Transcranial Magnetic Stimulation (TMS) - RFA MHTC/011

Sacramento County Department of Health Services (DHS), Division of Behavioral Health Services (BHS), is issuing this Request for Applications (RFA) to solicit qualified providers to deliver Transcranial Magnetic Stimulation (TMS) as part of the County’s specialty mental health service array for Medi‑Cal beneficiaries ages 15 and older with Serious Mental Illness (SMI). Sacramento County is one of the largest and most diverse counties in California, with an estimated population of 1.6 million residents, including more than 500,000 living in unincorporated areas. The County serves a multicultural community and supports seven threshold languages (Arabic, Cantonese, Farsi, Hmong, Russian, Spanish, and Vietnamese), requiring behavioral health services that are culturally responsive and linguistically accessible.

As the Mental Health Plan (MHP) under California’s 1915(b) waiver, BHS is responsible for ensuring access to medically necessary specialty mental health services for more than 645,000 Medi‑Cal beneficiaries. The County’s behavioral health continuum includes prevention and early intervention, outpatient treatment, crisis services, intensive community‑based programs, acute residential care, and inpatient psychiatric hospitalization. These services support individuals across the lifespan, including those transitioning from or at risk of entering acute care settings.

Through this RFA, Sacramento County seeks to expand access to evidence‑based psychiatrist services by integrating TMS into its specialty mental health service offerings for eligible beneficiaries ages 15 and up. TMS is an FDA‑approved, non‑invasive, neuroscience‑based treatment shown to reduce depressive symptoms and improve functioning for individuals with treatment‑resistant Major Depressive Disorder (MDD). Incorporating TMS into the County’s system of care is intended to increase treatment options, reduce reliance on higher‑level services, and support long‑term recovery and wellness.

Applicants must demonstrate the organizational capacity, clinical expertise, and cultural and linguistic competence necessary to deliver TMS services consistent with Sacramento County BHS’ system of care.

County of Sacramento Background

Introduction to Sacramento County

Sacramento County is one of eighteen counties located in the Central Mental Health Region of the State of California. In January 2025, the State of California, Department of Finance estimates the population of Sacramento County to be approximately 1.6 million. With more than a half million residents living in unincorporated Sacramento County, it makes our unincorporated county population the fifth largest in the state. As such, Sacramento is considered a large County, especially in comparison with the populations of surrounding counties.

Sacramento is one of the most ethnically and racially diverse communities in California. While the Wilton Rancheria Tribe is the only Federally Recognized Tribe in Sacramento County, Native Americans from local and out of state tribes currently reside in Sacramento. Historically, Sacramento County has been one of three counties with the highest number of newly arriving refugees in California. However, in recent years, Sacramento County has resettled the most Refugees and Special Immigrant Visa holders (SIVs) as compared to any other County in California. We welcome these new residents and continue to work towards meeting the unique needs of these emerging communities.

Specialty Mental Health Services

Since 1998, Sacramento County, through the DHS, BHS, has been the MHP responsible for the provision of specialty mental health services to Medi-Cal eligible Sacramento County residents. In August 2025, 645,289 individuals enrolled in Medi-Cal, with 26,854 unduplicated adults receiving services through the MHP and 5,792 beneficiaries in Substance Use Prevention and Treatment.

Specialty mental health services are provided in accordance with California’s 1915(b) Medi-Cal waiver. These services may be provided through the County or through contract providers. Specialty mental health services include mental health treatment as well as treatment of co-occurring substance use disorders, which include, but are not limited to: assessment, plan development, individual and group therapy, individual and group rehabilitation, collateral services (inclusion of family members or significant support persons in services provided to individuals), case management, intensive care coordination, intensive home-based services, medication support services, crisis intervention and crisis stabilization. Medi-Cal beneficiaries may receive specialty mental health services if it is medically necessary in order to address a particular mental health condition (diagnosis). A specialty mental health service is medically necessary if the interventions focus on addressing functional impairment resulting from a diagnosed mental disorder.

The mental health services system provides community-based mental health services for individuals being released from acute care settings or who are at risk of entering acute care settings and are not linked to on-going mental health services.

Sacramento County, Department of Health Services, Behavioral Health Services

In Sacramento County, BHS encompasses an array of services at all levels of care to adults and children of all ages. These services are provided along a continuum of prevention and early intervention services, outpatient, crisis continuum including stabilization, intensive outpatient, acute residential services, and inpatient psychiatric hospitalizations.

Sacramento County BHS’ Vision, Mission and Values

The following vision and mission statements define BHS' mental health system of care objectives. They also provide direction and guiding principles for how all services are delivered through the mental health system of care:

BHS Vision - We envision a community where persons from diverse backgrounds across the life continuum have the opportunity to experience optimum wellness.

BHS Mission - To provide a culturally competent system of care that promotes holistic recovery, optimum health, and resiliency.

BHS Values:

• Principled
• Respect
• Innovation
• Diversity and Inclusion
• Excellence