DATE: August 19, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Agreements for Target Populations Full-Service Partnerships Continuums of Care
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute an Agreement with The Fresno Center for culturally specific full-service partnership services effective September 1, 2025, through June 30, 2030, which includes a two-year ten-month base contract and two optional one-year extensions, total not to exceed $28,909,280;
2. Approve and authorize the Chairman to execute an Agreement with Mental Health Systems, Inc. dba TURN Behavioral Services for co-occurring full-service partnership services effective September 1, 2025, through June 30, 2030, which includes a two-year ten-month base contract and two optional one-year extensions, total not to exceed $22,980,568; and
3. Approve and authorize the Chairman to execute an Agreement with Turning Point of Central California, Inc. for rural mental health full-service partnership services effective September 1, 2025, through June 30, 2030, which includes a two-year ten-month base contract and two optional one-year extensions, total not to exceed $70,353,532.
REPORT
There is no additional Net County Cost associated with the recommended actions which will allow for the provision of full-service partnership services to be offered to targeted populations including Southeast Asians, persons with co-occurring disorders, and rural communities. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, persons with severe serious mental illnesses or serious emotional disturbances may experience a disruption in treatment services impacting their recovery.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum amounts of the agreements with The Fresno Center ($28,909,280), Mental Health Systems, Inc. dba TURN Behavioral Services ($22,980,568), Turning Point of Central California, Inc. ($70,353,532) will be fully offset with Behavioral Health Services Act (BHSA), Medi-Cal Federal Financial Participation (FFP), and Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2025-26 Recommended Budget and will be included in future budget requests.
DISCUSSION:
On June 20, 2023 the Department executed agreements with The Fresno Center, Mental Health Systems, Inc. dba TURN Behavioral Services (TURN) and Turning Point of Central California, Inc. (Turning Point) for full-service partnership services for the Southeast Asian, rural mental health, and co-occurring populations. The agreements included new requirements and payment structures as a result of CalAIM. The agreements have subsequently been amended to clarify service requirements and add funding due to increases in billable services or direct client expenses.
On March 21, 2025, a Request for Proposals (RFP) No. 25-074 for Full-Service Partnership (FSP) Services for Target Populations was issued, and on April 3, 2025, Addendum No. One (1) to RFP No. 25-074 was issued. The Department sought responses from bidders for three FSPs serving three distinct populations targeting co-occurring, rural mental health, and culturally specific persons. On April 17, 2025, RFP No. 25-074 closed, receiving three responses from The Fresno Center ($28,909,280), TURN ($22,980,568), and Turning Point ($70,353,532). The three vendors submitted responses with each proposing to serve different populations as indicated below:
• The Fresno Center - Southeast Asians
• Mental Health Services, Inc. dba TURN Behavioral Services - Persons with co-occurring disorders
• Turning Point of Central California, Inc. - Rural populations
An evaluation committee met on April 30, 2025, to conduct a comprehensive review of the submissions. The evaluation committee consisted of the following staff classifications from the Department: one Staff Analyst, one Utilization Review Specialist, one Program Manager, one Behavioral Health Board Member, and one Clinical Supervisor. The proposals were ranked and evaluators considered whether the responses had reasonable direct client support expense budgets, sufficient funds to assist persons using a “whatever it takes” model, their knowledge and awareness of the problems associated with providing the services proposed, whether they had a clear plan to deliver quality mental health services, whether their proposed staffing plans were appropriate both clinically and administratively, and whether they had the experience to produce desired outcomes among other measures. The Department determined that all three proposals would meet the needs of the County and is recommending all three vendors for award for these services, each serving a different target population as previously identified.
The Fresno Center is a current provider of these services. They demonstrated a strong understanding of CalAIM and Mental Health Services Act regulations as well as affirming that they will be adaptable to upcoming regulatory changes. The Fresno Center employs several bilingual staff allowing them to provide services to persons in their own language and build community relationships with the population they intend to serve. The Fresno Center also described how they developed their own community defined evidence-based practice, Southeast Asian Cross Cultural Counseling Model to render services to Southeast Asians.
TURN described how they would include the persons’ families and close relationships in the provision of treatment to work towards positive outcomes. They would incorporate “whole person” care into the persons’ treatment, and identified an extensive list of community resource partners to support the individual needs of the co-occurring population. Their response highlighted the importance of staff retention which would help with ongoing and consistent care for persons in the program.
Turning Point demonstrated their knowledge of the “whatever it takes” model to serve persons both in the field and at their home based on their individualized needs. They identified barriers to treatment, including the impact of the criminal justice system on their persons, and how they planned to address those barriers. Turning Point also expressed their willingness to use existing resources, including staff, to support and sustain these services as capacity increases.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this agreement at the July 2025 meeting.
REFERENCE MATERIAL:
BAI #51 June 24, 2025
BAI #29 May 6, 2025
BAI #34 January 28, 2025
BAI #29 July 9, 2024
BAI #39 April 9, 2024
BAI #47 November 7, 2023
BAI #44 June 20, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with The Fresno Center
On file with Clerk - Agreement with Mental Health Systems, Inc.
On file with Clerk - Agreement with Turning Point of Central California, Inc.
CAO ANALYST:
Ronald Alexander