Memorandum
Date: October 17, 2024
To: The Honorable Lake County Board of Supervisors
From: Rachael Dillman Parsons, Social Services Director
Subject: Consideration of patch payment on a Public Guardian conservatee “BB” from general funds in an amount not to exceed $30,000 at $5,000 per month, continued from October 8, 2024, Board of Supervisors agenda, item 7.6
Executive Summary:
On October 8, 2024, we brought to your board a request for approval of a patch payment for BB, a conserved individual under our care as Public Guardian, for the County of Lake, at the recommendation of our Deputy Public Guardian, Lisa Walker-Kohlman. At the October 8, 2024, BOS meeting additional questions arose, necessitating continuation of this item. Those questions are addressed herein.
BB is currently held in Lake County Jail and has served his sentence. BB is a 290 registered sex offender. Releasing BB with IHSS provider support is not an option given his medical condition, he needs more support than IHSS can provide, which is why he is conserved.
BB will be enrolled in Medi-Cal via the CalAIM justice involved (JI) pre-release application process as soon as his release date is known. A release date is required for enrollment.
However, Medi-Cal coverage is not the barrier to BB’s placement. We have contacted 15 facilities that take Medi-Cal and they are unwilling to take BB directly from jail due to the nature of his conviction. After exhausting facilities that accept Medi-Cal, we contacted 17 private-pay facilities.
We located one private-pay facility, Nazareth Classic Care, that is willing to take BB and is holding a place for him until 11/01/2024 pending the board’s action on this issue. This facility, while willing to take BB, does not accept Medi-Cal or Medicare.
BB’s placement at Nazareth Classic Care will ensure appropriate care and support for his unique needs. The patch payment will allow him to be placed in a facility that is well-suited for his medical and psychosocial needs, promoting both his well-being and stability, as well as public safety.
The Public Conservator is operated with General Funds, and this is not a unique request, although the last time this happened was in 2018. Social Services does not receive any state or federal funds to operate Conservatorship - in many counties Public Conservator is not under Social Services. If the conserved individual has money, we use the money in their estate. In this case, BB does not have any money in an estate. Although, we plan to use his Social Security back-pay to support him once it’s released to us, that will be several months and not enough money to cover this patch.
We hope that it will take less than 6 months to move BB from Nazareth Classic Care to a facility that accepts Medi-Cal. The likelihood of his being accepted into a Medi-Cal covered facility increases once he’s released from jail. We cannot predict how long it will take to place him, but our top priority is his placement in less than 6 months.
Attached, you will find additional documentation supporting this request, including an analysis of BB's current condition, the required level of care, and the cost breakdown for the placement, and two examples of similar historical patch payments for "TL" and "AB".
We appreciate your time and consideration in this matter.
If not budgeted, fill in the blanks below only:
Estimated Cost: ________ Amount Budgeted: ________ Additional Requested: ________ Future Annual Cost: ________
Purchasing Considerations (check all that apply): ☐ Not applicable
☒ Fully Article X. <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI>- and/or Consultant Selection Policy <http://lcnet.co.lake.ca.us/Assets/Intranet/Policy/Policies+$!26+Procedures+Manual/Ch4_2021v2.pdf>-Compliant (describe process undertaken in “Executive Summary”)
☐ Section 2-38 <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI> Exemption from Competitive Bidding (rationale in “Executive Summary,” attach documentation, as needed)
☐ For Technology Purchases: Vetted and Supported by the Technology Governance Committee <http://lcnet.co.lake.ca.us/Assets/Intranet/Intranet+Forms/Information+Technology/AdvPlan.pdf> (“Yes,” if checked)
☐ Other (Please describe in Executive Summary)
Consistency with Vision 2028 <http://www.lakecountyca.gov/Government/Directory/Administration/Visioning/Vision2028.htm> (check all that apply): ☐ Not applicable
☒ Well-being of Residents ☒ Public Safety ☐ Disaster Prevention, Preparedness, Recovery
☐ Economic Development ☐ Infrastructure ☐ County Workforce
☐ Community Collaboration ☐ Business Process Efficiency ☐ Clear Lake
Recommended Action:
We respectfully request that your board approve $30,000 transfer from general funds to public conservator account for “BB” to be used for monthly patch payments not to exceed $5,000 per month for his placement at Nazareth Classic Care, a private-pay facility that does not accept Medi-Cal or Medicare.