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Behavioral health expansion continues despite state payment pause; county used short-term loan to cover IGT timing
Summary
Behavioral Health Director Elise Jones described continued expansion of services funded by CalAIM and SUD funds, reported a $2 million short-term loan to cover IGT timing, and the board approved mental health and SUD budgets (mental health vote 4-1, SUD budgets 5-0).
Elise Jones, director of Lake County Behavioral Health, presented the department's FY2025''26 mental health and substance use disorder (SUD) budgets on June 24 and described ongoing service expansion under CalAIM and other funding. Jones said the department anticipates roughly $39.9 million in mental-health revenue and nearly $26 million in SUD revenue for the coming fiscal year.
Jones warned the board that the California Department of Health Care Services pauses certain intergovernmental transfer (IGT) payments each year (the department calls it a May pause) and that the county used a short-term $2 million loan to sustain contractor payments while claims were processing. She said, "The $2,000,000 short term loan that your board approved will, go to offset our cash flow disruptions, due to this state pause in payments... Repayment to commence late August, within the 90 days, and it is a top priority for our department to restore that $2,000,000 back to the general fund." Jones described the department's strategy to rebuild a cash-flow reserve and to continue scaling direct services including mobile crisis response and transportation.
Board concerns and votes: one supervisor expressed concern about the department's rising appropriations given uncertainty over state payments; Jones and staff emphasized that federal and state guidance keeps core Medicaid-covered behavioral health services intact and that the department is monitoring billing and contract performance. The board voted to approve the mental-health budget unit (4014) on a 4-1 roll call and approved the SUD and related budget units (4015 and 4018) on unanimous votes (5-0).
Why it matters: behavioral health services are a major county expenditure and essential safety-net services. The IGT and CalAIM transitions have changed how counties front funds and collect reimbursement; Lake County's use of a short-term loan is a stopgap to avoid service interruptions and protect subcontractor payments.
Next steps: Jones said loan repayment is expected by late August and staff will propose a recurring reserve allocation once cash flow normalizes.
