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Board approves Amendment No. 5 to Community Behavioral Health contract, shifts to 59% Medi‑Cal fee‑for‑service and raises cap to $24.6M
Summary
Lake County approved Amendment No. 5 to Community Behavioral Health’s contract, moving reimbursement to a fee‑for‑service model at 59% of DHCS Medi‑Cal published rates (effective 09/01/2025), increasing the contract cap by $9 million to $24.6 million; the measure passed 3–2 amid concerns about local funding impact and contractor classification.
The Lake County Board of Supervisors voted 3–2 to approve Amendment No. 5 to the agreement with Community Behavioral Health, transitioning compensation to a fee‑for‑service reimbursement model at 59% of Department of Health Care Services (DHCS) Medi‑Cal published rates and increasing the contract maximum by $9,000,000 to a new total not to exceed $24,600,000.
Deputy Director of Behavioral Health Christine Andres summarized the services covered by the contract as “all of our psychiatric services, including medications as well as therapy services,” and said the amendment is part of a fiscal restructuring that reduces the pass‑through rate to 59% for fee‑for‑service work and holds pass‑through disbursement until the county is reimbursed by the state.
Supervisor Cebatia said she appreciated the policy work but raised budgetary concerns, noting that roughly 33% of costs would come from county funds (MHSA or realignment). She also said sections of a shared‑space license agreement worried her because some provisions—such as possible internet/network access and provided furnishings—could make the contractor’s status appear too close to employment. “I do wanna, at least make that statement… I will not be in support of this amendment,” she said.
County Counsel told the board the original contract’s section 17 expressly recognizes the independent contractor relationship and that staff can work with the contractor to implement safeguards to avoid an employment relationship. The board discussed whether the shared‑space license term should be backdated to cover prior use; staff said the license was recently implemented and had started with the current date, but did not confirm backdating.
Supervisor Pysco moved to approve the amendment, which the motion describes as applying DHCS Medi‑Cal rates effective 09/01/2025 and increasing the contract maximum to $24,600,000; the motion received a second and passed 3–2.
The discussion recorded questions about which local funding buckets would absorb the county share (MHSA or realignment) and about operational details of the shared‑space license; those clarifications were not fully resolved at the meeting. The board authorized the chair to sign the amendment.
