Memorandum
Date: February 3, 2026
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: Approve Amendment No.1 to the Agreement Between County of Lake and Windsor Care Center of Sacramento MHRC for Adult Residential Support Services and Specialty Mental Health Services with No Change to Compensation for Fiscal Year 2025-2026 and Authorize the Board Chair to Sign.
Executive Summary: On July 1, 2025, the County of Lake entered into an agreement with Windsor Care Center of Sacramento MHRC for the provision of Adult Residential Support Services and Medi-Cal Specialty Mental Health Services (SMHS) at a licensed Mental Health Rehabilitation Center (MHRC). Subsequent review determined that additional MHRC-specific regulatory, clinical, and operational requirements must be explicitly incorporated into the agreement to ensure full compliance with California Department of Health Care Services (DHCS) licensing standards, Title 9 California Code of Regulations, Medi-Cal SMHS requirements, and federal oversight obligations.
This amendment revises and expands Exhibit A - Scope of Services to incorporate all required MHRC provisions, including but not limited to: DHCS licensing and certification requirements; staffing standards; admission and exclusion criteria; locked/semi-secure facility requirements; psychiatric rehabilitation program standards; documentation and Individual Program Plan (IPP) requirements; prohibitions on non-reimbursable services, bed holds, and duplicate billing; and enhanced reporting, audit, and federal oversight provisions. The amendment also clarifies billing limitations to ensure only medically necessary, allowable SMHS services are reimbursed and that services reimbursed under this agreement do not duplicate services covered by other payers or programs.
This amendment does not change the term of the agreement or increase the maximum contract amount. Rather, it strengthens contractual compliance, mitigates audit and recoupment risk, and aligns the agreement with current DHCS regulatory expectations for MHRC providers. Approval of this amendment is necessary to ensure continued regulatory compliance and to support the ongoing provision of MHRC services to Lake County beneficiaries.
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Recommended Action: Approve Amendment No.1 to the Agreement Between County of Lake and Windsor Care Center of Sacramento MHRC for Adult Residential Support Services and Specialty Mental Health Services with No Change to Compensation for Fiscal Year 2025-2026 and Authorize the Board Chair to Sign.