DATE: November 17, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 1 to Agreement with Central Star Behavioral Health,
Inc.
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 1 to Agreement No. A-25-379 with Central Star Behavioral Health, Inc. to revise exhibits A - C to align with Behavioral Health Service Act requirements for Full-Service Partnerships, effective December 1, 2026, with no change to the term of October 1, 2025 through June 30, 2030 and reducing the maximum compensation by $739,830 to a total of $24,209,989.
REPORT
There is no additional Net County Cost associated with the recommended action. The recommended action will amend the agreement with Central Star Behavioral Health, Inc. to revise the Scope of Work, Behavioral Health Requirements, Outcomes, Financial Terms and Conditions, and the contract expenditure limits to align Full-Service Partnership (FSP) services with Behavioral Health Service Act (BHSA) requirements. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department would be unable to implement the State-mandated requirements of BHSA, including the County’s three-year Integrated Plan and the associated FSP program regulations. The current Agreement would remain in effect; however, the current Mental Health Services Act (MHSA) funding will no longer be available.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum cost of the recommended Agreement ($24,209,989) will be funded with Medi-Cal Federal Financial Participation, BHSA funds, and Mental Health Realignment funds. Sufficient appropriations and estimated revenues are included in the Department of Behavioral Health’s Org 5630 FY 2026-27 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:
The Department released a Request for Proposal (RFP) on April 1, 2025, for the provision of Transitional Age Youth (TAY) Full-Service Partnership (FSP) Continuum of Care services including FSP, Intensive Case Management (ICM) and Outpatient (OP) levels of care. Language in the RFPs notified potential bidders to be prepared for a contract amendment to include changes specific to the implementation of BHSA requirements. The changes include formally defining FSP- ICM services, removing MHSA funds, and adding BHSA funds. Outpatient services will continue to be available with no significant changes.
On August 5, 2025, the Board approved Agreement No. A-25-379 with Central Star Behavioral Health, Inc. for TAY FSP Continuum of Care services.
Pursuant to voter approval of Proposition 1 in March 2024, the Department must implement a statewide reform and expansion of California’s behavioral health system. Proposition 1 replaces the Mental Health Services Act (MHSA) of 2004 with the BHSA. Key BHSA impacts on FSP programs include carving out housing support funds into a separate service category and formally delineating FSP services into distinct care levels, including FSP ICM.
The Department collaborated with the Purchasing Manager to align the scope of work across affected agreements with BHSA mandates. The Purchasing Manager concurs that amending the scope of work aligns with the intent and framework of the original RFP. Approval of the recommended Amendment will revise the Scope of Work, Behavioral Health Requirements, Outcomes, Financial Terms and Conditions, and the budget to align with BHSA requirements for Full-Service Partnerships. The revised Scope of Work replaces the FSP level of care with an FSP-ICM level of care which meets BHSA requirements for Full Service Partnerships and replaces the ICM and OP levels of care with an OP level of care which meets Medi-Cal requirements for Specialty Mental Health Services (SMHS). The Revised Behavioral Health Requirements includes clarifying language regarding cooperation with audits. The Revised Outcomes includes new state reporting measures required under BHSA. The Revised Financial Terms and Conditions contain clarifying language for invoicing processes and deadlines and updates the maximum compensation.
The maximum compensation for the Agreement has been adjusted from the current allocations. The maximum compensation for Cost Reimbursement services has been adjusted to remove funding allocated for housing support services, such as room and board, which cannot be paid using the BHSA FSP funding category, and to use a standardized allowance across all FSP-ICM contracts of $1,000 per person served in each fiscal year. The maximum compensation for SMHS in the FSP-ICM level has been adjusted to use a standardized allowance across all FSP-ICM contracts of $21,000 per person served in each fiscal year.
The new Agreement includes a maximum capacity for the FSP-ICM level of care of 100 individuals in FY 2026-27, increasing to 150 in FY 2027-28, 200 in FY 2028-29, and 225 in FY 2029-30. Maximum compensation for Specialty Mental Health Services in the OP level was calculated using historical cost data and expected need. The program served 81 individuals in the ICM and OP levels during FY 2025-26 at a projected cost per person of $8,845. The program is expected to serve 96 individuals in the revised OP level.
The maximum compensation for FY 2026-27 has been prorated to account for an effective date after the start of the fiscal year.
Assembly Bill 339 noticing has occurred and the Human Resources Department approved execution of the recommended amendment.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board will be notified of the recommended Amendment during the November 2026 meeting.
REFERENCE MATERIAL:
BAI #45 August 5, 2025
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No.1 with Central Star Behavioral Health, Inc.
CAO ANALYST:
Ronald Alexander Jr.