Memorandum
Date: February 10, 2026
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: Consideration of Amendment No.5 to the Agreement Between the County of Lake and Community Behavioral Health for Specialty Mental Health Services for Fiscal Years 2023-24, 2024-25 and 2025-26.
Executive Summary:
The Board of Supervisors is asked to consider approval of Amendment No. 5 to the Agreement between the County of Lake and Community Behavioral Health (CBH) for the provision of Specialty Mental Health Services for fiscal years 2023-24 through 2025-26. This amendment transitions the contract from a flat-rate compensation structure to a fee-for-service (FFS) reimbursement model tied to Medi-Cal Specialty Mental Health rates published by the Department of Health Care Services (DHCS), effective September 1, 2025. Under the new methodology, CBH will be reimbursed at fifty-nine percent (59%) of the applicable DHCS rate for all Medi-Cal eligible services.
The amendment also increases the total contract maximum by $9,000,000, for a new total not-to-exceed amount of $24,600,000, to align available funding with current utilization trends and projected service demand. Additional changes include establishment of a provisional monthly service ceiling to manage cash flow and prevent unplanned volume spikes, clarification of reimbursement and recoupment procedures, streamlining of training requirements to those mandated by law or County policy, authorization of reimbursement for defined administrative services, and clarification of CBH’s status as the only embedded contracted provider currently occupying County space with the potential for future standardized space and license cost allocation.
Approval of this amendment supports continued access to critical specialty mental health services for Lake County residents, improves fiscal oversight and alignment with State payment reform, and ensures the County can responsibly manage service utilization and reimbursement risk while maintaining continuity of care. All other terms and conditions of the original agreement remain in full force and effect.
If not budgeted, fill in the blanks below only:
Estimated Cost: ________ Amount Budgeted: ________ Additional Requested: ________ Future Annual Cost: ________
Purchasing Considerations (check all that apply): ☐ Not applicable
☒ Fully Article X. <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI>- and/or Consultant Selection Policy <http://lcnet.co.lake.ca.us/Assets/Intranet/Policy/Policies+$!26+Procedures+Manual/Ch4_2021v2.pdf>-Compliant (describe process undertaken in “Executive Summary”)
☐ Section 2-38 <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI> Exemption from Competitive Bidding (rationale in “Executive Summary,” attach documentation, as needed)
☐ For Technology Purchases: Vetted and Supported by the Technology Governance Committee <http://lcnet.co.lake.ca.us/Assets/Intranet/Intranet+Forms/Information+Technology/AdvPlan.pdf> (“Yes,” if checked)
☐ Other (Please describe in Executive Summary)
Consistency with Vision 2028 <http://www.lakecountyca.gov/Government/Directory/Administration/Visioning/Vision2028.htm> (check all that apply): ☒ Not applicable
☐ Well-being of Residents ☐ Public Safety ☐ Disaster Prevention, Preparedness, Recovery
☐ Economic Development ☐ Infrastructure ☐ County Workforce
☐ Community Collaboration ☐ Business Process Efficiency ☐ Clear Lake
Recommended Action: Approve Amendment No. 5 to the Agreement between the County of Lake and Community Behavioral Health for the provision of Specialty Mental Health Services for Fiscal Years 2023-24 through 2025-26, which transitions the compensation methodology to a fee-for-service reimbursement model at fifty-nine percent (59%) of Department of Health Care Services published Medi-Cal rates effective September 1, 2025, increases the contract maximum by $9,000,000 for a new total not-to-exceed amount of $24,600,000, and authorize the Board Chair to sign.