The Lake County Board of Supervisors on Oct. 31, 2025, approved a set of behavioral health service agreements for fiscal year 2025–26 that together commit $1,850,000 for inpatient and residential placements and voted to authorize county staff to accept a BHCIP Round 1 award and sign the State standard agreement to support a Clear Lake clinic remodel.

The actions included: approval of a up-to-$300,000 agreement with Sacramento Behavioral Healthcare Hospital LLC for acute inpatient psychiatric services; a $750,000 contract with Vista Pacifica Enterprises Inc. for adult residential support and specialty mental health services; a $300,000 agreement with Manzanita House for adult residential services; and a not‑to‑exceed $500,000 contract with Windsor Care Center of Sacramento (an MHRC) for adult residential support and specialty mental health services. The board also adopted a resolution authorizing the behavioral health director to sign the California Department of Health Care Services standard agreement (20440117) to accept BHCIP Round 1 launch‑ready funding for a South Shore clinic remodel in Clear Lake.

Why this matters: the contracts are intended to create a continuum of care that moves people from short‑term acute psychiatric placements through step‑down residential programs toward community‑based living. Staff said the county used at least one out‑of‑county acute facility last year, noting, "we served 18 unduplicated clients at this facility last year," a figure provided by presenter Christine Andress. Supervisors raised questions about per‑person costs, funding sources and the finite nature of county realignment and MHSA funds.

Details and debate

Sacramento Behavioral Healthcare Hospital LLC (agenda item 7.3): Christine Andress presented the agreement as a renewal of an acute psychiatric placement the county has previously used. She said the facility is an acute psychiatric placement; county placements there typically last "from anywhere from 3 to 14 days," after which clients step down to lower levels of care. The board approved the agreement with an authorization not to exceed $300,000.

Vista Pacifica Enterprises Inc. (agenda item 7.4): Staff described this provider as a step‑down, long‑term residential facility that serves many conserved clients and offers more specialized services. Supervisor Sabatini said he was concerned about rising costs, saying, "The cost is growing. We're looking at about a 120, $130,000 per person," based on his review of last year’s expenditures and unduplicated client counts. Staff said the facility’s goal is rehabilitation and stepping clients down to lower levels of care; for IMD‑level placements they typically aim for stays under six months, though skilled long‑term placements can be longer. The board approved the $750,000 agreement (vote recorded 4–0–0).

BHCIP grant and Clear Lake clinic remodel (agenda item 7.5): Christine described a grant award through the Behavioral Health Continuum Infrastructure Program (BHCIP) to support a capital project at the county’s South Shore clinic in Clear Lake. The item was a resolution authorizing the behavioral health director to sign the California Department of Health Care Services standard agreement number 20440117 for Round 1 launch‑ready funding. The board adopted the resolution (vote 4–0).

Manzanita House (agenda item 7.6): Staff said this local facility has long been used as the final residential step before clients move to independent housing and that it primarily serves conserved clients. Supervisor Sabatini reiterated concerns about constrained county funding sources and possible state recoupment that could pressure realignment dollars. Christine clarified a funding detail: "This particular contract is not covered by Medi Cal dollars or realignment dollars. It's actually covered by our mental health block grant" and that MHSA funds also support services for full‑service partnership clients while they are placed at the facility. The board approved the $300,000 agreement (vote recorded 4–0).

Windsor Care Center of Sacramento (agenda item 7.7): Staff presented the MHRC as a new contracted provider intended to help step clients out of state hospitals into shorter‑term rehabilitation with a stated goal of up to six months for rehabilitation and transition to a lower level of care. The board approved a not‑to‑exceed $500,000 agreement (vote recorded 4–0–0).

Votes at a glance

• Agenda item 7.3 — Agreement with Sacramento Behavioral Healthcare Hospital LLC for acute inpatient psychiatric services, not to exceed $300,000 — approved (motion carried; tally not specified).

• Agenda item 7.4 — Agreement with Vista Pacifica Enterprises Inc. for adult residential support and specialty mental health services, $750,000 — approved (vote recorded 4–0–0).

• Agenda item 7.5 — Resolution authorizing behavioral health director to sign CDHCS standard agreement 20440117 for BHCIP Round 1 launch‑ready funding (South Shore clinic remodel) — adopted (vote recorded 4–0).

• Agenda item 7.6 — Agreement with Manzanita House for adult residential facility services, $300,000 — approved (vote recorded 4–0).

• Agenda item 7.7 — Agreement with Windsor Care Center of Sacramento (MHRC) for adult residential support and specialty mental health services, not to exceed $500,000 — approved (vote recorded 4–0–0).

What to watch next

Supervisors requested additional data on treatment outcomes and a clearer accounting of county funding reserves. Supervisor Sabatini said he would like a deeper review of reimbursement exposure and remaining realignment and MHSA capacity before committing to more long‑term contracts. Staff signaled that some placements are short (3–14 days) while others can be months to long‑term depending on client needs, and that certain local contracts are funded from the mental health block grant and MHSA rather than Medi‑Cal or realignment.