DATE: August 25, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment to Various Substance Use Disorder Treatment Master Agreements
RECOMMENDED ACTION(S):
TITLE
1. Under Administrative Policy No. 34 for competitive bids or requests for proposals (AP 34), determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into an Agreement with Home Shelter Community Services as the vendor meets the specified requirements for Drug Medi-Cal outpatient substance use disorder treatment services and has demonstrated they can meet the scope of services outlined in the County’s Master Agreement No. 23-290;
2. Approve and authorize the Chairman to execute Amendment No. 2 to Master Agreement No. 23-290 with Drug Medi-Cal certified providers, to add Home Shelter Community Services, with no change to the term of July 1, 2023 through June 30, 2027;
3. Under Administrative Policy No. 34 for competitive bids or requests for proposals (AP 34) determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into an Agreement with A New Awakening of the San Joaquin as the vendor meets the specified requirements for Drug Medi-Cal residential substance use disorder treatment services and has demonstrated they can meet the scope of services outlined in the County’s Master Agreement No. 23-291;
4. Approve and authorize the Chairman to execute Amendment No. 3 to Master Agreement 23-291 with Drug Medi-Cal certified providers, to add A New Awakening of The San Joaquin, with no change to the term of July 1, 2023 through June 30, 2027;
5. Under Administrative Policy No. 34 for competitive bids or requests for proposals (AP 34) determine that an exception to the competitive bidding requirement under AP 34 is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into an Agreement with A New Awakening of the San Joaquin as the vendor meets the specified requirements for Drug Medi-Cal residential substance use disorder treatment services and has demonstrated they can meet the scope of services outlined in the County’s Master Agreement No. 23-292; and
6. Approve and authorize the Chairman to execute Amendment No. 2 to Master Agreement 23-292 with Drug Medi-Cal certified residential substance use disorder treatment providers, to add A New Awakening of The San Joaquin with no change to the term of July 1, 2023 through June 30, 2027 with no change to the maximum compensation amount of $27,353,032.
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommend actions will allow the Department of Behavioral Health (Department) to add Home Shelter Community Services to the existing Master Agreement for Drug Medi-Cal outpatient substance use disorder treatment services, and A New Awakening of The San Joaquin to the existing Master Agreements for Drug Medi-Cal residential substance use disorder treatment services, and room and board services not eligible for Medi-Cal reimbursement. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board does not approve the recommended actions, the Department will have a limited network of substance use disorders treatment providers, which may impact our California Department of Health Care Services mandated network adequacy requirements. Persons eligible for Medi-Cal will also have more limited choices of providers from which to seek care.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
It is requested that the County find under AP 34 that an exception to the competitive bidding requirement is satisfied, and a suspension of competition is warranted due to unusual or extraordinary circumstances, as the Department will contract with any vendor that meets the requirements of the Master Agreements, to ensure that sufficient capacity is available for Medi-Cal recipients throughout the Department’s provider network. The General Services Department - Purchasing concurs with the Department’s assessment that this satisfies the exception to the competitive bidding process required by AP 34.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The DMC Master Agreement No. 23-290 for outpatient substance use disorder treatment services and the DMC Master Agreement No. 23-291 for residential substance use disorder treatment services have no maximum compensation amounts for DMC funded services which are dependent on the number of services provided. The maximum compensation ($27,353,032) for Master Agreement No. 23-292 remains unchanged as there are sufficient funds that were previously not allocated to any vendor available to support the addition of A New Awakening of the San Joaquin. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2026-27 Recommended Budget and will be included in subsequent budget requests for the duration of the agreements.
DISCUSSION:
On June 20, 2023 the Board of Supervisors approved Master Agreement No. 23-290 for outpatient substance use disorder treatment services, Master Agreement No. 23-291 for residential substance use disorder treatment services, and Master Agreement No. 23-292 for Room and Board services for persons receiving residential substance use disorder treatment services.
On June 4, 2024, the Board approved Amendment No. 1 to Master Agreement No. 23-290, Amendment No. 1 to Master Agreement No. 23-291, and Amendment No. 1 to Master Agreement No. 23-292 to amend various subsections of the Master Agreement to update provider reporting requirements to align with California Advancing and Innovating Medi-Cal (CalAIM) initiatives and the new Electronic Health Records system; extend the term for the Contingency Management pilot program; and add contractor participation requirements for State efforts to improve culturally responsive care delivery. Amendment No. 1 to Master Agreement No. 23-292 also revised maximum compensation amounts and rates for various contractors to meet service needs.
On March 25, 2025, the Board approved Amendment No. 2 to Master Agreement No. 23-291 to increase reimbursement rates and set minimum reimbursement rates for various contractors on the Master Agreement.
Recommended Amendment No. 2 to Master Agreement No. 23-290 for outpatient substance use disorder treatment services would add Home Shelter Community Services to the Master Agreement. Home Shelter Community Services completed California DHCS Drug Medi-Cal and Alcohol and Other Drug certification requirements making them eligible to provide Medi-Cal funded outpatient services to eligible persons in Fresno County.
Recommended Amendment No. 3 to Master Agreement No. 23-291 for residential substance use disorder treatment services would add A New Awakening of the San Joaquin to the Master Agreement. A New Awakening of the San Joaquin completed California DHCS Drug Medi-Cal and Alcohol and Other Drug certification and licensing requirement making them eligible to provide Medi-Cal funded residential services to eligible persons in Fresno County.
Recommended Amendment No. 2 to Master Agreement No. 23-292 for Room and Board services for persons receiving substance use disorder treatment services would add A New Awakening of the San Joaquin to the Master Agreement. This Master Agreement is available to residential substance use disorder treatment service providers to reimburse them for services not eligible for reimbursement through Medi-Cal such as food, bedding, toiletries, and other activities indirectly related to treatment during a persons stay. The Master Agreement’s maximum compensation remains unchanged as there was sufficient existing funding available to support the addition of A New Awakening of the San Joaquin. The reimbursement rate for A New Awakening of the San Joaquin was determined through negotiation with the vendor. All services are reimbursed based on a fee for service model for actual services rendered.
AB 339 noticing has occurred and the Human Resources Department approved execution of the recommended amendments.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this agreement at the June 2026 meeting.
REFERENCE MATERIAL:
BAI #12, March 25, 2025
BAI #28, June 4, 2024
BAI #45, June 20, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request for 23-290
On file with Clerk - Amendment No. 2 to Master Agreement No. 23-290
Suspension of Competition Acquisition Request for 23-291
On file with Clerk - Amendment No. 3 to Master Agreement No. 23-291
Suspension of Competition Acquisition Request for 23-292
On file with Clerk - Amendment No. 2 to Master Agreement No. 23-292
CAO ANALYST:
Ronald Alexander