Lake County on Thursday paused consideration of Amendment 5 to its contract with Community Behavioral Health after staff discovered the meeting packet contained an outdated draft.

The item, introduced by the chair, would have finalized a negotiated change to the county’s Medi‑Cal/DHCS pass‑through rate for specialty mental health services covering fiscal years 2023–24 through 2025–26. Director Elise Jones, the county’s behavioral health director, told the board Community Behavioral Health is “one of our largest subcontracted providers” and said the amendment reduces the pass‑through rate — a change she said was negotiated to take effect Sept. 1 and yield savings beginning that month.

Why it mattered: Jones told the board the department billed about $8,300,000 to Medi‑Cal in fiscal 2024–25 and that the contract previously passed through roughly 65% of reimbursements to the provider. She said the change reduces that percentage by six points (from 65% to 59%), which she described as significant when “you're dealing with millions of dollars.” Jones also said the county is preparing an RFP for these services going forward.

Supervisor Sabatier pressed staff on multiple operational and fiscal questions, raising concern that the county lacks a facility‑use agreement with the contractor and pointing to an apparent tension between the contract’s payment clause and the county’s receipt‑linked payment practice. Sabatier said the contract’s exhibit B currently lists a per‑fiscal‑year line as “to be determined,” asked whether $10,000,000 should be added for FY 2025–26, and questioned the hourly rates cited in the record: “This is an extra $10,000,000 we’re paying, nurses $525 an hour,” Sabatier said in the meeting transcript.

Jones replied that payments are contingent on available funds and acknowledged the county is “probably four months behind in payments” to contractors, adding the department is prioritizing reimbursable medical services when funds arrive. She said the lease and facility discussions had been used as leverage in negotiations over the pass‑through rate and that mutual indemnification language already exists in the contract.

No members of the public offered comment. Before the board could act, Jones told the chair staff had notified her the document uploaded to the county’s packet (Granicus) was not the updated draft; she asked to withdraw the item and bring it back when the correct version is available. County counsel confirmed the decision to continue the item rests with the board, and members agreed to do so.

What’s next: The board did not vote on the amendment. Staff will return the item with the corrected contract for further consideration and potential action at a later meeting.