REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 9, 2026
FROM
JOSHUA DUGAS, Acting Director, Department of Behavioral Health
SUBJECT
Title
Amendments to Contracts for Substance Use Disorder Perinatal Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2 to contracts with the following agencies, for the provision of Substance Use Disorder Perinatal Services, updating standard contract language, increasing the combined amount by $332,062, from $8,122,956 to $8,455,018, with no change to the contract period of January 1, 2022 through December 31, 2026:
a. High Desert Child, Adolescent and Family Services Center, Inc., Contract No. 21-905, increasing the contract amount by $100,000, from $2,313,633 to $2,413,633.
b. Inland Behavioral and Health Services, Inc., Contract No. 21-906, increasing the contract amount by $132,062, from $3,249,244 to $3,381,306.
c. Inland Valley Recovery Services, Contract No. 21-907, reflecting the legal name change to Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services, and increasing the contract amount by $100,000, from $2,560,079 to $2,660,079.
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
Foster Sustainable Development Through Strategic Partnerships.
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). The recommended contract increase of $332,062 is needed due to higher costs per client under California Advancing and Innovating Medi-Cal (CalAIM) initiatives for clients receiving Substance Use Disorder (SUD) Perinatal Services (PS).
The increase will be funded by $298,856 (90%) from Federal Financial Participation Drug Medi-Cal (FFP) funding and $33,206 (10%) transferred from existing ongoing 2011 Realignment funding from Fund Center 9200001000 to Fund Center 1010571000, which will be backfilled with 1991 Realignment reserves. Of the total increase, $166,031 is required in 2025-26 and will be funded by $149,428 in FFP funding, and $16,603 transferred from existing ongoing 2011 Realignment, to be backfilled with 1991 Realignment reserves.
The remaining $166,031 will be included in a future Department of Behavioral Health (DBH) 2026-27 budget adjustment request and funded by $149,428 FFP funding, and $16,603 transferred from existing ongoing 2011 Realignment funding, to be backfilled with 1991 Realignment reserves.
DBH requests the following adjustments to the 2025-26 budget:
|
Fund Center |
Commitment Item |
Description |
Action |
Amount |
|
1010571000 |
52002445 |
Other Professional & Specialized Services |
Increase |
$166,031 |
|
1010571000 |
40408855 |
Medi-Cal Inpatient |
Increase |
$149,428 |
|
1010571000 |
40458711 |
Realignment 2011 |
Increase |
$16,603 |
|
9200001000 |
40458711 |
Realignment 2011 |
Decrease |
$16,603 |
|
9200001000 |
40458700 |
State Realignment Revenue |
Increase |
$16,603 |
|
1169001010 |
40458700 |
State Realignment Revenue |
Decrease |
$16,603 |
|
1169001010 |
40458702 |
Realignment Reserve (Budget) |
Increase |
$16,603 |
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 SUD services to county residents experiencing severe mental illness and/or SUD. DBH’s PS program provides evidence-based SUD treatment and therapeutic interventions for pregnant and parenting women. The program is designed to promote positive changes in thinking and behavior, reduce substance use, and prevent relapse. Services include a structured treatment program consisting of at least nine hours per week for adults, provided over a minimum of three hours per day, three days per week.
On December 7, 2021 (Item No. 14), as the result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-905 with High Desert Child, Adolescent and Family Services Center, Inc. (HDCAFSC) in the amount of $2,280,615, Contract No. 21-906 with Inland Behavioral and Health Services, Inc. (IBHS) in the amount of $3,201,125, Contract No. 21-907 with Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services (IVRS) in the amount of $2,518,260, to provide SUD PS for a combined contract amount of $8,000,000 for the period of January 1, 2022 through December 31, 2026.
On May 10, 2022 (Item No. 20), the Board approved Amendment No. 1 to Contract No. 21-905 with HDCAFSC, increasing the contract amount by $33,018, from $2,280,615 to $2,313,633; Amendment No. 1 to Contract No. 21-906 with IBHS increasing the contract amount by $48,119, from $3,201,125 to $3,249,244; and Amendment No. 1 to Contract No. 21-907 with IVRS increasing the contract amount by $41,819, from $2,518,260 to $2,560,079, increasing the total combined contract amount by $122,956, from $8,000,000 to $8,122,956, with no change to the contract period of January 1, 2022 through December 31, 2026.
On December 16, 2025 (Item No. 29), the Board approved a contract-amendment template to update the provisional payment language in contracts with providers of specialty mental health and/or Substance Use Disorder Recovery Services (SUDRS) to reflect a fee-for-service (FFS) payment methodology. As part of the California Department of Health Care Services (DHCS) CalAIM initiatives, DBH has shifted from cost-based reimbursement to FFS with eligible providers for Medi-Cal billable services, streamlining administrative processes to prioritize equitable health outcomes for all Californians.
In December 2025, DBH reviewed the finalized FFS rates and determined that, based on historical utilization patterns and recent provider cost data, providers had been reimbursed at levels below their actual costs. In addition, the new uniform FFS structure, developed using aggregated provider data from all DBH programs, further elevated costs for some programs, resulting in increased costs per client for DBH following the implementation of the FFS rates. The requested $332,062 increase will prevent service disruptions and ensure compliance with CalAIM requirements, including the required shift to FFS payment models under the Behavioral Health Payment Reform.
Approval of the recommendation will also update standard contract language to incorporate Behavioral Health Services Act performance requirements effective July 1, 2026, reflect the legal name change of IVRS, from Inland Valley Recovery Services to Inland Valley Drug and Alcohol Recovery Services dba Inland Valley Recovery Services, and include the Levine Act - Campaign Contribution Disclosure (formerly Senate Bill 1439).
From January 1, 2022, through December 31, 2025, the SUD PS program annually served:
• Approximately 148 unduplicated clients;
• Estimated cost of $10,977 per client across all providers.
For 2026, DBH projects the SUD PS program to serve:
• Approximately 148 unduplicated clients;
• Estimated cost of $13,221 per client across all providers.
DBH will also 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 (Diana Barajas, Administrative Supervisor I, 388-0862) on May 7, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 14, 2026; Auditor-Controller/Treasurer/Tax Collector (Charlene Huang, Auditor-Controller Manager, 382-3035) on May 21, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on May 26, 2026.