REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
May 19, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Contract for Inpatient Concurrent Review with Telligen, Inc.
End
RECOMMENDATION(S)
Recommendation
Approve Contract with Telligen, Inc., for the provision of Inpatient Concurrent Review services, in the amount not to exceed $9,475,830, for the period of July 1, 2026 through June 30, 2031.
(Presenter: Joshua Dugas, Acting Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Foster Sustainable Development Through Strategic Partnerships.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The contract amount not to exceed $9,475,830 for Inpatient Concurrent Review (ICR) is funded by existing ongoing 1991 and 2011 Realignment, and Federal Financial Participation Medi-Cal funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2026-27 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 San Bernardino County (County) residents experiencing severe mental illness and/or SUD. As part of this responsibility, DBH manages authorizations for inpatient acute psychiatric hospital services in accordance with Medi-Cal requirements. ICR services consist of real-time authorizations conducted for each Medi-Cal psychiatric inpatient stay. These reviews ensure that services remain medically necessary, are delivered at the appropriate level of care, and are aligned with an established discharge and aftercare plan. The ICR process enables DBH to meet mandated timeframes by completing initial and continued stay authorization requests within 24 hours.
ICRs provide hospitals with timely feedback, allowing for the correction or supplementation of documentation while patients are receiving inpatient care. This process improves compliance with Medi-Cal standards and increases the likelihood of reimbursement for authorized services. Additionally, inpatient authorization regulations allow for retroactive reimbursement for bed days in prior budget years under specific circumstances, including hospitalizations that span budget years, appealed bed days, and resubmitted documentation to address administrative errors.
The ICR approach supports compliance with state and federal requirements, including California Department of Health Care Services (DHCS) Behavioral Health Information Notice (BHIN) 19-026, BHIN 22-017, as well as the Parity in Mental Health and SUD Services Final Rule (Title 42 CFR, part 438.910), which establish concurrent review standards for psychiatric inpatient hospital and psychiatric health facility services.
Contracting for concurrent review services enhances the efficiency, consistency, and clinical appropriateness of inpatient utilization management. This approach ensures the uniform application of medical necessity criteria, reduces authorization delays, and promotes timely transitions to lower levels of care. Additionally, it allows County staff to reallocate resources toward care coordination activities, strengthens data reporting and accountability, and aligns with the California Advancing and Innovating Medi-Cal goals to streamline access to care, reduce unnecessary inpatient stays, and improve integration between behavioral and physical health systems.
DBH anticipates the following outcomes for ICR services:
• An estimate of 13,878 unduplicated clients annually
• Maintain an average cost of $136.56 per client
Approval of the contract to utilize the ICR services for quality control measures will help ensure that psychiatric inpatient stays meet both DBH and DHCS requirements.
DBH will also implement mechanisms to regularly review: 1) the concurrent review platform used to authorize inpatient acute psychiatric hospitalizations, including site visits and annual monitoring, ensuring performance and compliance standards of the PA are met; 2) documentation pertaining to approval/denial of psychiatric inpatient hospital services are transmitted to the appropriate entities for authorization and reimbursement; 3) provider invoices administratively and programmatically to ensure accuracy prior to payment processing.
PROCUREMENT
On December 16, 2025, the County Administrative Office approved and authorized the release of Request for Proposals (RFP) No. DBHE26-ADMN-6093 through the Electronic Procurement Network (ePro), to solicit interested and qualified organizations and agencies to provide ICR services. The RFP was publicly advertised in local newspapers and sent through direct mailings to more than 800 community-based organizations, service providers, and other interested parties.
A bidder’s conference was held on January 13, 2026. Four proposals were received in response to the RFP by the established deadline. All four proposals, submitted by the agencies listed below, met the minimum requirements and advanced to the evaluation phase of the procurement process:
|
Agency |
City and State |
Estimated Proposed Costs |
|
Carelon Behavioral Health of California, Inc. |
Cerritos, CA |
$11,976,575 |
|
Keystone Peer Review Organization, LLC DBA Acentra Health |
McLean, VA |
$10,852,438 |
|
Physio Solutions LLC DBA medlitix |
Wexford, PA |
$9,764,875 |
|
Telligen, Inc |
West Des Moines, IA |
$9,475,830 |
The evaluation committee, comprised of five individuals from Arrowhead Regional Medical Center and DBH, reviewed and evaluated the proposals in accordance with the criteria outlined in the RFP. Evaluation criteria included but was not limited to: the proposer’s ability to provide required services as specified in the RFP, capacity to serve the anticipated number of unduplicated participants, readiness to implement services, relevant experience, staffing levels and qualifications, and the ability to measure outcomes.
Based on the evaluation criteria and feedback from the committee, DBH’s Program Support Services determined that Telligen, Inc. is the most qualified proposer and is recommended for the award of the contract. Award and denial letters were issued to all responsive and responsible proposers on April 22, 2026. No protests were received within the allowable protest period.
The Purchasing Department concurs with the recommendation and supports this competitive procurement process conducted in accordance with County policy.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on April 24, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on April 27, 2026; Purchasing (Jessica Barajas, Supervising Buyer , 387-3365) on April 28, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on May 4, 2026.