REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 23, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for Comprehensive Treatment Services Student Assistance Program
End
RECOMMENDATION(S)
Recommendation
1. Approve amendments to contracts with the following agencies, for the provision of Comprehensive Treatment Services Student Assistance Program, updating standard contract language, increasing the combined amount by $10,374,382, from $50,200,775 to $60,575,157, and extending the contract term by an additional one year and six months, for the total contract period of April 1, 2025 through December 31, 2027:
a. Desert/Mountain Children’s Center, Amendment No. 2 to Contract No. 25-167, increasing the total contract amount by $2,665,298, from $18,124,095 to $20,789,393.
b. Lutheran Social Services of Southern California, Amendment No. 1 to Contract No. 25-168, increasing the total contract amount by $539,451, from $449,545 to $988,996.
c. Mountain Counseling & Training, Inc., Amendment No. 1 to Contract No. 25-169, increasing the total contract amount by $559,295, from $1,389,585 to $1,948,880.
d. South Coast Children's Society, Inc., dba South Coast Community Services, Amendment No. 3 to Contract No. 25-170, increasing the total contract amount by $4,654,827, from $15,751,925 to $20,406,752.
e. Victor Community Support Services, Inc., Amendment No. 1 to Contract No. 25-171, increasing the total contract amount by $1,351,839 from $10,180,605, to $11,532,444.
f. West End Family Counseling Services, Amendment No. 1 to Contract No. 25-172, increasing the total contract amount by $603,672, from $4,305,020 to $4,908,692.
2. Authorize the Auditor-Controller/Treasurer/Tax Collector to post the necessary budget adjustments as detailed in the Financial Impact section (Four votes required).
(Presenter: Joshua Dugas, Acting Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote and Fulfill the Countywide Vision.
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). The recommended contract increase of $10,374,382 and extension is needed due to the higher costs per client under the California Advancing and Innovating Medi-Cal (CalAIM) initiative for clients receiving Comprehensive Treatment Services (CTS), which includes Student Assistance Program (SAP) and School Aged Treatment Services (SATS). The SAP contract amendments retain consistent annual funding though the extended term, however the contract increase is requested at this time due to the higher cost per client under newly implemented CalAIM fee for service provisions.
The contract increase of $10,374,382, will be funded by $4,578,082 Federal Financial Participation Medi-Cal (FFP) funding, $3,664,779 in 1991 Realignment reserves, and $2,131,521 in Mental Health Services Act (MHSA)/Behavioral Health Services Act (BHSA) funding.
Of the total increase, $182,000 is required in 2025-26 and will be funded with $80,173 FFP funding, $64,292 in 1991 Realignment reserve funding, and $37,535 MHSA funding.
The remaining $10,192,382 will be included in a future Department of Behavioral Health’s (DBH) 2026-27 budget adjustment and included in the 2027-28 recommended budget. The increase will be funded with $4,497,909 FFP funding, $3,600,487 in 1991 Realignment reserve funding, and $2,093,986 BHSA funding.
DBH requests the following adjustments to the 2025-26 budget:
|
Fund Center |
Commitment Item |
Description |
Action |
Amount |
|
9200001000 |
52002445 |
Other Professional & Specialized Services |
Increase |
$128,584 |
|
9200001000 |
40458700 |
State Realignment Revenue |
Increase |
$64,292 |
|
1169001010 |
40458700 |
State Realignment Revenue |
Decrease |
$64,292 |
|
1169001010 |
40458702 |
Realignment Reserve (Budget) |
Increase |
$64,292 |
|
9200001000 |
40408855 |
Medi-Cal Inpatient |
Increase |
$64,292 |
|
9200002200 |
52002445 |
Other Professional & Specialized Services |
Increase |
$53,416 |
|
9200002200 |
40408820 |
State Other Support |
Increase |
$37,535 |
|
9200002200 |
40408855 |
Medi-Cal Inpatient |
Increase |
$15,881 |
BACKGROUND INFORMATION
DBH provides mental health and substance use disorder (SUD) services to San Bernardino County (County) residents experiencing severe mental illness and/or SUD. Through County-operated clinics and partnerships with community-based organizations, DBH delivers a comprehensive continuum of behavioral health services that support prevention, early intervention, treatment, education, recovery, and resiliency for individuals and families across the county.
CTS provides quality preventive mental health services to students and their families to support success in school and in the community. CTS is delivered through a culturally responsive, family-centered approach that emphasizes empowerment and the development of strong, supportive relationships. CTS consists of two distinct but complementary programs: SATS and SAP. Together, SATS and SAP represent a significant component of the children’s behavioral health continuum of care and are designed to collaborate to ensure coordinated and comprehensive service delivery.
