REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 4, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for Wraparound Mental Health Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 3 to the following contracts, for the provision of wraparound mental health services, increasing the total contract amount by $420,000, from $55,005,731 to $55,425,731, with no change to the contract period of January 1, 2022 through December 31, 2026:
1. Mountain Counseling & Training, Inc., Contract No. 21-941, increasing the total contract amount by $125,000, from $2,612,627 to $2,737,627.
2. Victor Community Support Services, Inc., Contract No. 21-944, increasing the total contract amount by $295,000, from $52,393,104 to $52,688,104.
(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 increase of $420,000 for wraparound mental health services (WMHS) will be funded by Medi-Cal Federal Financial Participation, Mental Health Services Act (MHSA) funds, and 2011 Realignment. The MHSA funding is available for this program through June 30, 2026. The 2011 Realignment funds will fund the portion of the program previously funded by MHSA from July 1, 2026 through December 31, 2026. The recommended contract increase of $420,000 is needed due to higher costs per client under California Advancing and Innovating Medi-Cal (CalAIM) initiatives for clients receiving WMHS. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2026-27 budget.
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. Chapter 795, Statutes of 1997 (Senate Bill [SB] 163), identifies wraparound services as an intensive, community-based, family-centered process designed to allow children with serious behavior and/or emotional difficulties to remain in their community or be placed in the lowest level of care possible instead of being placed in a group home setting.
The County implemented the wraparound program in June 2002 in response to the passage of SB 163. The program consists of two types of mental health services: SB 163 Wraparound and Comprehensive Child and Family Support System (CCFSS). An essential component of the service delivery system consists of County-operated and contracted service providers delivering a variety of mental health treatment services, including specialized services for children and youth that are at risk of being placed out of home. WMHS helps address the complex needs of children and youth involved with the Probation Department or the Department of Children and Family Services by providing intensive, community-based, and family-centered services intended to support placement stability and reduce the need for higher levels of care.
The implementation of a Fee-for-Service (FFS) rate structure occurred through the CalAIM initiative. Prior to January 2026, DBH operated the Victor Community Support Services (VCSS) and Mountain Counseling & Training, Inc. (MCT) contracts as cost reimbursement contracts. Under the FFS methodology, providers are reimbursed based on actual services delivered, which may exceed historical cost reimbursement levels VCSS and MCT have successfully implemented the CalAIM FFS requirements for Early and Periodic Screening, Diagnostic, and Treatment Medi-Cal Specialty Mental Health Services (SMHS).
Since January 2026 service expenditures have exceeded the prorated monthly contract amount (1/12th of the annual contract) by an average of 24.6% per month, with a range of 14.3% to 29.9% on any given month. This demonstrates the need for additional funding to meet service demand throughout the remainder of the contract period. The recommended amendments to the WMHS contracts with MCT and VCSS will increase the funds available to support service utilization and ensure continued provision of SMHS in accordance with CalAIM FFS requirements.
In 2024-25, WMHS achieved the following outcomes:
• 916 SB 163 WMHS and 1,243 CCFSS unduplicated clients for a total of 2,159 combined
• Average combined cost of $17,505 for SB 163 youth and $12,866 for CCFSS for a weighted average of $14,841
Upon approval of the recommended contract amendment, DBH anticipates:
• Serving approximately 916 SB 163 WMHS and 1,407 CCFSS unduplicated clients for a total of 2,323 combined
• Maintaining an average cost of $16,137 per client
On December 14, 2021 (Item No. 23), as a result of a formal procurement, the Board of Supervisors (Board) approved the contracts with MCT (Contract No. 21-941) in the amount of $2,550,000 and VCSS (Contract No. 21-944) in the amount of $43,250,000 to provide WMHS for the period of January 1, 2022 through December 31, 2026.
On March 26, 2024 (Item No. 33), the Board approved Amendment No. 1 to Contract No. 21-941 with MCT increasing the total contract amount by $62,627 from $2,550,000 to $2,612,627, and Amendment No. 1 to Contract No. 21-944 with VCSS, increasing the total contract amount by $9,143,104 from $43,250,000 to $52,393,104 for the provision of WMHS and updating contract language, with no change to the total contract period of January 1, 2022 through December 31, 2026.
On December 16, 2025 (Item No. 29), the Board approved contract amendment templates to update the provisional payment language in contracts with providers of specialty mental health and/or substance use disorder and recovery services. These amendments were required to align provider contracts with the California Department of Health Care Services' CalAIM Behavioral Health Payment Reform, which changed the methodology used to reimburse counties for Medi-Cal specialty behavioral health services from cost-based reimbursement to a prospective fee-schedule methodology funded through Intergovernmental Transfers.
On March 25, 2026, Amendment No. 2 to Contract No. 21-941 with MCT was amended to update the provisional payment language pursuant to the Board approved template in the contract via Delegated Authority.
On June 23, 2026, Amendment No. 2 to Contract No. 21-944 with VCSS was amended to update the provisional payment language pursuant to the Board approved template in the contract via Delegated Authority.
Performance measures for VCSS and their implementation of CCFSS youth indicate that they typically provided a service every three days, for an average time period of 195 days, with 11 hours of services provided in the first couple months and then gradually adjusting down to approximately eight hours per month. Outcome measures indicate that 78.8% of all recipients of SF/EW from VCSS show an improvement on an identified concern. Examples of the outcome areas evaluated and the percentage of clients who demonstrated improvement are summarized in the table below.
|
Area of Concern |
Clients with Identified Need (%) |
Clients with Noted Improvement (%) |
|
School Behavior |
49% |
69% |
|
School Achievement |
62% |
60% |
|
School Attendance |
38% |
61% |
|
Depression |
81% |
72% |
|
Anxiety |
83% |
62% |
|
Anger Control |
81% |
64% |
Performance measures for MCT and their implementation of CCFSS youth indicate that they typically provided a service every four days, for an average time period of 206 days, with 10 hours of services provided in the first couple months and then titrating down to approximately seven hours per month. Outcome measures indicate that 73.7% of all recipients of CCFSS from MCT show an improvement on an identified concern. Examples of the outcome areas evaluated and the percentage of clients who demonstrated improvement are summarized in the table below.
|
Area of Concern |
Clients with Identified Need (%) |
Clients with Noted Improvement (%) |
|
School Behavior |
44% |
74% |
|
School Achievement |
45% |
58% |
|
School Attendance |
25% |
77% |
|
Depression |
63% |
43% |
|
Anxiety |
64% |
44% |
|
Anger Control |
54% |
40% |
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on July 7, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 14, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on July 20, 2026.