Consent-Health & Human Services # 20.
Board of Supervisors
- Meeting Date:
- 03/03/2026
- Brief Title
- Eighth Amendment to Agreement 24-47 with American Medical Response
From:
Monica Morales, Director, Health and Human Services Agency
Staff Contact:
Tony Kildare, Behavioral Health and Veterans Services Branch Director, Health and Human Services Agency x2757
Supervisorial District Impact:
Countywide
Subject
Approve eighth amendment to Agreement No. 24-47 with American Medical Response to extend the term of the Agreement through June 30, 2026, and add funding in the amount of $510,000 for Fiscal Year 2025-26 for a new contract maximum of $2,703,810, for the period of December 31, 2023 through June 30, 2026 for the provision of mandated Medi-Cal mobile crisis services for Medi-Cal beneficiaries. (No general fund impact) (Morales)
Recommended Action
Approve eigth amendment to Agreement No. 24-47 with American Medical Response to extend the term of the Agreement through June 30, 2026, and add funding in the amount of $510,000 for Fiscal Year 2025-26 for a new contract maximum of $2,703,810 for the period of December 31, 2023 through June 30, 2026 for the provision of mandated Medi-Cal mobile crisis services for Medi-Cal beneficiaries
Strategic Plan Goal(s)
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Thriving Residents |
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County Mandated Service |
Reason for Recommended Action/Background
The County has entered into agreements with the State of California, Department of Health Care Services (DHCS), to provide mental health services to County of Yolo residents and State Managed Care Mental Health Plan (MHP) Agreement.
The American Rescue Plan Act of 2021 section 9813 (42 U.S.C. section 1396w–6) allowed states to add qualifying community-based mobile crisis intervention services as a covered Medi-Cal benefit for a five-year period, beginning April 1, 2022, and ending March 31, 2027. The Medi-Cal Mobile Crisis Benefit became a federal mandate on January 1, 2024. Mobile crisis services are intended to provide community-based crisis resolution and reduce unnecessary law enforcement involvement and emergency department utilization. These services are provided 24 hours per day to ensure County residents, including Medi-Cal beneficiaries, have continuous access to coordinated crisis care.
DHCS, as a part of its California Advancing and Innovating Medi-Cal (CalAIM) initiatives, amended its State Plan to include community-based mobile crisis intervention services. Per Behavioral Health information Notice (BHIN) 23-025, county Mental Health Plan’s (MHPs), Drug Medi-Cal (DMC) counties, and Drug Medi-Cal Organized Delivery System (DMC-ODS) counties (collectively, “Medi-Cal behavioral health delivery systems”) shall provide, or arrange for the provision of, qualifying mobile crisis services in accordance with the requirements set forth in this BHIN. Mobile crisis services are an integral part of California’s efforts to strengthen the continuum of community-based care for individuals who experience behavioral health crises.
On or about December 29, 2023, the County entered into ratification Agreement No. 24-47 with American Medical Response to provide mobile crisis response services in the amount of $243,420 for the period of December 31, 2023, through February 28, 2024. The Agreement included an optional extension through June 30, 2024, with no additional funding. Since then, the Agreement has been revised several times to extend the term and add funding.
In the past twelve (12) months, HHSA has released two (2) RFPs and has been unsuccessful in choosing a new vendor through the RFP process to ensure the County’s continued compliance with the requirement to provide the Medi-Cal Mobile Crisis Benefit.
Multiple extensions via several amendments to this contract have been necessary to continue to provide mandated services and to avoid any potential sanctions under federal and state regulations.
Approval of this eighth amendment will allow the term of the agreement to be extended through June 30, 2026; and add funding for fiscal year 2025-26 in an amount of $510,000 for a new contract maximum of $2,703,810.
Approval of this amendment will prevent a contract lapse and disruption in services and ensure the County’s continued compliance with the provision of the Medi-Cal Mobile Crisis Benefit while a new vendor is sought.
