Memorandum
Date: August 5, 2025
To: The Honorable Lake County Board of Supervisors
From: Rachael Dillman Parsons, Social Services Director
Subject: Consideration of Update Regarding Public Guardian Conservatee “BB”
Executive Summary:
On October 17, 2024, your board approved a patch payment for Public Guardian conservatee, “BB”, from general funds in the amount of $30,000 to cover six (6) months of placement. Public Guardian receives no State or Federal funding to operate. Although BB had Medi-Cal coverage, the only facility that would accept BB did not accept Medi-Cal. Placement fees were $5,000 per month. On November 1, 2024, BB was placed in care while Public Guardian continued to seek a Medi-Cal covered placement for BB. On April 15, 2025, your board approved an additional $15,000 to cover three (3) additional months of placement, while Public Guardian continued to seek a Medi-Cal covered placement. To date, BB remains in a private-pay facility.
On May 21, 2025, Public Guardian was able to relocate BB to a less expensive private pay facility, with a base rate of $3,600 per month. Once approved, BB’s Veteran’s and Social Security benefits will be approximately $3,600 per month. On Jun 15, 2025, BB began receiving his $1,784 per month Social Security payments. Most of his back-pay was withheld by Social Security to repay previous Social Security benefit overpayment. The remaining balance of $2,172 was placed in his Public Guardian account to cover his placement. BB’s Veteran’s benefits are anticipated to start soon.
Public Guardian is not asking your board for additional General Fund to support BB’s placement. It is anticipated that BB’s remaining account balance will be sufficient to cover his placement until his Veteran’s benefits begin.
Public Guardian continues to diligently and repeatedly contact all suitable facilities in the State of California that accept Medi-Cal to secure placement for BB. As previously reported, facilities are reluctant to accept BB’s placement. Facilities can decline to accept our request to place him. Nearly all facilities do not have waiting lists and will not notify Public Guardian when a bed becomes available. The one facility which had placed BB on their waiting list removed him from the waiting list upon reviewing his application more closely. Public Guardian must continuously contact facilities to check on bed availability, and beds fill fast. Public Guardian contacts the list of facilities at least weekly.
BB’s income will be used to pay for his private-pay placement until a Medi-Cal facility is found. Once Public Guardian secures a placement for BB that accepts Medi-Cal, we will work with County Administration and the Auditor to repay the $45,000 received from General Fund out of BB’s future Social Security and Veteran’s benefits. BB’s income should be used to pay for his own care retroactively.
We thank your board for providing the funding necessary to meet the County’s Public Guardian mandates to place BB in adequate care, ensuring he was not on the street posing a risk to himself or the public.
If not budgeted, fill in the blanks below only:
Estimated Cost: _$45,000_ Amount Budgeted: _$45,000_ Additional Requested: _$0_ Future Annual Cost: _$0_
Purchasing Considerations (check all that apply): ☒ Not applicable
☐ Fully Article X. <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI>- and/or Consultant Selection Policy <http://lcnet.co.lake.ca.us/Assets/Intranet/Policy/Policies+$!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
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☐ Economic Development ☐ Infrastructure ☐ County Workforce
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Recommended Action: Consideration of Update Regarding Public Guardian Conservatee “BB”