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, to execute agreements and/or amendments, subject to review and approval as to form by County Counsel, as follows:
i) A first amendment with California Hearing Officers, LLP for Administrative Hearing Officer services, increasing the original contract amount by $110,000 for a new not-to-exceed amount of $210,000 and extending the term for an additional six months, ending on June 30, 2026.
ii) An agreement with California Mental Health Services Authority for Healthcare Effectiveness Data and Information Set (HEDIS) Performance Measurement services, in a not-to-exceed amount of $60,750, with a term from January 1, 2025, through December 31, 2029.
iii) An Opioid Settlement Fund agreement with Buckelew Programs for the Sonoma County Housing for Hope Recovery, with a new term end date of June 30, 2028.
iv) A second amendment with Drug Abuse Alternatives Center for Drug Medi-Cal Organized Delivery System Outpatient and Narcotic Treatment Services for Fiscal Year 2024-2025, increasing the contract amount by $118,436, with a new not-to-exceed amount of $3,135,436.
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 Department of Health Services Fiscal Year 2025-2026 adopted budget, increasing appropriations in the amount of $118,436 to support Drug Abuse Alternatives Center to provide outpatient Substance Use Disorder and Narcotic Treatment services under the Drug Medi-Cal Organized Delivery System. (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 four new agreements for behavioral health-related contracts or amendments, as detailed below:
• A first amendment with California Hearing Officers, LLP for Administrative Hearing Officer services;
• A participation agreement with the California Mental Health Services Authority to support Healthcare Effectiveness Data and Information Set (HEDIS) performance measurement requirements;
• A new agreement with Buckelew Programs for their Sonoma County Housing for Hope Recovery Residences Opioid Settlement Fund housing initiative; and
• A second amendment with Drug Abuse Alternatives Center for Drug Medi-Cal Organized Delivery System Outpatient and Narcotic Treatment Services for Fiscal Year 2024-2025.
The Department of Health Services is also requesting appropriations in the amount of $118,436 to support the second amendment referenced above with Drug Abuse Alternatives Center, for outpatient Substance Use Disorder and Narcotic Treatment services under the Drug Medi-Cal Organized Delivery System.
These agreements strengthen the Department of Health Service's ability to deliver a coordinated continuum of behavioral health care-from prevention and early intervention to crisis stabilization, inpatient treatment, and long-term recovery-while reducing compliance risks and enhancing service quality and safety.
Discussion:
The mission of the Sonoma County Department of Health Services (DHS), Behavioral Health Division, is to promote recovery and wellness for County residents by delivering a full spectrum of mental health and substance use disorder (SUD) services-from prevention and early intervention to treatment, aftercare, and recovery. To achieve this, DHS partners with a broad network of contracted providers offering clinical and administrative behavioral health services.
Administrative Hearing Officer Services - California Hearing Officers, LLP
Recommended Term: July 1, 2025 through June 30, 2026
In California, hearing officers-licensed attorneys-conduct administrative and quasi-judicial hearings to uphold fairness and due process. These hearings may be held virtually or in person and involve administering oaths, managing evidence, ruling on motions, and issuing written decisions or recommendations. They are integral to matters such as involuntary mental health certifications.
California Hearing Officers, LLP, provides hearing services required under Sections 5256 and 5270.15 of the California Welfare and Institutions Code. These hearings are coordinated between the County’s Patient Rights Advocate and the detaining facilities, including those designated under the Lanterman-Petris-Short (LPS) Act. The firm ensures compliance with mandated timelines and procedural requirements throughout the certification process.
The Department’s existing agreement with California Hearing Officers is nearing its term end, and a Request for Proposals (RFP) for future services is currently being finalized. However, the RFP and subsequent Blanket Purchase Order (BPO) are unlikely to be executed before the current agreement expires. The Sonoma County Purchasing Agent approved Single Source Waiver 25-050 on November 7, 2025. DHS is therefore requesting delegated authority to increase the agreement by $110,000 for FY 2025-2026, for a revised not-to-exceed amount of $210,000, with the term extended through June 30, 2026, subject to County Counsel review and approval as to form.
