Lake County approves $1 million agreement with Community Behavioral Health to expand medication-assisted treatment

The Lake County Board of Supervisors voted 3-2 to approve an agreement with Community Behavioral Health to provide medication-assisted treatment services for fiscal year 2025–26 in the amount of $1,000,000 and authorized the board chair to sign.

Director Jones said the contract “represents a significant step forward in implementing our organized Drug Medi-Cal delivery system.” She said Lake County previously had very few in-county MAT programs and that the new agreement will provide prescriber and nursing staffing to run a program combining MAT with intensive outpatient counseling.

The contract covers staffing that Community Behavioral Health will supply to County clinics. Director Jones clarified the billing structure: contracted services are billed at Medicaid rates and the county is billed 65% of that rate, with the county retaining the remaining 35% to cover administrative costs and back-office functions. She also said the county currently has business associate agreements and has conducted a risk analysis to ensure contracted staff are not supervising county employees. The county has not yet executed a lease or space-use agreement for the vendor’s use of county clinic space.

Supervisor Sabatier raised concerns about costs and facility use, asking whether the county is paying for utilities or janitorial services and noting hourly staffing rates cited in the meeting materials. Sabatier said she was conflicted and that she could not support the item without further review and consultation with the union and more clarity about any facility-use or lease arrangements.

Supervisor Pysco asked whether other providers in the county offer MAT; Director Jones said individual primary care providers and some federally qualified health centers may prescribe MAT, but that a specialized MAT clinic embedded with outpatient counseling is a new, more programmatic offering for some patients in Lake County. Pysco also noted that if Medicaid funding were reduced, the county would need to revisit the contract.

The board motion to approve the agreement was moved by Supervisor Jerry and seconded by the Vice Chair. During the vote a member verbally registered “Nay.” The motion carried, 3-2.

County staff said the loan referenced during the discussion pertains to the specialty mental health budget and not the Drug Medi-Cal/Ongoing Delivery System or SUDT budget unit, and that Medicaid reimbursements were continuing at the time of the meeting.

The county said it plans to expand access to MAT and to convene local health-care providers to coordinate program offerings. The board also directed staff to follow up with administration and county counsel about the potential of a formal lease or space-use agreement for contracted providers.