DATE: June 24, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
Sanja Bugay, Director, Department of Social Services
SUBJECT: Amendments to Extend the Term of Various Agreements
RECOMMENDED ACTION(S):
TITLE
1. Approve and Authorize the Chairman to execute the following Amendments with various contractors to extend the term of each agreement by three months with an optional three-month extension, all effective July 1, 2025:
a. Amendment No. 3 to Master Agreement for Adult Continuum Full-Service Partnership services
b. Amendment No. 5 to Agreement with Mental Health Systems, Inc. dba TURN Behavioral Health Services for Adult Co-occurring Full-Service Partnership services
c. Amendment No. 3 to Agreement to Master Agreement for Cultural Specific Continuum Full-Service Partnership services
d. Amendment No. 1 to Agreement with Turning Point of Central California, Inc. for Rural Continuum Full-Service Partnership services
e. Amendment No. 2 to Agreement for Children’s Continuum Full-Service Partnership services
f. Amendment No. 2 to Agreement with Pacific Clinics for Youth Continuum Full-Service Partnership services
g. Amendment No. 3 to Agreement with Central Star Behavioral Health, Inc. for Transitional Age Youth Continuum Full-Service Partnership services
h. Amendment No. 1 to Agreement with JDT Consultants, Inc. for Therapeutic Behavioral Services
i. Amendment No. 5 to Master Agreement for Specialized Residential Mental Health Services
j. Amendment No. 1 to Master Agreement for Child Welfare Mental Health services
k. Amendment No. 5 to Master Agreement for Locum Tenens Psychiatric services
l. Amendment No. 4 to Master Agreement for Telemedicine services
REPORT
There is no additional Net County Cost associated with the recommended actions, which will allow the Department to extend the term of each Agreement by six months and increase the maximum compensation of each Agreement accordingly to continue to provide services until each new Agreement is adopted. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, existing individuals served by expiring Agreements will experience a gap in services. If Agreements expire, the Department will not meet mandated provider network capacity standards to serve the community. The Department has an insufficient volume of clinical staff to provide services provided by the various contractors associated with the recommended contract amendments and cannot absorb the population served by the various contractors within county-operated programs nor could the Department hire fast enough to staff clinics to serve the populations without gaps in service.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. Attachment A includes the contract amounts for the time period of July 1, 2025 to December 31, 2025, the maximum compensation amounts, and funding sources of each contract therein.
Each of the Agreements identified within Attachment A will be fully funded by their existing funding sources including, but not limited to: Medi-Cal Federal Financial Participation, Mental Health Realignment Funds, 2011 Child Welfare Realignment, and Mental Health Services Act funds (Community Services and Supports).
DISCUSSION:
On June 20, 2023, the Board executed multiple superseding agreements to allow the Department to appropriately analyze and adhere to the Department of Health Care Services (DHCS) implemented California Advancing and Innovating Medi-Cal (CalAIM) regulations throughout the Behavioral Health System of Care. The Department superseded the agreements to include CalAIM requirements and extended each term by two (2) years to better understand the requirements of CalAIM to include in new agreements after the two year term extension. This change affected all the recommended amendments for extension on this item which are now approaching the termination of the Agreements.
The Department has released multiple Requests for Proposal (RFP) and Requests for Statement of Qualification (RFSQ) to renew the existing agreements for the following service types:
• Adult Continuum Full-Service Partnership - RFP 25-078
• Adult Target Population Continuum Full-Service Partnership - RFP 25-074 (includes Adult Co-Occurring Full-Service Partnership, Rural Continuum Full-Service Partnership, and Cultural-Specific Continuum Full-Service Partnership services)
• Children’s Continuum Full-Service Partnership - RFP 25-071
• Transitional Age Youth (TAY) Continuum Full-Service Partnership - RFP 25-072
• Youth Continuum Full-Service Partnership - RFP 25-070
• Eating Disorder Services - RFSQ 25-094
• Therapeutic Behavioral Services (TBS) - RFP 25-073
• Child Welfare Mental Health Services - RFP 25-069
At this time the procurements process has not been completed for all service lines. Out of an abundance of caution, the Department is requesting to execute amendments to extend the term, and increase the maximum compensation, on each Agreement for a period of three months with an optional three-month extension to ensure uninterrupted services are provided timely to County persons served by allowing the Department to continue to utilize the current contractors’ services as needed while the procurement process is finalized for each Agreement. Furthermore, should a new vendor be awarded for any of the contracts, the additional three (3) months of services will allow for a transition from the current contractor(s) to the new selected contractor(s) without disruption to the provision of services for County persons served. All provisions, terms, and conditions contained in these Agreements that are not amended shall remain unchanged and in full force and effect.
For the Locum Tenens and Telemedicine Master Agreements, the Department is requesting approval to extend these agreements to avoid a gap in services provided to Fresno County persons served while the Department works with all the various contractors on these agreements to enter into one Master Agreement that includes both Locum Tenens and Telemedicine services. This new agreement will be brought before your board at the earliest possible date.
Attachment A includes information for twelve (12) recommended amendments to extend the term of each agreement which includes original agreement and amendment numbers, dates of previous board actions, contractor names, service description, modality, contract maximum per funding source, reason for extension, and the entire contract term leading up to June 30, 2025.
The Department has been working in collaboration with the General Services Department’s Purchasing Division to analyze service needs and issue a variety of competitive bid documents, i.e., RFP’s, RFQ’s, and RFSQ’s as deemed necessary to renew the agreements.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of this agenda item and related amendments at the June 2025 meeting.
REFERENCE MATERIAL:
BAI #44, June 20, 2023
BAI #45, June 20, 2023
BAI #46, June 20, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
Attachment A
On file with Clerk - Amendment No. 3 to Master Agreement for Adult FSP Services
On file with Clerk - Amendment No. 5 with Mental Health Systems, Inc.
On file with Clerk - Amendment No. 3 to Master Agreement for Adult FSP Cultural Specific Services
On file with Clerk - Amendment No. 1 with Turning Point of Central California, Inc.
On file with Clerk - Amendment No. 2 to Agreement for Children’s FSP Services
On file with Clerk - Amendment No. 2 with Pacific Clinics
On file with Clerk - Amendment No. 3 with Central Star Behavioral Health, Inc.
On file with Clerk - Amendment No. 1 with JDT Consultants, Inc.
On file with Clerk - Amendment No. 5 to Master Agreement for Specialized Residential Mental Health Services
On file with Clerk - Amendment No. 1 to Master Agreement for Child Welfare Mental Health Services
On file with Clerk - Amendment No. 5 to Master Agreement for Locum Tenens Services
On file with Clerk - Amendment No. 4 to Master Agreement for Telemedicine Services
CAO ANALYST:
Ronald Alexander