The SATS program primarily serves school-aged children and youth, up to 21 years of age, experiencing mild to moderate mental health challenges within the spectrum of medical necessity, as well as those with established long-term behavioral health needs who do not require intensive or in-home services. SATS provides a full range of services that are tailored to the needs of the target population in each geographic area of the county, including crisis and emergency services when necessary. The goal of the SATS program is to restore or maintain learning, development, independent living skills, and self-sufficiency among Medi-Cal eligible school-aged children who have experienced significant impairment due to mental health difficulties.
With the support from clinical staff, participants in SAP work toward achievable goals that include: (1) strengthening student health and wellness by reducing risk factors, barriers, and stressors; (2) building protective factors and supports within the school and community to improve mental, emotional, and relational functioning; and (3) implementing appropriate strategies, activities, and interventions tailored to the needs of students and their families. SAP services are provided at school sites and through after-school programs using culturally and linguistically appropriate practices aligned with the needs of the populations served.
Over the contract term, SAP achieved the following outcomes:
• Served 42,431 unduplicated participants
• Maintained an average cost of $160 per client
• Following completion of services, children and youth demonstrated the following improvements in functioning:
o Quality of life and social interaction improved by 58%
o Healthy development of interpersonal strengths improved by 71%
o Behavioral health and emotional needs were successfully addressed by 51% of the participants
Upon approval of the recommended contract amendments, DBH anticipates:
• Serving approximately 45,441 additional unduplicated clients annually
• An average cost of $149 per client
o Costs per client may decrease upon agencies serving over 45,441 annual clients
On March 25, 2025 (Item No. 21), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 25-167 with Desert/Mountain Children’s Center (DMCC) in the amount of $18,124,095, Contract No. 25-168 with Lutheran Social Services of Southern California in the amount of $449,545, Contract No. 25-169 with Mountain Counseling & Training, Inc. in the amount of $1,389,585, Contract No. 25-170 with South Coast Children's Society, Inc., dba South Coast Community Services (SCCS) in the amount of $15,751,925, Contract No. 25-171 with Victor Community Support Services, Inc. in the amount of $10,180,605 and Contract No. 25-172 with West End Family Counseling Services in the amount of $4,305,020 for the provision of CTS, SAP, and SATS, for the period of April 1, 2025 through June 30, 2026.
On December 16, 2025 (Item No. 29), the Board approved standardized contract templates to amend the provisional payment language depending on the provisional payment structure, for providers of Specialty Mental Health Services, as a result of the Department of Health Care Services (DHCS) CalAIM Behavioral Health Payment Reform. The Board also approved delegated authority to the Director of DBH to execute the contract templates. On January 27, 2026 (Item No. 19), the Board approved Amendment Nos. 1 to Contract No. 25-167 with DMCC and Contract No. 25-170 with SCCS for the provision of CTS, SAP, and SATS, updating standard contract language and updating the grantor’s name from the State of California Mental Health Services Oversight Accountability Commission to the State of California Behavioral Health Service Oversight and Accountability Commission, and updating the grant name from Mental Health Student Services Act to Behavioral Health Student Services Act with no change to the contract period of April 1, 2025 through June 30, 2026, or contract amounts.
On March 28, 2026, the Director of DBH executed Amendment No. 2 to Contract No. 25-170 with SCCS, amending the provisional payment language with no change to the contract period of April 1, 2025 through June 30, 2026, or contract amounts.
On June 9, 2026 (Item No. 23), the Board approved the establishment of new contracts for SATS, separate from SAP. To align with new funding structures and State reporting requirements effective July 1, 2026, the original CTS contracts, which previously encompassed both SATS and SAP, will be processed as separate agreements on that date.
Performance measures for SAP contracts focus on tracking service quality, timeliness, accessibility, and outcomes to ensure providers meet established standards. Contractors are required to submit regular reporting such as monthly service logs, outcome data, fiscal reports, and compliance documentation, which allows the department to monitor progress and identify trends or concerns. Accountability mechanisms, including performance audits, contract monitoring meetings, site visits, and corrective action plans, help ensure that services are delivered as intended and align with program goals. Together, these structures promote transparency, support continuous improvement, and ensure that community members receive high quality, effective behavioral health services.
The implementation of BHSA, formerly known as MHSA, primarily impacts SAP due to the updated funding model requirements. This transition provides an opportunity for the CTS programs to be contracted independently. Approval of the amendments will increase funding and extend the term of the contracts to allow SAP services to continue uninterrupted for students receiving needed behavioral health support, while DBH prepares formal procurements for SATS and SAP services separately and evaluates ongoing operational requirements under BHSA. DBH anticipates issuing a formal procurement for SAP prior to the expiration of the contracts to allow DBH to maintain service stability for clients and communities while implementing the significant structural changes required under BHSA guidelines.
DBH will continue to implement mechanisms to regularly review 1) client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) 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 DHCS billing requirements; and 3) provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on May 4, 2026; Deputy County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on June 10, 2026; Auditor-Controller/Treasurer/Tax Collector (Charlene Huang, Auditor-Controller Manager, 382-3035) on May 26, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on June 11, 2026.