The American Rescue Plan Act of 2021 section 9813 (42 U.S.C. section 1396w–6) allowed states to add qualifying community-based mobile crisis intervention services as a covered Medi-Cal benefit for a five-year period, beginning April 1, 2022, and ending March 31, 2027. The Medi-Cal Mobile Crisis Benefit became a federal mandate on January 1, 2024. Mobile crisis services are intended to provide community-based crisis resolution and reduce unnecessary law enforcement involvement and emergency department utilization. These services are provided 24 hours per day to ensure County residents, including Medi-Cal beneficiaries, have continuous access to coordinated crisis care.
DHCS, as a part of its California Advancing and Innovating Medi-Cal (CalAIM) initiatives, amended its State Plan to include community-based mobile crisis intervention services. Per Behavioral Health information Notice (BHIN) 23-025, county Mental Health Plan’s (MHPs), Drug Medi-Cal (DMC) counties, and Drug Medi-Cal Organized Delivery System (DMC-ODS) counties (collectively, “Medi-Cal behavioral health delivery systems”) shall provide, or arrange for the provision of, qualifying mobile crisis services in accordance with the requirements set forth in this BHIN. Mobile crisis services are an integral part of California’s efforts to strengthen the continuum of community-based care for individuals who experience behavioral health crises.
On or about December 29, 2023, the County entered into ratification Agreement No. 24-47 with American Medical Response to provide mobile crisis response services in the amount of $243,420 for the period of December 31, 2023, through February 28, 2024. The Agreement included an optional extension through June 30, 2024, with no additional funding. Since then, the Agreement has been revised several times to extend the term and add funding.
In the past twelve (12) months, HHSA has released two (2) RFPs and has been unsuccessful in choosing a new vendor through the RFP process to ensure the County’s continued compliance with the requirement to provide the Medi-Cal Mobile Crisis Benefit.
Multiple extensions via several amendments to this contract have been necessary to continue to provide mandated services and to avoid any potential sanctions under federal and state regulations.
Approval of this eighth amendment will allow the term of the agreement to be extended through June 30, 2026; and add funding for fiscal year 2025-26 in an amount of $510,000 for a new contract maximum of $2,703,810.
Approval of this amendment will prevent a contract lapse and disruption in services and ensure the County’s continued compliance with the provision of the Medi-Cal Mobile Crisis Benefit while a new vendor is sought.
Collaborations (including Board advisory groups and external partner agencies)
County Counsel has approved this Amendment as to form.
General Services Department, Procurement Division
General Services Department, Procurement Division
Competitive Bid Process/Vendor Performance
On December 15, 2023, the Yolo County Procurement Manager or designee approved a sole/single source procurement for these services. Without sole source approval of the agreement, the County would be out of compliance with the requirements of Behavioral Health Information Notice (BHIN) 23-025 and may face sanctions from DHCS. Factors considered, in approving the sole source included but were not limited to: 1) Pursuant to DHCS Info Notice BHIN 23-025 the County is required to implement a 24/7 operational Medi-Cal Mobile Crisis response team; 2) the vendor was a long standing (5+ years) county vendor with successful performance; 3) competitive pricing/cost savings; 4) without sole source approval the County would not be providing mandated Medi-Cal Mobile Crisis Services to Yolo County residents; and 5) the County risked being in violation of State requirements and being sanctioned if services as mandated in BHIN 23-025 were not provided.
Pursuant to the authority provided to County’s Deputy Director of GSD/Manager of Procurement/County Purchasing Agent (Purchasing Agent) under the current Yolo County Procurement Policy and based on past vendor performance (see below) the Purchasing Agent has determined that it is in the best interest of the County to extend this Agreement, based on satisfactory service and to avoid the interruption of County business.
Vendor Performance:
The Performance Measures were included in the underlying Agreement and are not being revised at this time (See Att. B. Performance Measures).
HHSA confirms American Medical Response is performing satisfactorily under this agreement to date. Quarter 1 Performance Measure data is provided below.
