DATE: September 9, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Behavioral Health Housing Supportive Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute an Agreement with Hope & Healing Family Therapy Center, Inc. for the provision of housing supportive services to individuals with serious mental illnesses living in Fresno County effective upon execution, not to exceed five consecutive years, which includes a three-year initial term and two optional one-year extensions, total not to exceed $16,368,597.
REPORT
Approval of the recommended action will authorize Hope & Healing Family Therapy Center, Inc. (Hope & Healing) to provide housing supportive services (HSS) to tenants with serious mental illnesses (SMI) living in permanent supportive housing (PSH) to reduce homelessness and assist in achieving self-sufficiency and housing stability. The recommended agreement will be funded with Medi-Cal Federal Financial Participation (FFP) funds and Mental Health Services Act - Community Services and Supports (MHSA - CSS), with no Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended action is not approved, the Department of Behavioral Health (Department) will be unable to fulfill its longstanding commitment to provide HSS to individuals with SMI residing at our ten partnered housing sites across Fresno County. These services are critical to helping residents maintain stable, permanent housing. Without continued support, many individuals may be at risk of housing instability or returning to homelessness.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation for the agreement with Hope & Healing is $16,368,597 and will be funded with MHSA-CSS funds and Medi-Cal FFP funds. Sufficient appropriations and estimated revenues will be included in the Department Org 5630 FY 2025-26 Recommended Budget and will be included in future budget requests.
DISCUSSION:
Housing supportive services are essential for tenants living with SMI due to the high rates of homelessness among this population. The Department is currently the HSS provider for ten PSH sites scattered throughout Fresno County and is responsible for providing HSS to Department persons served residing at those PSH sites.
Housing supportive services include, but are not limited to:
* Ongoing assessment of needs;
* Case management services;
* Life skills development;
* Benefits counseling and advocacy;
* Educational and job resources; and,
* Linkages to other needed services.
On March 23, 2021, the Board approved Agreement No. 21-083 with Exodus Recovery, Inc (Exodus) to provide HSS for the Villages at Paragon PSH site.
On May 25, 2021, the Board approved Amendment No. 1 to Agreement No. 21-083 (Agreement No. 21-083-1) to increase the maximum compensation and add additional service locations, including the Renaissance Alta Monte, Renaissance Santa Clara, Renaissance Trinity, and Villages at Broadway PSH sites.
On September 20, 2022, the Board approved Amendment No. 2 to Agreement No. 21-083 (Agreement No. 22-423) to increase the maximum compensation and add additional service locations, including Alegre Commons and Butterfly Gardens.
On June 20, 2023, the Board approved Agreement No. 23-288 with Exodus to replace, restate, and supersede Agreement No. 21-083, as amended, to include a new billing structure as required by the implementation of CalAIM (California Advancing and Innovating Medi-Cal).
Since June 20, 2023, three additional PSH sites, Arthur at Blackstone, Avalon Commons, and Crossroads Village, have become operational and have been receiving HSS services through Department staff. The agreement with Exodus for HSS expired on June 30, 2025. Department staff are providing HSS services at all ten PSH sites until services can be transferred to the selected vendors.
The County is currently committed to providing services to tenants at the following ten PSH sites: Alegre Commons, The Arthur at Blackstone, Avalon Commons, Butterfly Gardens, Crossroads Village, Renaissance Alta Monte, Renaissance Santa Clara, Renaissance Trinity, Villages at Broadway, and Villages at Paragon.
The Department, in coordination with the General Services Department - Purchasing, issued Request for Proposals No. 25-076 for HSS on March 19, 2025, for qualified vendors to provide evidence-based specialty mental health and HSS to Department persons served residing at PSH developments throughout Fresno County. Four proposals were received by the April 18, 2025 closing date, from the following vendors:
1. RH Community Builders ($35,247,462) included ten out of ten PSH sites.
2. Hope & Healing ($36,798,402) included four out of ten PSH sites.
3. Environmental Alternatives, DBA EA Family Services ($32,555,456) included four out of ten PSH sites.
4. Kings View ($23,549,321) included ten out of ten PSH sites
The four proposals were received and ranked by an evaluation committee according to Purchasing guidelines based on a comprehensive review of the proposal contents which included but was not limited to: sufficient and appropriate staffing, local partnerships to support services and programming, experience working with persons with serious mental illnesses or co-occurring disorders, and demonstrated knowledge of additional community-based services and resources for linkages and coordinated care. The evaluation committee consisted of two Department clinicians, a Department MHSA Fiscal Analyst, one Department utilization review specialist, and the County Administrative Office Homelessness Program Manager, who reviewed the proposals. Hope & Healing was selected as one of the two most qualified bidders to best meet the needs of the County and was tentatively awarded the Avalon Commons, the Arthur at Blackstone, and Butterfly Gardens PSH sites. The Department will return to your Board with an agreement with the other awarded vendor, RH Community Builders, for the remaining sites at a future date.
Hope & Healing demonstrated experience and familiarity with Fresno County and its specific needs, familiarity with providing similar services in Fresno and in other California counties, and included clear and well-defined descriptions of their ability to render the requested services in a manner that would be responsive to Department persons served. Hope & Healing also reflected the Department's guiding principles of care, which provide a clinical framework that influences decision-making in all aspects of care delivery, and was able to articulate how their programming would support and adhere to each principle.
Hope & Healing will provide vocational and educational services such as employment services, employment services intake, employment preparation, job development and placement, employment retention and job coaching. Persons served will also receive peer supported services, peer training, and supportive mentoring through the program. Services will be individualized to address each participant's interests, goals, skills, abilities, and needs.
The modification clause of the agreement delegates the Board's authority to the DBH Director to make non-material changes to the agreement during the term of the agreement, as further described in the modification clause of the agreement. These changes shall not result in any changes to the maximum compensation amount.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board will be notified of this agreement at the September 2025 meeting.
REFERENCE MATERIAL:
BAI #45, June 20, 2023
BAI #27, September 20, 2022
BAI #39, May 25, 2021
BAI #32, March 23, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Hope & Healing Family Therapy Center, Inc.
CAO ANALYST:
Dylan McCully