From: Elise Jones, Director of Behavioral Health Services
Subject: Consideration of Agreement No. 26.27.25 between the County of Lake and Windsor Care Center of Sacramento MHRC for Mental Health Rehabilitation and Residential Support Services for the period of July 1, 2026, through June 30, 2027, in an amount not to exceed $1,800,000 and authorize the Chair to sign
Executive Summary:
Lake County Behavioral Health Services (LCBHS) requests approval of an agreement with Windsor Care Center of Sacramento MHRC for specialized mental health rehabilitation and residential support services for Lake County clients. The agreement covers Fiscal Year 2026-27, effective July 1, 2026, through June 30, 2027, with maximum compensation of $1,800,000. Approval is requested retroactive to July 1, 2026, for the FY 2026-27 agreement period.
LCBHS arranges placements for clients whose mental health needs require a structured treatment setting and twenty-four-hour supervision. Windsor operates a Mental Health Rehabilitation Center (MHRC) that provides this level of care for individuals who meet medical necessity criteria for intensive psychiatric rehabilitation. Maintaining access to these services allows LCBHS to arrange clinically appropriate placements for clients who require more support and supervision than can be provided through outpatient services or a lower level of residential care.
Under the agreement, Windsor will provide psychiatric oversight, nursing support, medication education and support, crisis intervention, and rehabilitation services focused on symptom management, daily living skills, socialization, and community reintegration. Each client must have an individualized treatment plan identifying rehabilitation goals, services, measurable objectives, and discharge criteria. Windsor is required to develop the plan within fourteen days of admission and review and update it at least every thirty days.
During FY 2025-26, Windsor served four Lake County clients. LCBHS currently anticipates approximately twelve client placements during FY 2026-27. The proposed $1,800,000 maximum is intended to accommodate this anticipated increase, with actual expenditures dependent on each client’s authorized level of care, length of stay, and required supervision. The projection represents anticipated placements during the year rather than twelve continuously occupied beds.
The agreement uses a tiered daily rate structure, with rates ranging from $470 to $1,025 based on the authorized level of care. Supplemental charges are subject to additional County approval. These include an $80-per-day non-Medi-Cal placement or facility add-on, when specifically authorized for an allowable cost and funding source, and one-to-one supervision at $27 per hour. Initial authorization for one-to-one supervision may not exceed seventy-two hours; continued supervision requires County review and a new written authorization. Supplemental charges must be supported by documentation and may not duplicate amounts paid by another funding source.
LCBHS retains responsibility for determining whether placement is medically necessary and authorizing the facility, level of care, duration, and applicable rate. Windsor may not independently increase a client’s rate tier or add supplemental services without County approval. The agreement requires monthly utilization review and discharge planning with LCBHS to assess continued placement needs and identify opportunities for transition to a lower level of care. Continued placement beyond an approved authorization period requires further County review and written authorization.
Windsor must maintain the licensure, staffing, clinical documentation, and reporting necessary to provide MHRC services. The agreement also requires timely notification of admissions and discharges, participation in care coordination, and submission of information needed for County utilization review and payment verification. These requirements support ongoing oversight of client care and placement costs.
The agreement will be funded through patient revenue and realignment dollars. No County General Fund contribution is requested. The $1,800,000 maximum establishes the County’s spending limit for the agreement term; actual payments will be based on authorized placement days, services provided, and applicable contract rates. LCBHS will monitor expenditure and utilization throughout the year.
Windsor must submit itemized monthly invoices with documentation identifying the client, service dates, placement days, authorized level of care, and applicable rates. Payment is subject to County review, acceptance of allowable charges, and the availability and receipt of applicable funding. The agreement permits delayed payment when State or federal reimbursement is delayed and provides for recovery of overpayments, duplicate payments, and disallowed costs.
The agreement identifies Section 2-38.2(2) of the County’s Purchasing Policy/Code as the basis for exemption from competitive solicitation due to the specialized professional services being provided. Windsor’s services require an appropriately licensed treatment facility, qualified psychiatric and rehabilitation staff, and the ability to meet clients’ individual clinical and supervision needs.
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Recommended Action: Approve Agreement No. 26.27.25 between the County of Lake and
Windsor Care Center of Sacramento MHRC for Mental Health Rehabilitation and
Residential Support Services for the period of July 1, 2026, through June 30, 2027, in an
amount not to exceed $1,800,000 and authorize the Chair to sign.