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Kings County approves standing agreement with Merced Behavioral Health for high-acuity placements
Summary
The Board approved a standing agreement with Merced Behavioral Health to secure skilled nursing and Specialized Treatment Program (STP) beds for adults with severe mental illness; county staff said it will authorize up to $2.2 million for FY2025–26 and $2.8 million for FY2026–27 and will not hit the general fund.
The Kings County Board of Supervisors on Aug. 25 approved a standing agreement with Merced Behavioral Health to provide skilled nursing facility and Specialized Treatment Program services for county behavioral health clients, county staff said.
Christy Lehi, assistant director for Kings County Behavioral Health, told the board that as a designated county mental health plan the county is required by its mental health plan agreement (22-159) with the California Department of Health Care Services to ensure access to medically necessary specialty services, including SNF-STP placements. "I respectfully request your board's approval of this agreement with Merced Behavioral Health to ensure Kings County Behavioral Health remains compliant with DHCS requirements and is able to meet the needs of our most vulnerable residents on LPS conservatorship receiving specialty mental health services," Lehi said.
Lehi said Kings County referred 11 clients to Merced last fiscal year at a cost of $1,800,000 and that the proposed agreement would authorize expenditures of up to $2,200,000 for fiscal year 2025–26 and $2,800,000 for fiscal year 2026–27 to cover placements as needed. She said the contract has been reviewed by county counsel "as to form" and that sufficient appropriations are included in the FY 2025–26 budget; she added there is "no impact to the county general fund."
Lehi described STP beds as scarce: "There are only 20 licensed STPs in California, of which 2 are within the Central Valley," she said, noting the county already contracts with two Merced-area providers and competes regionally for limited capacity. The state now requires standing agreements rather than single-case contracts, Lehi said, to demonstrate counties' capacity to place high-need clients.
Supervisor Rusty Robinson moved approval; the motion passed on roll call with supervisors present voting yes and one member absent. The agreement takes effect Sept. 1, 2025, and staff said it will be used when clinically appropriate to place adults on LPS conservatorship who require secure, rehabilitative care.
Board materials cited California Code of Regulations Title 9 (as referenced during the presentation) and the county's mental health plan agreement in support of the requirement to maintain access to STP services.
