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 Contract with Victor Community Support Services for 0 - 5 Comprehensive Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 24-923 with Victor Community Support Services, Inc., for the provision of 0 - 5 Comprehensive Treatment Services, increasing the total contract amount by $230,000, from $22,495,665 to $22,725,665, with no change to the contract period of October 1, 2024 through June 30, 2028.
(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 $230,000 for 0 - 5 Comprehensive Treatment Services (0-5 CTS) will be funded by Medi-Cal Federal Financial Participation and the Behavioral Health Services Act. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2026-27 budget and will be included in the 2027-28 recommended 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. An integral component of the County’s behavioral health service delivery system consists of County-operated clinics and contracted providers delivering a broad range of specialty mental health services (SMHS), including the 0 - 5 CTS program. The 0 - 5 CTS program was a Mental Health Services Act Prevention and Early Intervention program that transitioned to a Behavioral Health Services Act Early Intervention program on July 1, 2026. The 0 - 5 CTS program consists of two countywide service components: Screening, Assessment, Referral, and Treatment (SART) and Early Identification and Intervention Services (EIIS), which together support the early detection and treatment of behavioral health concerns among young children and their families.
The SART program is designed to improve the social, developmental, cognitive, emotional, and behavioral functioning of children from birth through age five who have been diagnosed with mental health disorders that require SMHS. Children referred to SART have experienced abuse (e.g., physical, sexual, or emotional), neonatal complications such as premature birth, poor maternal nutrition, and prenatal exposure to alcohol or other drugs, family-related challenges including domestic violence, parental substance use disorders, or maternal mental illness, and/or involvement in the foster care system. Children who begin SART services before their sixth birthday may continue services until their seventh birthday. The EIIS program provides services to children ages zero through nine who exhibit social-emotional disturbances or developmental concerns that require less intensive interventions than those provided through SART. EIIS is designed to serve children who are unserved or underserved, as well as those referred through SART or other community-based referral sources, with the goal of promoting healthy development and addressing behavioral health concerns before they become more severe.
The implementation of a Fee-for-Service (FFS) rate structure occurred through the California Advancing and Innovating Medi-Cal (CalAIM) initiative. Prior to January 2026, DBH operated the Victor Community Support Services (VCSS) contract as a cost reimbursement contract. Payment is made for services provided under the FFS system and this may exceed the cost for the provision of services. VCSS has successfully implemented the CalAIM FFS requirements for EPSDT Medi-Cal SMHS.
Since January 2026, service expenditures have exceeded the prorated monthly contract amount, which equates to 1/12th of the annual contract value, by an average of 27.7%, with a range of 16.6% to 39.3% in any given month. This demonstrates a higher than anticipated demand for services and the need for additional funding to ensure continued service delivery throughout the remainder of the contract period. Amendment No. 2 with VCSS increases the available funding to support the continued delivery of SMHS in accordance with the CalAIM FFS reimbursement model. VCSS has successfully implemented the CalAIM FFS component of its EPSDT Medi-Cal contract for SMHS.
In 2024-25, 0 - 5 CTS achieved the following outcomes:
• Served 2,442 unduplicated SART clients
• Average cost of $5,660 per client
• Served 1,382 unduplicated EIIS clients
• Average cost of $7,204 per client
In 2026-27, DBH anticipates:
• Serving approximately 2,423 unduplicated SART clients
• Average cost per client of $6,301
• Serving approximately 1,129 unduplicated EIIS clients
• Average cost of $7,165 per client.
On March 27, 2024, the County Administrative Office approved and authorized the release of Request for Proposals (RFP) No. DBHE24-ADMN-5334 through the County’s Electronic Procurement Network to solicit interested and qualified organizations and agencies to provide 0 - 5 CTS, for the period of October 1, 2024 through June 30, 2028. The RFP was advertised through direct mailings to 614 community-based organizations, educational providers, service providers and other interested parties; and advertised in local newspapers.
On September 24, 2024 (Item No. 26), the Board of Supervisors (Board) approved Contract No. 24-923 with VCSS for the provision of 0-5 CTS in the amount of $22,495,665 for the contract period of October 1, 2024 through June 30, 2028.
On December 16, 2025 (Item No. 29), the Board approved contract amendment templates to update the provisional payment language in contracts with providers of SMHS and/or SUD and recovery services. This item also authorized the department’s Assistant Executive Officer, Deputy Executive Officer, or DBH Director to execute this amendment (including non-substantive changes) using the approved amendment templates.
On March 17, 2026, Amendment No. 1 to Contract No. 24-923 with VCSS was amended to update the provisional payment language pursuant to the Board approved template in the contract via Delegated Authority by the DBH Acting Director.
Performance measures for 0 - 5 CTS 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.
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.