DATE: July 14, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Access Agreement with California Department of Health Care Services for the Behavioral Health Bridge Housing Program
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute an Access Agreement with the California Department of Health Care Services for the Behavioral Health Bridge Housing Program, effective upon execution through June 30, 2027 ($0).
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will allow the California Department of Health Care Services (DHCS), and any of their authorized representatives, access to the Behavioral Health Bridge Housing (BHBH) property pursuant to Agreement No. 23-626 (Underlying Agreement) by and between Advocates for Human Potential, Inc. (AHP), as representative for DHCS, and the Department of Behavioral Health (Department). Although this item pertains to locations in District 1 and District 2, the impact is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, DHCS will terminate BHBH services, which would result in the displacement of over 180 homeless individuals.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action.
DISCUSSION:
Through the BHBH Program, DHCS will provide $1.5 billion in funding statewide to operate bridge housing to address the immediate and sustainable housing needs of people experiencing homelessness who have a serious mental illness (SMI) and/or substance use disorder (SUD). The BHBH Program, which was signed into law in September 2022 under Assembly Bill (AB) 179 (Ting, Chapter 249, Statutes of 2022), provides funding through June 30, 2027.
On February 21, 2023, DHCS released the initial non-competitive round of the BHBH Program through a Request for Application (RFA) that will provide $907,936,000 to California counties for use in the planning and implementation of bridge housing services for Californians experiencing homelessness who have serious behavioral health conditions (a serious mental illness and/or substance use disorder). The maximum BHBH allocation for Fresno County is $21,833,333. The additional funding sources will come from Medi-Cal Federal Financial Participation and CalAIM Enhanced Care Management and Community Supports. Once the initial implementation is underway, Fresno County will be eligible for two additional rounds of funding in the next couple of years.
On April 27, 2023, the Department submitted an application to DHCS for the Non-Competitive BHBH Suspension of Competition with RH Community Builders, LP for a total of $21,833,333 and was approved by DHCS on September 5, 2023.
On November 28, 2023, the Board approved the Underlying Agreement with DHCS for the Non-Competitive BHBH grant allocation for $21,833,333, and Agreement No. 23-627 with RH Community Builders. Funds from the BHBH Program will be used for bridge housing to build collaboration, increase resources, and fill gaps by addressing the housing needs of individuals experiencing both homelessness and a serious behavioral health condition (SMI, SUD, or both).
On June 24, 2025, your Board approved Agreement No. 25-276 (Access Agreement) with DHCS to allow DHCS and their authorized representatives: (1) physical access to the BHBH sites; and (2) access to the information outlined in the Underlying Agreement to confirm Department compliance with BHBH program requirements and restrictions, as well as applicable Federal and State regulations.
On June 24, 2025, DHCS notified the County that DHCS made changes to the structure of their agreement template and requested that the County sign a newly revised copy of the Access Agreement. Agreement No. 25-276 was never signed by DHCS, therefore the agreement was never fully executed.
Approval of the recommended action will execute an access agreement with DHCS and allow the County to comply with the requirements of the Underlying Agreement, which will provide DHCS and their authorized representatives (1) access to inspect BHBH properties and facilities; and (2) the information outlined in the Underlying Agreement to confirm Department compliance with BHBH program requirements and restrictions, as well as applicable Federal and State regulations.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this agreement at the May 2026 meeting.
REFERENCE MATERIAL:
BAI #47, June 24, 2025
BAI #48, November 28, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - BHBH Access Agreement
CAO ANALYST:
Dylan McCully