Memorandum
Date: June 23, 2026
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: Adopt Resolution Authorizing Standard Agreement No. 26-60035 Between the County of Lake and the California Department of Health Care Services for the Administration, Oversight, and Compliance of County Behavioral Health Programs, and Authorizing the Behavioral Health Director to Sign the Agreement and Related Administrative Documents.
Executive Summary:
Lake County Behavioral Health Services requests approval of a Resolution authorizing Standard Agreement No. 26-60035 between the County of Lake and the California Department of Health Care Services. This agreement establishes the programmatic, administrative, fiscal, reporting, oversight, and compliance requirements necessary for the County to administer state and federally funded behavioral health programs and services.
The term of the agreement is July 1, 2026 through June 30, 2029. This is a zero-dollar agreement; however, approval is necessary for the County to continue participating in and administering applicable behavioral health programs in compliance with DHCS requirements.
Although the agreement does not provide a direct allocation of funds, it is not merely ministerial.
The agreement functions as the County’s behavioral health performance contract with DHCS and incorporates significant state and federal requirements applicable to County-administered behavioral health programs. It also reflects the transition from the Mental Health Services Act to the Behavioral Health Services Act, which places increased planning, reporting, fiscal accountability, access, provider oversight, and performance-measurement obligations on county behavioral health departments.
Key changes and increased obligations under this agreement include, but are not limited to:
• Implementation of Behavioral Health Services Act requirements, including compliance with the BHSA County Policy Manual and future DHCS guidance issued during the agreement term;
• Development and submission of three-year Integrated Plans, Annual Updates, and, when needed, Intermittent Updates using DHCS-required templates and processes;
• Expanded use of local data, including mental health and substance use disorder prevalence data, unmet need data, health disparities data, homelessness point-in-time information, and community health improvement planning information;
• Reporting of planned activities and projected expenditures across the County Behavioral Health System and the broader Behavioral Health Care Continuum, rather than only reporting on a narrower subset of programs;
• Board of Supervisors approval of the Integrated Plan and certification that the County will meet applicable realignment obligations, including time and distance standards and appointment time standards, without utilizing waitlists;
• Compliance with BHSA fiscal policies, including required funding allocations, administrative cost limitations, planning cost limitations, and detailed reporting of administrative expenditures;
• Implementation of Full Service Partnership, Behavioral Health Services and Supports, and Housing Interventions requirements, including applicable priority populations, allowable expenditures, documentation requirements, and transition policies;
• Coordination with Medi-Cal managed care plans and other payers to ensure BHSA funds are not used for services that are otherwise covered by Medi-Cal managed care or other available coverage sources;
• Increased documentation and reporting requirements, including requirements related to the Behavioral Health Outcomes, Accountability, and Transparency Report;
• Expanded County oversight responsibilities for BHSA-funded providers, including contracted providers and County-operated programs; and
• Increased DHCS oversight and enforcement authority, including compliance reviews, document requests, provider and personnel interviews, corrective action plans, required revisions to County plans or updates, temporary monetary withholds, and monetary sanctions for noncompliance.
Approval of this agreement will allow Lake County Behavioral Health Services to continue administering state and federally funded behavioral health programs while maintaining compliance with DHCS requirements. Approval also acknowledges that the Department will be operating under a more complex and demanding state accountability structure during the 2026-2029 agreement period.
There is no direct fiscal impact associated with approval of this agreement, as Standard Agreement No. 26-60035 is a zero-dollar agreement. However, the agreement establishes the administrative and compliance framework necessary for the County to receive, administer, and remain eligible for applicable behavioral health funding. The expanded planning, reporting, fiscal tracking, data analysis, provider oversight, and compliance requirements will require ongoing staff time and departmental infrastructure to implement.
There is no County General Fund impact associated with approval of this item.
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Recommended Action: Adopt Resolution Authorizing Standard Agreement No. 26-60035 Between the County of Lake and the California Department of Health Care Services for the Administration, Oversight, and Compliance of County Behavioral Health Programs, and Authorizing the Behavioral Health Director to Sign the Agreement and Related Administrative Documents.