DATE: April 7, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 1 to Agreement with Fresno County Superintendent of
Schools
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 1 to Agreement No. A-25-092 with Fresno County Superintendent of Schools for a multi-tiered system of supports model, revising Exhibit C effective upon execution with no change to the term of July 1, 2025, through June 30, 2030, and increasing the maximum by $38,215,225 to a total of $188,215,225.
REPORT
There is no additional Net County Cost associated with the recommended action. The recommended action will allow the Department to continue to provide a multi-tiered system of supports, including Specialty Mental Health Services (SMHS), integrated with school resources, reducing barriers to access. Through this increase to the maximum compensation, Fresno County Superintendent of Schools (FCSS) will be able to continue the provision of services without delay, including individual therapy, group therapy, and other related mental health services, provided in the home, hub locations, schools sites and other locations throughout the community. The revision of Exhibit C includes the increase to the maximum compensation and updates invoicing requirements to align with Department standards. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department will be unable to reimburse FCSS for any additional services provided once the current maximum compensation is reached. FCSS is currently projected to exceed the previously anticipated volume of services in the upcoming fiscal year, resulting in potential denials of services, creating a barrier in services for more than 3,000 persons served in Fresno County. The recommended action serves to increase the maximum compensation accordingly to account for the increased volume of services rendered to prevent any potential denials or delays in receiving essential mental health services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amount of the Agreement ($188,215,225) will be funded with Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI), Community Services and Support (CSS) and Medi-Cal Federal Financial Participation (FFP). The increase to the maximum amount will be distributed evenly over the five years of the agreement, following the same proportions as the original agreement outlay. Sufficient appropriations and estimated revenues are included in the Department of Behavioral Health’s Org 5630 FY 2025-2026 Adopted Budget and will be included in future budget requests for the duration of the term of the Agreement. Actual costs will be determined by actual services provided.
DISCUSSION:
On March 11, 2025, your Board approved Agreement No. A-25-092 with FCSS for a multi-tiered system of services including SMHS and Early Intervention services, as part of Fresno County’s MHSA CSS Plan and PEI Plan.
Utilization Data (As of 1/16/2026)
Fiscal Year Unique Persons Served Services Delivered
2023-2024 3,258 149,842
2024-2025 4,808 183,062
2025-2026 4,144 106,680
Utilization data for this program indicates an average of 48% growth in unique persons served and an average of 22% growth in services delivered from FY 2023-24 to FY 2024-25. The proposed maximum compensation is based on the percentage growth in invoicing between corresponding months in FY 2024-25 and FY 2025-26. The current highest percentage growth, a 49% increase from September 2024 compared against September 2025, was applied to corresponding invoices from December through June of FY 2024-2025 to project invoicing for the remainder of FY 2025-26. The proposed maximum compensation accounts for the maximum recorded growth in invoicing this FY to ensure all services provided can be reimbursed.
On March 4, 2026, the Department completed development of a revised Financial Terms & Conditions Exhibit template to better delineate expectations for contractor compliance with invoicing requirements and ensure all contractors are held to a consistent standard. Revised Exhibit C includes both the proposed increase to the maximum compensation and the implementation of clearer, more defined deadlines and requirements for invoicing and recoupment procedures. The revision of the exhibit is intended across all Department agreements to maintain procedural consistency.
The Department has notified and received approval from Main HR of execution of the recommended amendment to comply with AB 339.
Approval of the proposed action to increase the maximum compensation and revise Exhibit C of the Agreement is necessary to ensure alignment with the Department’s updated invoicing requirements and ensure the continued provision of services to persons served without exceeding the current maximum compensation.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board will be notified of the recommended Amendment during the April 2026 meeting.
REFERENCE MATERIAL:
BAI #11, March 11, 2025
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 1 with FCSS
CAO ANALYST:
Ronald Alexander, Jr.