To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-4774;
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Behavioral Health Agreements
End
Recommended Action:
Recommended action
A) Authorize the County Executive Officer, or designee, delegated authority to execute agreements and/or amendments, subject to review and approval as to form by County Counsel, as follows:
i) An agreement with Muir Wood LLC for youth substance use treatment services, from date of execution through June 30, 2027, for an amount not-to-exceed $1,602,000.
ii) A first amendment with the Siyan Clinical Corporation agreement for temporary staffing services, increasing the original contract amount by $120,000 for a new total not-to-exceed amount of $505,152 due to cost and utilization increases.
iii) A third amendment with the California Mental Health Services Authority agreement for electronic health record services, increasing the contract maximum by $30,000 for a new total not-to-exceed amount of $5,556,045.25 due to American Medical Association Current Procedural Technology code licensing requirements.
iv) A first amendment to the Crestwood Behavioral Health, Inc. agreement for Psychiatric Health Facility services, which do not change the contract maximum or term but which includes nonstandard indemnification language.
B) Authorize the County Executive Officer, or designee, to execute modifications to the agreements associated with this Item in order to address changes in service needs, payment or reimbursement methodologies, subject to available funding as well as review and approval by County Counsel.
C) Adopt a Resolution authorizing budgetary adjustments to the Fiscal Year 2025-2026 adopted budget, increasing appropriations in the amount of $401,000 ($100,000 for New Hope, and $301,000 for Muir Wood LLC) to support youth impacted by severe substance use disorders and at-risk youth addressing high-risk behaviors providing support for substance use prevention. (4/5th Vote Required)
end
Executive Summary:
The Department of Health Services is requesting delegated authority for the County Executive Officer, or designee, to execute agreements or amendments to five agreements as outlined below.
• An agreement with Muir Wood LLC to add the County’s first contracted youth residential substance use treatment provider.
• The first amendment with Siyan Clinical Corporation to sustain 24/7 psychiatric coverage amid higher demand at the Crisis Residential Unit.
• The third amendment with California Mental Health Services Authority’s SmartCare agreement to satisfy new CalAIM and licensing requirements.
• The first amendment with Crestwood’s Psychiatric Health Facility agreement which would approve vendor requested non-standard indemnification language.
Additional appropriations are being requested in the amount of $401,000. The appropriations will include $301,000 for Muir Wood LLC and $100,000 for New Hope for Youth prevention, as part of the Opioid Settlement Fund planning approved by the Board on August 28, 2025. These actions provide the Department of Health Services a safer continuum from prevention to crisis stabilization, inpatient care, and recovery, with reduced compliance and safety risk.
Discussion:
The mission of the Sonoma County Department of Health Services (hereinafter “DHS” or “the Department”), Behavioral Health Division is to promote recovery and wellness to Sonoma County residents and provide mental health and substance use disorder services across the service spectrum, from prevention, early intervention and treatment, to aftercare and recovery. To achieve this, the Department contracts with a broad range of providers for mental health, substance use disorder, and Behavioral Health administrative services.
Muir Wood LLC - Residential Substance Use Disorder Treatment Agreement - $1,602,000 New Agreement
There are currently no Drug Medi-Cal youth residential facilities in the entire Bay Area. The San Francisco facility slated to open soon does not have availability to share treatment beds to clients from Sonoma County. DHS is seeking to contract with Muir Wood, a non-Drug Medi-Cal private facility located in Petaluma, via single source waiver to meet an urgent network need to treat youth impacted by severe substance use disorders (SUD). This will expand SUD adolescent residential treatment from zero contracted facilities to one. Muir Wood serves adolescents ages 12-17 and has a capacity of 64 licensed beds in Sonoma County. The contract between DHS and Muir Woods would allocate two beds for DHS clients, and would serve an average of two youth at a time providing comprehensive family therapy, relapse prevention training, weekly meetings with certified recovery counselors, self-help groups, and evidence-based programming including cognitive behavioral therapy, dialectical behavior therapy, skills training, and Medication Assisted Treatment services when indicated. The program includes psychiatric services, nursing services, and licensed and registered therapeutic treatment providers. DHS is requesting delegated authority to enter into an agreement ending June 30, 2027, in an amount not to exceed $1,602,000. The funding sources for this agreement are Opioid Settlement Funds, 2011 Realignment and Measure O.
Siyan Clinical Corporation Agreement - $120,000 Amendment
Siyan Clinical Corporation is a contracted service provider that provides in-person and on-call psychiatric staffing for the DHS Crisis Stabilization Unit. Due to an increase in both service utilization and costs, DHS is requesting the delegated authority to increase the Siyan Clinical Corporation temporary staffing agreement by $120,000 for Fiscal Year 2025-2026 for a new not-to-exceed amount of $505,152, with a term ending on June 30, 2026, subject to review and approval as to form by County Counsel. The funding sources for this agreement are Federal Financial Participation funds and Measure O.
California Mental Health Services Authority (CalMHSA) Agreement - $30,000 Amendment
In 2022, DHS entered into a multi-year contract with CalMHSA, which provides a fully integrated, web-based Electronic Health Record system designed for program, billing, and revenue management. This system (called SmartCare) supports Sonoma County’s core business requirements and addresses all regulatory requirements specific to the State of California by establishing consistent workflows, configuration, and functionality, including compliance with the State’s California Advancing and Innovating Medi-Cal Behavioral Health Quality Improvement Program.
