REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 22, 2026
FROM
JOSHUA DUGAS, Acting Director, Behavioral Health
SUBJECT
Title
Amendment to Contract with Telecare Corporation for Assertive Community Treatment Team Case Management Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to Contract No. 24-280 with Telecare Corporation, for the provision of Assertive Community Treatment Team Case Management Services, updating contract language, the scope of work, and increasing the contract amount by $5,338,729, from $7,431,600 to an amount not to exceed $12,770,329, with no change to the contract term of April 1, 2024 through March 31, 2029.
(Presenter: Joshua Dugas, Acting Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Improve County Government Operations.
Operate in a Fiscally-Responsible and Business-Like Manner.
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 $5,338,729 for the provision of Assertive Community Treatment (ACT) Team case management services is funded by Mental Health Services Act (MHSA) and Behavioral Health Services Act (BHSA) funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2026-27 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH provides specialty mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and SUD. Since 2002, DBH has contracted with community-based providers to operate ACT Teams that deliver specialty mental health services using the Recovery Model. The Recovery Model supports individuals with severe and persistent mental illness in achieving meaningful recovery, increased independence, and improved quality of life while reducing the need for a higher level of care. Through person-centered, multidisciplinary services, ACT Teams assist clients in building the skills and support needed to transition successfully to less restrictive, community-based settings.
ACT Teams provide intensive, community-based case management, treatment, rehabilitation, and support services to adults with severe mental illness, including individuals who frequently utilize acute psychiatric hospitals and locked adult residential treatment facilities. Services are available 24 hours a day, seven days a week, to support successful transitions from institutional settings to stable community living, reduce psychiatric hospitalizations, and promote long-term recovery.
Using a multidisciplinary team approach, ACT Teams provide comprehensive, individualized services tailored to each client’s behavioral health and community support needs. Services include outreach and engagement, assessment, case management, medication support, psychiatric services, individual and group counseling, rehabilitation, advocacy, referrals, and coordination with community resources to promote recovery and self-sufficiency.
On March 26, 2024 (Item No. 32), as a result of a formal procurement, the Board of Supervisors approved Contract No. 24-280 with Telecare Corporation (Telecare) to provide ACT Team case management services in the amount of $7,431,600 for the contract period of April 1, 2024 through March 31, 2029.
During this period, Telecare also provided ACT Model services to severely and persistently mentally ill clients identified as high users of acute psychiatric hospital services under Contract No. 21-696, which is scheduled to sunset September 30, 2026. The recommended amendment will allow Telecare to consolidate these services under Contract No. 24-280, enabling the continuation of ACT Team case management services for adults with severe mental illness and expanding the scope to include individuals who are high utilizers of acute psychiatric hospitals and other emergency psychiatric services. This consolidation will promote greater efficiency through expanded case management services.
The ACT Team model provides the flexibility to increase the intensity of services based on each client’s clinical needs and emphasizes frequent face-to-face contact to deliver treatment, rehabilitation, and supportive services. The primary goals of the program are to improve clients’ ability to live independently in the community, support long-term recovery, and reduce unnecessary admissions and readmissions to acute psychiatric hospitals and locked adult psychiatric residential facilities.
Since 2024, Telecare has provided ACT Team case management services to:
• Approximately 75 unduplicated clients annually
• An estimated annual cost of $19,818 per client
Upon approval of the recommended amendment, DBH anticipates that Telecare will provide BHSA aligned ACT Team case management services to:
• Approximately 100 clients annually
• An estimated cost of $36,218 per client over the remaining contract period.
The recommended amendment is necessary to implement new BHSA requirements that align Telecare’s program with the standardized evidence-based ACT model and fidelity requirements. The amended scope of work expands the population served, establishes caseload limits of no more than 100 clients per ACT team, increases staffing and service requirements, consolidates two specialty ACT contracts into one program, and establishes formal fidelity and monitoring requirements. Under the amended model, clients must meet ACT level-of-care criteria, and clients who no longer meet those criteria will be transitioned to another appropriate level of care rather than continuing to receive Intensive Case Management services through the ACT team. These changes, along with the anticipated increase in clients served, result in increased staffing and service needs and a higher cost per client.
Performance measures for ACT Team case management services 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
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Marianna Martinez, Administrative Supervisor II, 383-3940) on July 17, 2026; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on August 20, 2026; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 386-8392) on September 3, 2026.