Memorandum
Date: August 25, 2026
To: The Honorable Brad Rasmussen, Chair, Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: Approve Amendment No. 1 to Participation Agreement No. 5107-INT-2023-LC with the California Mental Health Services Authority for the Interoperability Solution Program, effective January 1, 2026 through December 31, 2026, increasing the agreement maximum by $22,500, from $222,948 to $245,448, and authorize the Chair to sign
Executive Summary:
Lake County Behavioral Health Services participates in the California Mental Health Services Authority’s (“CalMHSA”) Interoperability Solution Program. The program supports secure health information exchange, care coordination, referral management, and compliance with applicable state and federal interoperability requirements.
The original Participation Agreement No. 5107-INT-2023-LC is effective January 1, 2024 through December 31, 2026, with a current agreement maximum of $222,948. Amendment No. 1 adds specified services and associated fees for the period January 1, 2026 through December 31, 2026, and does not extend the overall term of the Participation Agreement.
Amendment No. 1 adds access to the CalMHSA Connex Admission, Discharge, and Transfer (“ADT”) Dashboard and implementation and subscription services for the CalMHSA Connex Closed Loop Referral and Prior Authorization (“CLR/PA”) Module. Amendment No. 1 is effective retroactively for the period January 1, 2026 through December 31, 2026. Retroactive approval is requested because the amendment was finalized in May 2026, after the January 1, 2026 effective date, and County staff subsequently completed the necessary programmatic, fiscal, technology, contracting, and legal review prior to presentation to the Board of Supervisors. The amendment itself is dated May 28, 2026 and establishes the January 1 through December 31, 2026 service period.
The ADT Dashboard will allow authorized County staff to view real-time and historical admission, discharge, and transfer information received through approved third-party health information exchange organizations. The information may be used to support care coordination and operational decision-making. CalMHSA will provide access to the dashboard, process and display available data, facilitate connectivity with approved data sources, and provide first-line technical support.
The ADT Dashboard is provided at no cost only through December 31, 2026. Continuation after that date may require additional implementation and subscription fees at CalMHSA’s then-current rates and would be subject to available appropriations and any required future approval. CalMHSA may also assess additional implementation costs if the County requests connectivity with additional ADT data sources. Such additional implementation or connectivity costs are not included in the funding increase presented for approval under this item and will not be incurred unless separately authorized in accordance with applicable County contracting and budget authority. The amendment expressly limits the no-cost ADT subscription to December 31, 2026.
ADT information displayed through the dashboard will originate from third-party Qualified Health Information Organizations and other health information exchange organizations. CalMHSA will serve as the technical intermediary and will not independently originate or validate the accuracy, completeness, timeliness, availability, or content of the information received from those organizations. The existing JPA Business Associate Agreement will remain in effect, subject to the ADT-specific provisions contained in Amendment No. 1.
The CLR/PA Module will support the electronic initiation, submission, tracking, and confirmation of referrals and prior authorization requests through the Connex platform. The project includes system design and configuration, development of referral and authorization workflows, role-based access controls, testing, training, deployment, user documentation, technical support, and post-launch stabilization. Behavioral Health Services will designate a project lead and subject matter experts, provide existing referral workflows and related documentation, participate in implementation, testing, training, and validation, coordinate engagement with local providers and managed care plans, and maintain an accurate list of authorized users.
Amendment No. 1 increases the agreement maximum by $22,500, from $222,948 to $245,448. The additional cost consists of a one-time implementation and project management fee of $12,500 and an annual subscription fee of $10,000 for the CLR/PA Module. The implementation and project management fee will be invoiced upon execution of Amendment No. 1, and the annual subscription fee will be invoiced quarterly in arrears.
The standard CLR/PA subscription includes up to 250 transactions per month. Amendment No. 1 also identifies optional additional transaction capacity in increments of 500 transactions per month at a rate of $500 per month. No optional additional transaction capacity is included in the requested $22,500 increase. Any additional capacity that would increase the agreement maximum would require separate authorization and available appropriations.
Funding for the $22,500 increase is available within Fund 145, Behavioral Health Services Budget Unit 4014, using Prop 30 Federal - Interoperability funding. County fiscal records identify the CalMHSA Participation Agreement - Interoperability within Budget Unit 4014 and classify the expenditure as Prop 30 Federal - Interoperability. The $10,000 annual subscription fee covers January 1 through December 31, 2026; therefore, $5,000 is attributable to FY 2025-26 and $5,000 is attributable to FY 2026-27. The FY 2025-26 portion will be accrued, as applicable, as part of fiscal year-end close. The $12,500 implementation and project management fee is payable upon execution of Amendment No. 1 and will be attributable to FY 2026-27. No additional impact to the County General Fund is anticipated.
Purchasing Considerations: A Section 2-38 exemption from competitive bidding is requested because Amendment No. 1 adds services provided through CalMHSA’s existing Connex interoperability platform under the County’s current Participation Agreement rather than procuring a separate technology platform from a new vendor. CalMHSA is the existing contracting entity responsible for the Interoperability Solution Program and the Connex platform through which the additional ADT Dashboard and CLR/PA Module services will be provided.
If not budgeted, fill in the blanks below only:
Estimated Cost: ________ Amount Budgeted: ________ Additional Requested: ________ Future Annual Cost: ________
Purchasing Considerations (check all that apply): ☐ Not applicable
☐ Fully Article X. <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI>- and/or Consultant Selection Policy <http://lcnet.co.lake.ca.us/Assets/Intranet/Policy/Policies+$!26+Procedures+Manual/Ch4_2021v2.pdf>-Compliant (describe process undertaken in “Executive Summary”)
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☐ 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
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Recommended Action: Approve Amendment No. 1 to Participation Agreement No. 5107-INT-2023-LC with the California Mental Health Services Authority for the Interoperability Solution Program, effective January 1, 2026 through December 31, 2026, increasing the agreement maximum by $22,500, from $222,948 to $245,448, and authorize the Chair to sign.