Memorandum
Date: October 21, 2025
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: Consideration of Agreement Between County of Lake and Sacramento Behavioral Healthcare Hospital, LLC for Acute Inpatient Psychiatric Hospital Services and Professional Services Associated with Acute Inpatient Psychiatric Hospitalizations for Fiscal year 2025-2026.
Executive Summary:
Approval is requested for an agreement between the County of Lake and Sacramento Behavioral Healthcare Hospital, LLC (SBHH) for the provision of acute inpatient psychiatric hospital services and associated professional services from July 1, 2025, through June 30, 2026, in an amount not to exceed $300,000.
This agreement ensures the continued availability of 24-hour, licensed inpatient psychiatric care for Lake County residents requiring involuntary or voluntary psychiatric hospitalization under Welfare and Institutions Code (W&I) §§ 5150-5152 and related provisions governing acute psychiatric treatment and stabilization.
SBHH operates a licensed, Joint Commission-accredited facility in Sacramento County and provides a secure, clinically appropriate environment for individuals meeting criteria for acute inpatient care. The agreement enables Lake County Behavioral Health Services (LCBHS) to access these critical services when local or regional bed capacity is insufficient.
Background and Justification
Counties are responsible under California Welfare and Institutions Code §§ 5600 et seq. and Title 9, California Code of Regulations (CCR), § 1810.345 for ensuring the provision of medically necessary specialty mental health services, including inpatient psychiatric hospitalization for Medi-Cal beneficiaries and uninsured residents.
Acute inpatient psychiatric services are required for individuals who present an imminent danger to themselves or others, or who are gravely disabled due to a mental disorder. As a Small County Mental Health Plan, Lake County does not operate its own inpatient psychiatric facility and must therefore maintain contracts with regional hospitals to fulfill these obligations.
SBHH is a DHCS-certified and Medi-Cal-approved acute psychiatric hospital that provides:
• 24/7 inpatient psychiatric treatment and professional services (psychiatric, nursing, and clinical support);
• Compliance with CCR, Title 22, Division 5 (licensure of health facilities) and Title 9, § 1810.435 (provider selection and compliance);
• Compliance with HIPAA and 42 CFR Part 2 confidentiality requirements;
• Maintenance of patient rights under W&I § 5325 and 42 CFR § 438.100.
The agreement further requires adherence to federal and state audit provisions under 42 CFR § 438.230, DHCS Information Notices, and the County’s own compliance and cultural competency policies.
Fiscal Impact
• Funding Source: Realignment and Medi-Cal Federal Financial Participation (FFP)
• Budgeted: Yes - FY 2025-26 Mental Health Services Budget
Reimbursement is based on a per diem rate for eligible services rendered, in accordance with Exhibit B (Fiscal Provisions) of the contract. Payments are made for verified claims submitted through the County’s contractor portal following concurrent utilization review and authorization.
Regulatory and Compliance Context
This agreement supports the County’s statutory responsibilities under the Short-Doyle Medi-Cal system and 1915(b) Medicaid Waiver, which govern the delivery and reimbursement of specialty mental health services.
SBHH must maintain:
• All required licensure and certifications (DHCS, CMS, and The Joint Commission);
• Compliance with the Deficit Reduction Act of 2005, the False Claims Act, and HIPAA/HITECH;
• Policies for client rights, grievances, and cultural competence consistent with the National CLAS Standards; and
• Annual program and fiscal reporting, audit compliance, and data retention for at least ten years.
County oversight and monitoring are authorized under W&I § 14712(c)(3) and CCR, Title 9, §§ 1810.380-1810.385, which empower the County to audit, evaluate, and impose sanctions for noncompliance.
Service Continuity and Public Impact
Approval of this contract is essential to maintain uninterrupted access to inpatient psychiatric care for Lake County residents. Without such agreements, individuals in psychiatric crisis may experience extended emergency department boarding or transport delays, compromising clinical outcomes and increasing costs to the County.
SBHH remains one of the few regional providers consistently accepting Lake County placements, particularly for clients with high acuity, Medi-Cal eligibility, or limited local stabilization options.
If not budgeted, fill in the blanks below only:
Estimated Cost: ________ Amount Budgeted: ________ Additional Requested: ________ Future Annual Cost: ________
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Recommended Action: Approve the agreement between the County of Lake and Sacramento Behavioral Healthcare Hospital, LLC for acute inpatient psychiatric hospital and professional services for FY 2025-26, in the amount not to exceed $300,000, and authorize the Chair of the Board to sign.