Memorandum
Date: June 3, 2025
To: The Honorable Lake County Board of Supervisors
From: Elise Jones, Director of Behavioral Health Services
Subject: Approve the Memorandum of Understanding (MOU) Between the California Mental Health Services Authority (CalMHSA) and the California Department of State Hospitals for County Use of State Hospital Beds and Authorize the Behavioral Health Director to Sign the MOU.
Executive Summary:
Purpose:
The purpose of this agenda item is to seek the Board’s approval for the Memorandum of Understanding (MOU) between the California Mental Health Services Authority (CalMHSA) and the California Department of State Hospitals (DSH) for County use of state hospital beds. This MOU will outline the terms under which Lake County and other participating counties will utilize DSH facilities for patients requiring the highest level of psychiatric care, as defined by the Lanterman-Petris-Short (LPS) Act.
Background:
This MOU addresses the use of state hospital beds for patients who are under LPS conservatorship and who require acute psychiatric care that cannot be provided in less restrictive settings. CalMHSA serves as the administrative agent for participating counties, negotiating the MOU terms with DSH and ensuring compliance with the terms of use. The MOU will be effective from July 1, 2025, through June 30, 2027, with negotiated bed rates for the fiscal years 2025-2026 and 2026-2027. A new bed allocation methodology and associated rate increases have been incorporated for more equitable distribution of available beds.
Key Terms:
• Bed Types and Rates: The MOU specifies bed rates for three types of facilities-Acute Psychiatric Hospital (APH), Intermediate Care Facility (ICF), and Skilled Nursing Facility (SNF)-with a 4% increase for FY 2025-26 and 3.5% for FY 2026-27.
• Admission and Referral Process: Counties must follow the established referral process, including documentation submission and coordination with DSH staff. Counties will designate points of contact for managing referrals and patient prioritization.
• Discharge Planning: A shared goal between the County and DSH is to transition patients to the least restrictive setting as clinically appropriate, in alignment with state policies.
• Bed Allocation: The allocation of beds is based on a new, data-driven methodology that considers population size, historical bed utilization, and behavioral health needs. The County of Lake is assigned a total of 2 beds for LPS patients for FY 2025-26.
Financial Impact:
Lake County will reimburse DSH for the use of these beds, with costs based on actual bed usage. The bed rates for FY 2025-26 and 2026-27 are outlined in Exhibit 3 of the MOU, with a scheduled increase over the term of the agreement. The agreement also includes provisions for the management of bed availability and utilization, ensuring that the County only pays for the beds it uses.
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Recommended Action: Approve the Memorandum of Understanding (MOU) Between the California Mental Health Services Authority (CalMHSA) and the California Department of State Hospitals for County Use of State Hospital Beds and Authorize the Behavioral Health Director to Sign the MOU.