DATE: February 10, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director Department of Behavioral Health
SUBJECT: Agreement with Central Star Behavioral Health Inc. for Crisis Residential Treatment Services.
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute an Agreement with Central Star Behavioral Health, Inc. for Crisis Residential Treatment services, effective March 1, 2026, through June 30, 2030, which includes a two-year and four-month base contract and two optional one-year extensions, total not to exceed $14,734,783; and
2. Approve and authorize the Chairman to execute License Agreement with Central Star Behavioral Health, Inc. for use of the County’s Crisis Residential Unit, 496 S. Barton, Fresno CA 93702, effective March 1, 2026, through June 30, 2030, which includes a two-year and four-month base contract and two optional one-year extensions ($0).
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will allow Central Star Behavioral Health, Inc. to provide mandated crisis residential treatment services to individuals ages 18-59. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, mandated services will not be provided to individuals in need within Fresno County. Your Board may direct the Department to assume operations of any of these services; however, the decision will result in added costs to the County and a delay in services as the Department obtains the required staff and licensure.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the agreement ($14,734,783) will be fully offset with Medi-Cal Federal Financial Participation (FFP) and Mental Health Realignment funds. Sufficient appropriations and estimated revenues are included in the Department of Behavioral Health Org 5630 FY 2025-26 Adopted Budget and will be included in future budget requests for the remainder of the term of the Agreement.
DISCUSSION:
Service Agreement History:
On June 20, 2023, the Board approved Agreement No. 23-275 with Central Star Behavioral Health, Inc., for a sixteen (16) bed crisis residential treatment facility (CRT) which provides a residential structured therapeutic program as an alternative to hospitalization. The therapeutic and rehabilitative services are provided as defined in California Code of Regulations (CCR), Title 22, 1810.208.
On June 24, 2024, the Board approved Amendment No. 1. 25-279 to Agreement No. 23-275 to extend the term for one year and adjust FY 2024-25 budget to ensure uninterrupted mandatory services to County persons served while the Department finalizes the Request for Proposal (RFP) process.
License Agreement History:
On November 14, 2017, the Board approved License Agreement No. 17-581 to allow Central Star Behavioral Health, Inc. to utilize County owned building space located at 496 S. Barton, Fresno CA 93702 to operate a Crisis Residential Treatment Facility,
On June 20, 2023, the Board approved Amendment No. 1. 23-297 to License Agreement No.17-581 to extend the term to June 30, 2025.
On June 24, 2025, the Board approved Amendment No. 2. 25-280 to License Agreement 17-581 to allow for the continued use of the County’s Crisis Residential Treatment Facility.
Current Status:
On March 7, 2025, Request for Proposal (RFP) 25-066 for Crisis Residential Treatment Services was issued. Addendums were published on March 27, April 4, and April 9, 2025. The RFP closed April 22, 2025. The Department received four bids: CRT Programs, with a Fee for Service (FFS) Program Maximum Compensation of $13,400,004 and a Cost Reimbursement (CR) total of $16,481,118 Jackson House, with a FFS Program Maximum Compensation of $15,774,395 and a CR total of $2,758,501, Sierra Meadows, with a FFS Program Maximum Compensation of $15,982,821 and a CR total of $14,954,454, and Stars Behavioral Health, with a FFS Program Maximum Compensation of $14,079,305 and a CR total of $2,922,390. The RFP was awarded to Central Star Behavioral Health based on their extensive knowledge and experience in providing crisis residential treatment services, their knowledge of relevant rules and regulations.
In FY 2023-24, 191 unique individuals were served, with an average monthly census of 12. In FY 2024-25 160 unique individuals were served with an average monthly census of 10.
Approval of the recommended actions will authorize the Department to continue providing mandated CRT services in a County owned location.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this item at the February 2026 meeting.
REFERENCE MATERIAL:
BAI #49. June 24, 2025
BAI #46, June 20, 2023
BAI #44, June 20, 2023
BAI #34, November 14, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Central Star Behavioral Health
On file with Clerk - License Agreement with Central Star Behavioral Health
CAO ANALYST:
Ronald W. Alexander, Jr.