Memorandum
Date: September 15, 2026
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: a) Consideration of a Resolution amending Resolution No. 2025-118, as previously amended, to amend the FY 2025-26 Adopted Budget for Fund 145 (Mental Health), Budget Unit 4014, by increasing revenues and appropriations by $4,861,792; and b) Consideration of a Resolution amending Resolution No. 2025-118, as previously amended, to amend the FY 2025-26 Adopted Budget for Fund 141 (Substance Use Disorder Services), Budget Unit 4015, by increasing Medi-Cal/DMC-ODS revenue and appropriations by $9,975,000
Executive Summary:
This item requests approval of year-end budget amendments for Fund 145, Budget Unit 4014 (Mental Health), and Fund 141, Budget Unit 4015 (Substance Use Disorder Services). The amendments are necessary to provide sufficient revenue and appropriation authority to recognize and process Fiscal Year 2025-26 revenues, expenditures, and outstanding obligations identified through the year-end closing process.
Fund 145 - Mental Health
For Fund 145, Budget Unit 4014, the proposed amendment increases revenues and appropriations by $4,861,792. The adjustment is based on updated Specialty Mental Health Services (SMHS) Medi-Cal revenue projections and outstanding year-end service obligations.
The additional Fund 145 revenue consists of $4,032,512 in projected SMHS Medi-Cal revenue associated with approximately $4,157,229.12 in billed but not yet paid claims, reduced by the Department’s 3 percent average denial rate, and $829,280 in SMHS administrative claims submitted to the California Department of Health Care Services for reimbursement. Total additional anticipated revenue is therefore $4,861,792.
Corresponding Fund 145 appropriation increases include $2,311,792 for contracted SMHS billable provider services, $850,000 for supplies and services, and $1,700,000 for client placements. These adjustments reflect actual service delivery and placement costs identified during the Fiscal Year 2025-26 closing process and provide the budget authority necessary to recognize those obligations in the appropriate fiscal year.
Fund 141 - Substance Use Disorder Services
For Fund 141, Budget Unit 4015, the proposed amendment increases Medi-Cal/DMC-ODS revenue and appropriations by $9,975,000. A significant portion of this activity relates to New Life Health Authority dba New Life, LLC, which provides Narcotic Treatment Program services under the County’s Drug Medi-Cal Organized Delivery System.
For New Life activity, the County serves as a fiscal pass-through for the applicable intergovernmental transfer or other non-federal share and the corresponding Medi-Cal/DMC-ODS reimbursement. The County does not retain the associated New Life revenue.
As part of the year-end review, Behavioral Health identified approximately $9,033,633.33 in New Life pass-through obligations and approximately $890,000 in other Fund 141 obligations charged to Professional and Specialized Services account 740.23-80. Approximately $49,000 in existing appropriation authority remains available in that account. The requested $9,975,000 increase will provide sufficient authority for the identified obligations and a limited year-end contingency of approximately $100,366.67.
The Fund 141 amendment increases Medi-Cal/DMC-ODS revenue account 452.53-62 by $9,975,000 for New Life NTP pass-through and other DMC-ODS billable services and increases contracted services account 740.23-80 by $9,975,000 for New Life NTP pass-through and other Fund 141 contracted obligations.
Combined Fiscal Impact
Combined, the two resolutions increase Fiscal Year 2025-26 Behavioral Health revenues and appropriations by $14,836,792. The requested appropriation increases are fully supported by anticipated revenues within each respective fund.
These amendments are being brought forward as part of the Fiscal Year 2025-26 year-end closing process. Updated Medi-Cal claiming information, contracted provider expenditures, client placement costs, and other outstanding obligations identified the need for additional budget authority so that activity attributable to Fiscal Year 2025-26 can be properly recognized and processed.
The requested amendments do not represent an immediate cash need. Related receipts and payments will occur through the normal Medi-Cal claiming, reimbursement, County payment, and year-end accrual processes.
The adjustments are supported by anticipated Medi-Cal/DMC-ODS and Specialty Mental Health Services revenues and do not require an additional County General Fund contribution. The requested adjustments provide budget authority only for existing Fiscal Year 2025-26 obligations and do not authorize new contracts or services.
Pursuant to Government Code section 29130, adoption of each resolution requires a four-fifths vote of the Board.
If not budgeted, fill in the blanks below only:
Estimated Cost: $14,836.792 Amount Budgeted: $0 Additional Requested: $14,836.792 Future Annual Cost: $0
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Recommended Action:
a) Adopt a Resolution amending Resolution No. 2025-118, as previously amended, to amend the FY 2025-26 Adopted Budget for Fund 145 (Mental Health), Budget Unit 4014, by increasing revenues and appropriations by $4,861,792; and
b) Adopt a Resolution amending Resolution No. 2025-118, as previously amended, to amend the FY 2025-26 Adopted Budget for Fund 141 (Substance Use Disorder Services), Budget Unit 4015, by increasing Medi-Cal/DMC-ODS revenue and appropriations by $9,975,000.