DATE: June 24, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Master Agreement with Individual and Group Providers for Outpatient Specialty Mental Health Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute a Master Agreement with Individual and Group Providers for outpatient specialty mental health services, effective July 1, 2025, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $45,000,000.
REPORT
There is no additional Net County Cost associated with the recommended action, which will enable the Department of Behavioral Health (DBH) to continue to provide Medi-Cal beneficiaries with medically necessary outpatient specialty mental health services. The services will be provided by qualified mental health professionals who have been credentialed with the Fresno County Behavioral Health Plan. This item is countywide.
ALTERNATIVE ACTION(S):
If your Board does not approve of the recommended Master Agreement, outpatient specialty mental health services currently being provided to Medi-Cal beneficiaries will be disrupted and wait times may increase for other contracted Medi-Cal mental health providers.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum cost of the recommended Master Agreement ($45,000,000) will be financed with Medi-Cal Federal Financial Participation and Behavioral Health Realignment funds. Sufficient appropriations and estimated revenues will be included in the Department’s Behavioral Health Org 5630 FY 2025-26 Recommended Budget and will be included in future budgets for the duration of the Agreement. Actual costs will be determined by actual services provided.
DISCUSSION:
On March 21, 2025, the General Services Department - Purchasing Division (Purchasing) released request for statement of qualifications (RFSQ) #25-085 seeking individual and group providers for specialty mental health services. On April 10, 2025, Purchasing issued Addendum #1 to RFSQ #25-085. On April 23, 2025, RFSQ #25-085 closed with Purchasing receiving 19 responses and after review determined all responses met all requirements stated in the RFSQ. 18 responsive bidders are included as contractors in the recommended Master Agreement; 1 bidder will not be included at this time due to not completing site certification in time - they will be added at a later Board date.
DBH is responsible for ensuring Medi-Cal beneficiaries of all ages have access to medically necessary outpatient specialty mental health services. The recommended Master Agreement allows mental health services to be available and delivered through the broadest base of providers. Contractors on this recommended Master Agreement include psychiatrists, psychologists, licensed clinical social workers, licensed professional clinical counselors, and licensed marriage and family therapists acting either as individuals or groups as defined by Title 9 California Code of Regulations §1810.218.2 and §1810.222. Additionally, the recommended Master Agreement allows for associated and unlicensed staff under the direct supervision of a licensed professional to render services in accordance with Department of Health Care Service regulations.
To be a part of this Master Agreement and prior to rendering services, every provider must:
• Be approved through the DBH credentialing process;
• Adhere to the requirements established in the Fresno County Behavioral Health Plan Provider Manual;
• Complete documentation, billing, and compliance training; and
• Complete a DBH site certification process of the office.
Services provided under this agreement include, but are not limited to rehabilitative mental health services, targeted case management, psychiatric services, psychologist services, and early and periodic screening and diagnosis treatment supplemental specialty mental health services. Services are available to all persons eligible for Medi-Cal residing in Fresno County.
Reimbursements to providers are made using a fee for service model based on services provided to Medi-Cal eligible persons. The reimbursement fee schedule is based on an hourly rate with payments made to providers based on DHCS’s billing rules using current procedural terminology codes. The hourly rates are dependent on the provider’s professional discipline or license type.
The modification clause of the agreement delegates the board’s authority to the DBH Director to make certain changes to the agreement during the term of the agreement, as further described in Article 15, Section 2 of the Agreement.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this agreement at the June 2025 meeting.
REFERENCE MATERIAL:
BAI #36 May 20, 2025
BAI #41 December 17, 2024
BAI #41 November 5, 2024
BAI #27 May 21, 2024
BAI #32 January 9, 2024
BAI #43 June 20, 2023
BAI #33 June 23, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Master Agreement
CAO ANALYST:
Ronald Alexander