Due to new American Medical Association Current Procedural Technology code licensing requirements, DHS is requesting the delegated authority to increase the CalMHSA agreement for electronic health record services by a total of $30,000 for a new not-to-exceed amount of $5,556,045.25, with no change to the term ending on March 18, 2029, subject to review and approval as to form by County Counsel. The funding source for this agreement would be Behavioral Health Services Act.
Crestwood Behavioral Health Inc. Psychiatric Health Facility Agreement - $0 Amendment (Non-standard Indemnification Language)
The Sonoma Healing Center, Sonoma County‘s 16-bed Psychiatric Health Facility (PHF) operated by Crestwood Behavioral Health, provides 24-hour acute inpatient mental health treatment and services, which may include evaluation and stabilization of individuals in acute psychiatric crisis, psychiatric consultation services, 24-hour nursing care, medication monitoring, and referrals to appropriate community supports and services. The facility serves both Sonoma and Marin counties. The amendment to this agreement, with no change to the term ending June 30, 2028, updates the remit address and rate tables which do not require Board authority, but the agreement also includes nonstandard indemnification language which does require Board authority.
The indemnification change will read: Contractor’s obligations under this Article apply except to the extent of concurrent or contributory negligence on County’s part. A change from: Contractor’s obligations under this Article apply whether or not there is concurrent or contributory negligence on County’s part, but to the extent required by law, excluding liability due to County’s conduct.
New Hope for Youth Agreement - $100,000 Appropriations
According to the plan outlined on the August 26, 2025 Board Item for Opioid Settlement Funds Notice of Funding Availability Recommendations <https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=7517744&GUID=5C4B3496-FA40-47AF-9015-6EED6928B988&Options=ID|Text|&Search=opioid>, DHS intends to execute an agreement with New Hope for Youth. The New Hope for Youth program focuses on at-risk youth and addressing high-risk behaviors providing support for substance use prevention, improving decision making skills, and building long-term wellness. Services are trauma informed and using the Botvin Life Skills Training <https://www.lifeskillstraining.com/> curriculum which supports reduction in tobacco, alcohol, and illicit drug use. The program provides meaningful alternatives and wraparound support for youth in at risk settings and involved in Driving Under Influence. DHS is requesting increased appropriations from the Opioid Settlement Fund. This contract also is funded by the Substance Use Block Grant (SUBG).
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 3: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
August 26, 2025 - Opioid Settlement Funds Notice of Funding Availability Recommendations <https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=7517744&GUID=5C4B3496-FA40-47AF-9015-6EED6928B988&Options=ID|Text|&Search=opioid>
July 8, 2025 - Department of Health Services Delegated Authority for Service Agreements <https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=7451377&GUID=B43C1F85-F995-4CDB-9C82-35D842ED7534&Options=ID|Text|&Search=delegated>
July 23, 2024 - Delegated Authority for State and Federal Revenue Agreements <https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=6791408&GUID=2388E29A-DD40-4354-B847-9E92B2603A9F&Options=ID|Text|&Search=delegated>
July 11, 2023 - Delegated Authority for State and Federal Revenue Agreements <https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=6277624&GUID=87F0055B-5A2E-4A40-9B51-09E61380EAC8&Options=ID|Text|&Search=delegated>
September 13, 2022 - California Mental Health Services Authority Semi-Statewide Enterprise Health Record <https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=5812353&GUID=6352ACFD-F134-4C97-8996-8A7FF0B53389&Options=ID|Text|&Search=semi-statewide>
Fiscal Summary
|
Expenditures |
FY 25-26 Adopted |
FY 26-27 Projected |
FY 27-28 Projected |
|
Budgeted Expenses |
$6,714,411 |
$7,126,812 |
$6,469,581 |
|
Additional Appropriation Requested |
$401,000 |
|
|
|
Total Expenditures |
$7,115,411 |
$7,126,812 |
$6,469,581 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$2,688,830 |
$2,784,095 |
$2,661,618 |
|
Fees/Other |
$4,426,581 |
$4,342,717 |
$3,807,963 |
|
Use of Fund Balance |
|
|
|
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General Fund Contingencies |
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|
|
|
Total Sources |
$7,115,411 |
$7,126,812 |
$6,469,581 |
Narrative Explanation of Fiscal Impacts:
DHS requests to add additional appropriations for the fiscal year 2025-2026 budget of $401,000 funded by Opioid Settlement Funds fund balance. The previously budgeted amount of $6,714,411 for the listed contracts in the action portion of the item is funded as follows: $4,025,581 from Measure O fund balance, $2,508,830 from Federal Financial Participation (FFP), $30,000 from Mental Health Services Act (MHSA), $100,000 from Substance Use Block Grant (SUBG), and $50,000 from 2011 Realignment fund balance.
The subsequent amounts will be included in the Fiscal Year 2026-2027 and Fiscal Year 2027-2028 budget through the normal budget process.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Budget Resolution
Attachment 2 - Sample Agreement Muir Wood LLC
Attachment 3 - Draft Agreement Siyan Clinical Corporation
Attachment 4 - Draft Agreement California Mental Health Services Authority
Attachment 5 - Draft Agreement Crestwood Behavioral Health Inc.
Related Items “On File” with the Clerk of the Board:
None