DATE: November 18, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Affiliation Agreement with Regents of the University of California on Behalf of the University of California, San Francisco - Fresno, Medical Education Program for Psychiatric Resident Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute an Agreement with the Regents of the University of California on behalf of the University of California, San Francisco - Fresno, Medical Education Program for psychiatric resident services provided at the Department of Behavioral Health facilities effective upon execution through June 30, 2030 ($0); and
2. Approve and authorize the Director of Behavioral Health, or designee, as signatory on behalf of the Board of Supervisors on the associated Program Letter of Agreement.
REPORT
There is no Net County Cost associated with the recommended actions. Approval of the recommended actions will allow the Department of Behavioral Health (Department) to provide clinical experience to psychiatric residents (Residents) from the University of California San Francisco - Fresno (UCSF - Fresno). This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, Residents from UCSF - Fresno will not be able to obtain broader clinical learning experiences from the Department.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The recommended agreement does not provide any compensation between the County and UCSF - Fresno.
DISCUSSION:
UCSF conducts accredited medical educational programs for psychiatric resident and fellows and desires to collaborate with facilities in which these program participants can obtain broader clinical learning experiences. The Department’s collaboration with UCSF will advance the Residents’ knowledge of the field of behavioral health, while also providing the Department with additional skilled professional psychiatric personnel to assist with behavioral health treatment. The Department’s Medical Director will be the faculty site director who assumes administrative, educational, and supervisory responsibilities for the Residents during the rotation. This collaboration will help provide the community with psychiatric providers that possess more comprehensive knowledge and experience to better service the public. This collaboration will also provide Residents with an opportunity to work in behavioral health and possibly make a career in this underserved area.
The recommended agreement will allow for psychiatric residents to provide direct patient care and maintain caseloads as part of the residency program. Their residencies allow for the County to have sufficient levels of psychiatric services for persons served, especially during this time with a shortage of County psychiatrists. The UCSF - Fresno Psychiatry Residency Program currently has six (6) resident positions per year and all six (6) residents provide services to DBH persons served as part of their training. Each month, the six (6) residents provide 200-300 hours of services in-person at the DBH Metro Clinic.
Approval of the second recommended action will allow the Director of Behavioral Health, or designee, as signatory on behalf of the Board of Supervisors on the associated Program Letter of Agreement. The recommended agreement deviates from the County’s standard indemnification language because it includes a mutual indemnity clause.
REFERENCE MATERIAL:
BAI #59, December 3, 2024
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Regents of the University of California
On file with Clerk - Program Letter of Agreement
CAO ANALYST:
Ronald Alexander