After deadlock, board approves amended short-term loan to Behavioral Health to cover Medi-Cal cash-flow gap

Lake County supervisors on Tuesday approved an amended short-term loan to Behavioral Health Services to address an ongoing Medi-Cal reimbursement cash-flow gap, after an earlier vote deadlocked and the board reconsidered the matter.

Behavioral Health Director Elise Jones asked the board for a $2 million short-term loan from the county general fund. Jones told supervisors her department had repaid $2 million of a prior short-term loan but still owed roughly $2 million; the requested loan would cover contracted specialty mental-health services during a reimbursement delay tied to the county—s intergovernmental transfer (IGT) process.

During discussion several supervisors pressed for clarity about repayment and expressed concern that repeated extensions would commit general-fund dollars without a clear long-term plan. Supervisor Sabatier said she would not support a 12-month extension, citing unease about continuing to use the general fund without firmer repayment assurances; another supervisor urged a shorter extension and a public follow-up review of Health and Human Services finances.

When the board first voted on the resolution as presented, the motion did not carry. The clerk recorded a 3-2 tally in which Supervisors Rasmussen, Paiske and Crandall voted in favor and Supervisors Owen and Sabatier voted no; because the board had set a higher internal threshold or because the posted motion required broader support, staff noted the resolution was not adopted at that time.

A member of the board who supported the earlier majority moved to reconsider the action later in the same meeting. That motion to reconsider passed. The board then offered an amended resolution that revised fund-number references and added a timeline for repayment: the resolution requires loan repayment in full within 90 days of the resolution—s adoption (effectively a three-month repayment period). With those amendments the resolution was offered and the board passed the amended resolution.

Jones said the loan would be used primarily to cover contracted nursing and psychiatric services within the county—s specialty mental-health program while Medi-Cal reimbursements temporarily lag. She told supervisors she expected the IGT-related cash-flow issue to resolve by late summer and that the department would present a fuller financial update to the board during upcoming budget hearings.

Supervisors asked staff to bring a public presentation to the board on July/August budget meetings outlining which behavioral-health programs are mandated and which services are discretionary, and how the department expects to repay the loan once reimbursement resumes.

Because the resolution was amended on the floor after reconsideration, county staff said clerical corrections to fund numbers would be made in the posted resolution to reflect the correct internal fund coding before final administrative processing.