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 Contract with West End Family Counseling Service for General Mental Health Outpatient Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 3 to Contract No. 21-693 with West End Family Counseling Service, for the provision of General Mental Health outpatient services, updating standard contract language to add provisional payment language, and increasing the total contract amount by $141,914, from $3,119,365 to $3,261,279, with no change to the total contract period of October 1, 2021 through September 30, 2026.
(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 increase of $141,914 for General Mental Health (GMH) outpatient services is funded by Federal Financial Participation Medi-Cal, and existing ongoing 1991 and 2011 Realignment funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2025-26 and 2026-27 budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to County residents experiencing severe mental illness and/or SUD. GMH outpatient services are designed to support an individual in reduction of mental disability by enhancing self-sufficiency through mental health activities promoting learning, self-development, and achievement of personal milestones.
GMH outpatient services are County-operated services that deliver Specialty Mental Health Services (SMHS) as required under the State of California Department of Health Care Services (DHCS) Mental Health Plan contract. GMH contract provider, West End Family Counseling Service (WEFCS), augments the capacity of DBH to meet the Federal Center for Medicare and Medicaid Services mandates for timeliness and access to services (42 Code of Federal Regulations Parts 431, 432, and 438).
GMH outpatient services are provided to indigent or Medi-Cal-eligible adults who meet criteria for SMHS level of care. Individuals requiring SMHS experience severe functional impairment related to a persistent mental illness and/or SUD, affecting one or more areas of functioning, including health, self-care, housing, employment, education, legal involvement, financial management, and interpersonal or social relationships. Services include assessments and evaluations, therapy, rehabilitation, medication support, crisis intervention, and case management.
GMH outpatient services are also provided to children experiencing serious mental and emotional challenges that result in significant impairment in daily living activities and overall functioning. Eligible children are considered high-risk and/or seriously emotionally disturbed. This includes minors with a mental disorder, other than a primary substance use or developmental disorder, whose behaviors are inappropriate for their age based on expected developmental norms. To qualify for services, children must also meet medical necessity criteria, including significant impairment or the likelihood of significant deterioration in an important area of functioning, or the probability that the child will fail to progress developmentally without intervention.
DBH GMH outpatient services served approximately 800 clients in 2024-25. DBH GMH outpatient services are expected to serve for the contract period from October 1, 2025 through September 30, 2026:
• Approximately 156 clients beyond service levels
• Estimated annual cost of $4,908 per client.
On September 21, 2021 (Item No. 9), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-693 with WEFCS to provide GMH outpatient services in the amount of $1,871,619 for the contract period of October 1, 2021 through September 30, 2024.
On September 10, 2024 (Item No. 21), the Board approved Amendment No. 1 to Contract No. 21-693 with WEFCS, adding Contract Exclusivity and Notice of Delays clauses to update standard contract language, and adding Executive Order N-6-22 - Russia Sanctions and Campaign Contribution Disclosure (Senate Bill (SB) 1439), increasing the total contract amount by $623,873 from $1,871,619 to $2,495,492, and extending the contract term one year for a total contract period of October 1, 2021 through September 30, 2025.
On August 19, 2025 (Item No. 18), the Board approved Amendment No. 2 to Contract No. 21-693 with WEFCS, updating the Levine Act - Campaign Contribution Disclosure (formerly referred to as SB 1439), reflecting the legal name change, increasing the total contract amount by $623,873, from $2,495,492 to $3,119,365, and extending the contract term one year for a total contract period of October 1, 2021 through September 30, 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 SMHS and/or SUD and recovery services. These amendments are required due to the DHCS Behavioral Health Payment Reform, which transitioned the Medi-Cal reimbursement from DHCS to DBH at the County level. As a result, DBH must revise Contract No. 21-693 to align with the new payment methodology.
Performance measures for General Mental Health Outpatient Services 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 recommended Amendment will update standard contract language by adding provisional payment language and increase the Contract amount by $141,914 in order to provide continued services to GMH clients through the end of the contract term during the transition from cost reimbursement to a fee-for-service payment structure.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Diana Barajas, Administrative Supervisor I, 388-0862) on May 13, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 21, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on June 4, 2026.