Yolo supervisors direct staff to add behavioral‑health case managers and Medi‑Cal billing coordinator as part of BHSA draft plan

The Yolo County Board of Supervisors voted unanimously March 3 to direct staff to develop a Behavioral Health Services Act (BHSA) draft plan that includes a Medi‑Cal billing coordinator and additional full‑time case managers to stabilize three county‑supported permanent supportive housing projects.

The board’s action adopted staff’s recommended scenario—labeled option 3 in staff materials—which seeks to shift $1.4 million from the BHSA housing interventions component to behavioral‑health services and to use roughly $1.8 million of BHSA fund balance to offset other short‑term pressures. Under the scenario staff recommended adding a Medi‑Cal billing coordinator (to increase federal drawdowns) and three behavioral‑health case managers to support permanent supportive housing sites; staff also described suboptions for adding more case managers if the board chooses to deepen the investment.

Why it matters: BHSA is a newly restructured statewide funding framework that requires counties to set aside 30% of their allocation for housing interventions and 35% for full‑service partnership (FSP) services. Staff told the board the county faces a roughly $1.1 million BHSA gap and larger combined deficits across behavioral‑health realignment and general‑fund supports (about $4.1 million total). The recommended approach seeks to preserve a portion of the $14.2 million BHSA fund balance while making targeted investments that staff say will reduce longer‑term costs by improving billable Medi‑Cal revenue and stabilizing housing sites.

What staff proposed and the board directed: Staff presented three scenarios. The board backed scenario 3, which includes: - Shifting $1.4 million from housing interventions into behavioral health services and supports (within the statutory flexibility staff described). - Using approximately $1.8 million in BHSA fund balance to reduce immediate cuts and increase base funding. - Funding a Medi‑Cal billing coordinator position to pursue increased federal financial participation (staff said the county had roughly $1.5 million in rejected claims in 2024 that might be recoverable with better billing processes). - Adding three behavioral‑health case managers (option 3A); staff presented higher staffing options (3B, 3C) and associated multi‑year costs.

Public testimony and operational urgency: Housing developers and service providers—Mercy Housing, Yolo County Housing and site operators—told the board that three recent supportive‑housing developments (West Beamer Place, East Beamer Street and 1801 West Capitol) were under‑staffed and experiencing lease terminations, property damage and safety incidents. Mercy Housing’s regional vice president Erica Plumb said higher on‑site staffing “is foundational” to the state funding commitments and urged the board to meet the eight on‑site FTE staffing levels promised in long‑term agreements. West Sacramento Police Chief Rob Strange and other public commenters described increased calls for service tied to reduced on‑site support.

Board conditions and follow‑ups: The board’s motion included several instructions: staff should (1) incorporate the staffing and Medi‑Cal billing positions into the BHSA draft plan to be submitted to the state; (2) pursue legal and policy clarification about the allowable uses of the housing interventions bucket (the board asked county counsel and staff to press the state for guidance); (3) seek cost‑sharing conversations with city partners where the projects sit; and (4) begin recruitment/hiring work prior to July to address immediate operational risks. Supervisors emphasized the need for a transparent draft and for further review at a March 24/31 meeting cycle and again when the final plan returns to the board before June.

Numbers from the meeting: staff reported a BHSA fund balance of about $14.2 million, a BHSA structural gap of about $1.1 million, combined behavioral‑health deficits of roughly $4.1 million (including realignment and general‑fund pressures), and modelled plan‑level expenditures rising to approximately $21.8 million under the chosen scenario. Staff estimated that adding the full complement of eight on‑site positions would increase annual costs by roughly $1 million and would draw down fund balance across the three‑year plan.

What comes next: Staff will prepare the BHSA draft for the March 31 state submission and return a refined draft to the board in late March for review and direction before finalizing it for state submission and public comment. The board asked staff to pursue state guidance on allowable uses and to return with clearer options for funding and timing.