California Mental Health Services Authority - Four-Year Participation Agreement
Recommended Term: January 1, 2025, through December 31, 2029
DHS seeks delegated authority to enter into a four-year participation agreement with the California Mental Health Services Authority (CalMHSA). This agreement, received from the State in October, supports Sonoma County’s compliance with the Behavioral Health Accountability Set (BHAS) metrics required for participation in the Healthcare Effectiveness Data and Information Set (HEDIS) Performance Measurement Program. These services assist in the calculation, reporting, and monitoring of key behavioral health performance indicators. The maximum funding obligation of the agreement will be $60,750.
A single source waiver was approved by the Sonoma County Purchasing Agent on November 10, 2025 based on the following:
1. CalMHSA is the DHS electronic health record vendor so they have in-depth knowledge of the Electronic Health Record system (SmartCare) and help ensure that DHS data is being captured in way that meets the measure specifications.
2. They have a data sharing relationship with DHS, which eliminates the need for another third party to have access to the immense amount of client Personal Health Information needed for the calculations.
3. They have access to some of the data already, which decreases the amount that DHS teams need to upload.
4. Since they are working on behalf of so many counties, they establish a direct relationship with Health Service Advisory Group who is contracted by the State to conduct the required External Quality Review, which makes the process easier and more streamlined for DHS.
5. They have an established relationship with DHCS and can advocate on behalf of the County when there are technical issues.
Buckelew Programs Recovery Residences - Opioid Funds Settlement Agreement Term Update
Recommended Term: Effective date through June 30, 2028
On August 26, 2025, the Board authorized DHS to execute an Opioid Settlement Fund Agreement with Buckelew Programs Recovery Residences for an amount not to exceed $3,873,235. The agreement’s term was initially listed as ending June 30, 2026. DHS now requests delegated authority to amend the agreement to reflect the correct term end date of June 30, 2028, in alignment with the original Notice of Funding Availability.
Drug Abuse Alternatives Center - Drug Medi-Cal Organized Delivery System Outpatient and Narcotic Treatment Services - $118,436 Amendment
Agreement term (no recommended changes): July 1, 2024 through June 30, 2025
DHS contracts with Drug Abuse Alternatives Center (DAAC) to provide outpatient Substance Use Disorder (SUD) and Narcotic Treatment services under the Drug Medi-Cal Organized Delivery System (DMC-ODS). These services are essential to maintaining a robust and compliant behavioral health network that meets federal and state access standards, including cultural and linguistic competency, geographic coverage, and timely access to care.
While DHS makes annual projections of service volume and resource needs, actual demand can exceed forecasts. Final utilization of DAAC’s outpatient and narcotic treatment services in FY24-25 has surpassed anticipated levels. DHS is therefore requesting delegated authority to increase the agreement by $118,436 to cover the unanticipated demand and ensure continuity of care
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
Fiscal Summary
|
Expenditures |
FY25-26 Adopted |
FY26-27 Projected |
FY27-28 Projected |
|
Budgeted Expenses |
$4,143,985 |
|
|
|
Additional Appropriation Requested |
$118,436 |
|
|
|
Total Expenditures |
$4,262,421 |
|
|
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$119,968 |
|
|
|
Fees/Other |
$3,998,235 |
|
|
|
Use of Fund Balance |
$144,218 |
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$4,262,421 |
|
|
Narrative Explanation of Fiscal Impacts:
DHS requests an increase of $118,436 to the FY 2025-2026 Adopted Budget to support the DAAC contract, funded with $59,218 Federal Financial Participation (FFP) and a $59,218 match from 2011 Realignment Fund Balance.
Additional contract adjustments funded within the FY25-26 Adopted Budget include California Hearing Officers, increased by $110,000 to a total of $210,000 and funded with $85,000 of 1991 Mental Health Realignment Fund Balance; California Mental Health Services Authority, $60,750 supported by Proposition 30 reimbursement from DHCS; and Buckelew Programs Recovery Residences, $3,873,235 funded with Opioid Settlement Funds.
Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Budget Resolution
Attachment 2 - Draft Amendment California Hearing Officers
Attachment 3 - Draft Agreement Cal MHSA
Attachment 4 - Sample Agreement Buckelew Recovery Residences
Attachment 5 - Draft Amendment Drug Abuse Alternatives Center
Related Items “On File” with the Clerk of the Board:
None