# of mobile crisis responses: 1593
# of in-person mobile crisis response incidents in urban Yolo County areas that resulted in an in-person response within one hour of request: 1202
% of in-person mobile crisis response incidents in urban Yolo County areas that resulted in an in-person response within one hour of request: 97%
Average response time (rural) in minutes: 7
Average response time (urban) in minutes: 11
# of in-person mobile crisis response incidents in rural Yolo County areas that resulted in an in-person response within two hours of request: 87
% of in-person mobile crisis response incidents in rural Yolo County areas that resulted in an in-person response within two hours of request: 100%
# of mobile crisis response that resulted in transporting the client to the Emergency Room: 1135
% of mobile crisis response that resulted in transporting the client to the Emergency Room: 71%
Pursuant to the authority provided to County’s Deputy Director of GSD/Manager of Procurement/County Purchasing Agent (Purchasing Agent) under the current Yolo County Procurement Policy and based on past vendor performance (see below) the Purchasing Agent has determined that it is in the best interest of the County to extend this Agreement, based on satisfactory service and to avoid the interruption of County business.
Vendor Performance:
The Performance Measures were included in the underlying Agreement and are not being revised at this time (See Att. B. Performance Measures).
HHSA confirms American Medical Response is performing satisfactorily under this agreement to date. Quarter 1 Performance Measure data is provided below.
# of mobile crisis responses: 1593
# of in-person mobile crisis response incidents in urban Yolo County areas that resulted in an in-person response within one hour of request: 1202
% of in-person mobile crisis response incidents in urban Yolo County areas that resulted in an in-person response within one hour of request: 97%
Average response time (rural) in minutes: 7
Average response time (urban) in minutes: 11
# of in-person mobile crisis response incidents in rural Yolo County areas that resulted in an in-person response within two hours of request: 87
% of in-person mobile crisis response incidents in rural Yolo County areas that resulted in an in-person response within two hours of request: 100%
# of mobile crisis response that resulted in transporting the client to the Emergency Room: 1135
% of mobile crisis response that resulted in transporting the client to the Emergency Room: 71%
Fiscal Impact
Fiscal impact (see budgetary detail below)
Fiscal Impact (Expenditure)
- Total cost of recommended action:
- $ 510,000
- Amount budgeted for expenditure:
- $ 965,000
- Additional expenditure authority needed:
- $
- One-time commitment:
- Yes
Source of Funds for this Expenditure
- MHSA
- $510,000
Further explanation as needed:
No general funds are required for this action. These services will be funded by Mental Health Services Act (MHSA). The action increases Fiscal Year 2025-26 funding by $510,000 for a new contract maximum of $2,703,810 for the period of December 31, 2023 through June 30, 2026. The amount of $510,000 is included in the HHSA adopted budget for fiscal year 2025-26.
The following is the breakdown of funding for this agreement.
The following is the breakdown of funding for this agreement.
| Fiscal Year 2023-24 December 31, 2023 through June 30, 2024 |
Fiscal Year 2024-25 July 1, 2024 through June 30, 2025 |
Fiscal Year 2025-26 July 1, 2025 through June 30, 2026 |
Total |
| $608,550 | $1,130,260 | $965,000 | $2,703,810 |
Attachments
Form Review
| Inbox | Reviewed By | Date |
|---|---|---|
| Tony Kildare | Tony Kildare | 02/02/2026 09:35 AM |
| Evis Morales | Evis Morales | 02/02/2026 12:45 PM |
| Financial Services | Laura Liddicoet | 02/02/2026 01:25 PM |
| County Counsel | Hope Welton | 02/02/2026 02:12 PM |
| Yen Nguyen | Julie Dachtler | 02/03/2026 05:14 PM |
| Yen Nguyen | Julie Dachtler | 02/12/2026 02:28 PM |
| Laura Galindo | Laura Galindo | 02/13/2026 03:13 PM |
- Form Started By:
- Kimberly Mayfield
- Started On:
- 12/12/2025 09:36 AM
- Final Approval Date:
- 02/13/2026