DATE: June 16, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 2 to Master Agreement No. 25-321 for Individual and Group Providers
RECOMMENDED ACTION(S):
TITLE
1. Under Administrative Policy No. 34 for competitive bids or requests for proposals (AP 34), determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances due to the noncompetitive nature of Master Agreements; and
2. Approve and authorize the Chairman to execute Amendment No. 2 to Master Agreement No. 25-321 for Individual and Group Providers for the Fresno County Behavioral Health Plan, to add Khalsa Foundation dba Khalsa Community Center, Reflection Family Therapy Inc. dba Reflection Wellness Center, The Way Forward Professional Clinical Counselor Corporation dba The Way Forward Therapy, Nasim Nancy Lynch, and Quality Group Homes, Inc. to the Agreement effective upon execution with no change to the maximum term of July 1, 2025, through June 30, 2030, or maximum compensation of $45,000,000.
REPORT
The recommended actions will add the following providers to the Individual and Group Provider Master Agreement: Khalsa Foundation dba Khalsa Community Center, Reflection Family Therapy Inc. dba Reflection Wellness Center, The Way Forward Professional Clinical Counselor Corporation dba The Way Forward Therapy, Nasim Nancy Lynch, and Quality Group Homes, Inc. effective upon execution, to provide Specialty Mental Health Services to Medi-Cal recipients. There is no additional Net County Cost associated with approval of the recommended actions as there are sufficient existing funds allocated to the master agreement. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the Department of Behavioral Health (DBH) will not be able to increase its network of providers, possibly leading to longer wait times for persons served. It may also cause the Department to be out of compliance with State-mandated network adequacy and time and distance requirements.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
It is requested that the County find under AP 34 that an exception to the competitive bidding requirement is satisfied, and a suspension of competition is warranted due to unusual or extraordinary circumstances, as the Department will contract with any vendor that meets the requirements of the Master Agreement, to ensure that sufficient capacity is available for Medi-Cal recipients throughout the Department’s provider network. The General Services Department - Purchasing concurs with the Department’s assessment that this satisfies the exception to the competitive bidding process required by AP 34.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum cost of the recommended Master Agreement ($45,000,000) will be funded with Medi-Cal Federal Financial Participation and Behavioral Health Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Behavioral Health Org 5630 FY 2025-26 Adopted Budget and will be included in future budgets for the duration of the term of the Agreement. Actual costs will be determined by actual services provided.
DISCUSSION:
On June 24, 2025 the Department executed Master Agreement No. 25-321 with Individual and Group Providers to provide outpatient specialty mental health services for Medi-Cal beneficiaries. On July 8, 2025, the Department executed Amendment No. 1 (25-350) to Master Agreement No. 25-321 to add 18 providers to the Master Agreement. The Department is responsible for ensuring Medi-Cal beneficiaries of all ages have access to medically necessary outpatient specialty mental health services. The Master Agreement allows specialty mental health services to be available and delivered through the broadest base of providers.
Providers on this Master Agreement include psychiatrists, psychologists, licensed clinical social workers, licensed professional clinical counselors, and licensed marriage and family therapists acting either as individuals or groups as defined by Title 9 California Code of Regulations §1810.218.2 and §1810.222. Additionally, the Master Agreement allows for associated and unlicensed staff under the direct supervision of a licensed professional to render services in accordance with Department of Health Care Services (DHCS) regulations. To be a part of this Master Agreement and prior to rendering services, every provider must:
• Be approved through the DBH credentialing process;
• Adhere to the requirements established in the Fresno County Department of Behavioral Health and the California State Department of Health Care Services;
• Complete documentation, billing, and compliance training;
• Complete a DBH site certification process of the service location.
Services provided under this agreement include, but are not limited to rehabilitative mental health services, targeted case management, psychiatric services, psychologist services, and early and periodic screening and diagnosis treatment supplemental specialty mental health services. Services are available to all persons eligible for Medi-Cal residing in Fresno County. During the current fiscal year 2025-26 as of January 23, 2026, providers on this Master Agreement rendered services to 2,748 persons.
Reimbursements to providers are made using a fee for service model based on actual services provided. The reimbursement fee schedule is based on an hourly rate with payments made to providers based on DHCS’s billing rules using current procedural terminology codes. The hourly rates are dependent on the provider’s professional discipline or license type. Contractors acknowledge that the rates are all-inclusive rates which account for program operating expenses.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board will be notified of this agreement at the May 2026 meeting.
REFERENCE MATERIAL:
BAI # 34 July 8, 2025
BAI # 52 June 24, 2025
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request
On file with Clerk - Amendment No. 2 to Master Agreement
CAO ANALYST:
Ronald Alexander