Memorandum
Date: March 4, 2025
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Behavioral Health Director
Subject: Consideration of A. Presentation of Fiscal Data and Loan Repayment Status and B. Resolution Authorizing Extension of Loan Term for Lake County Behavioral Health Services.
Executive Summary:
This presentation provides the Board with a financial update on Intergovernmental Transfer (IGT) funding and Medi-Cal reimbursements for Specialty Mental Health Services (SMHS). Additionally, we are requesting the Board’s approval to extend the repayment term for the Lake County Behavioral Health Services (LCBHS) loan to June 30, 2025, to ensure fiscal stability.
Financial Overview of IGT Funding & Reimbursements (July - February):
• Funds sent to the state: $5,887,428
• Payments received: $4,909,069
• Ongoing gap between funds sent and reimbursements received:
Medi-Cal Funding Update:
• Receivable funding (from EHR): $14,708,022
• Funds received as of December: $11,307,825
• Outstanding Medi-Cal balance: $3,400,197 (previously over $7 million).
Revenue & Expenditures Analysis:
• Significant fluctuations in monthly Medi-Cal revenue due to ongoing delays in claims processing.
• Gaps in Medi-Cal revenue have been supplemented with grant funding and other revenue sources.
• Cumulative revenue trends highlight increasing receipts, though timing of payments remains unpredictable.
Loan Repayment Extension Request
In March 2023, LCBHS transitioned to the California Mental Health Services Authority's Semi-Statewide Enterprise Health Record system. Due to technical delays in claims submission, Medi-Cal reimbursements were significantly impacted, delaying revenue flow. Despite these challenges, LCBHS was able to maintain services while facing extreme payment delays. As a result, we requested the loan in 2024 after dealing with system issues and other problems from the EHR.
To date, LCBHS has repaid $2,000,000 of the original $4,000,000 loan, including:
• $1,000,000 repaid to the Department of Social Services.
• $1,000,000 repaid to the County General Fund.
However, given continued claims processing delays and fiscal uncertainties, we are requesting the Board approve a resolution to extend the loan repayment term to June 30, 2025. This extension will:
✔ Ensure fiscal stability for Behavioral Health operations.
✔ Avoid disruptions to essential mental health services.
✔ Maintain the County’s overall financial health, as the extension does not impact the general reserve.
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Recommended Action: Adopt Resolution Authorizing Extension of Loan Term for Lake County Behavioral Health Services.