard Agreement Template for Children’s Residential Intensive Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 1 to the standard agreement template, for ongoing Children’s Residential Intensive Services, to amend the provisional payment language to a Fee-for-Service structure, with no change to the total aggregate amount of $72,200,000 or total contract period of July 1, 2024, or date of youth placement, whichever occurs later, through December 31, 2026.
2. Authorize the Director or Assistant Director of the Department of Behavioral Health to execute the amendment to the standard agreement template with individual Children’s Residential Intensive Services providers, including any non-substantive changes, on behalf of the County, subject to review by County Counsel.
(Presenter: Joshua Dugas, Acting Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
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 additional Discretionary General Funding (Net County Cost) and will not change the aggregate contract amount of $72,200,000. The item will revise the standard agreement template for ongoing Children’s Residential Intensive Services (ChRIS) reimbursement methodology from provisional payments to a Fee-for-Service (FFS) payment structure. ChRIS is funded by Federal Financial Participation Medi-Cal, existing ongoing 2011 Realignment, a Memorandum of Understanding with the Department of Children and Family Services, which is funded 70% by 2011 Realignment and 30% by Net County Cost, and Mental Health Services Act funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) and the Human Services Administrative Claim’s 2026-27 budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to San Bernardino County residents experiencing severe mental illness and/or SUD. As part of its continuum of care, DBH provides Specialty Mental Health Services (SMHS) to minors receiving treatment in residential care settings. Since 2010, DBH has provided ChRIS to children requiring SMHS while placed in Short-Term Residential Therapeutic Programs (STRTPs).
ChRIS is a structured residential program delivered through STRTPs that incorporates the principles and behaviors of the Integrated Core Practice Model (ICPM). ICPM is a team-based approach implemented through four phases: Engagement, Service Planning, Monitoring and Adapting, and Transition. Through individualized service plans that address the unique needs of each child and family, ICPM fosters collaborative partnerships that support the well-being, permanency, and successful transition of children and youth receiving ChRIS services.
ChRIS providers must meet established licensing, accreditation, qualification, and program requirements to be included in the DBH’s qualified provider pool. The California Department of Health Care Services (DHCS) requires DBH to execute an agreement within 30 days of notification from a qualified agency requesting to provide ChRIS services. Timely execution of these agreements ensures continued compliance with DHCS requirements and maintains access to residential SMHS for eligible youth.
On January 13, 2026 (Item No. 22), the Board of Supervisors approved a standard agreement template (Template) to be used for the provision of ChRIS, in the aggregate amount not to exceed $72,200,000, for the period of July 1, 2024, or date of youth placement, whichever occurs later, through December 31, 2026.
The ChRIS Template establishes the terms and conditions for reimbursement of SMHS provided to youth with serious emotional disturbances placed in STRTPs. Use of the Template also enables DBH to execute agreements with qualified providers within DHCS's expected 30-day timeframe.
DHCS is transforming the Medi-Cal program through the multi-year California Advancing and Innovating Medi-Cal (CalAIM) initiative, which is designed to create a more coordinated, person-centered, and equitable health system. As part of the CalAIM initiatives, Behavioral Health Payment Reform (BHPR) transitioned Medi-Cal reimbursement for SMHS from a cost-based reimbursement methodology administered by DHCS to a rate-based FFS reimbursement model administered by DBH. This transition streamlines administrative processes, improves payment timelines and transparency, and establishes the foundation for future value-based payment models that emphasize quality and health outcomes.
Approval of this item will update the standard agreement template to replace the provisional payment language to align with the rate-based FFS reimbursement methodology implemented under the CalAIM BHPR initiative.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on July 22, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 28, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392 and John Hallen, Principal Administrative Analyst, 388-0208) on August 12, 2026.