DATE: June 30, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Intergovernmental Transfer Agreements for Behavioral
Health Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and Authorize the Chairman to execute a retroactive Intergovernmental Transfer (IGT) Agreement with the California Department of Health Care Services (DHCS) to manually transfer the county share in an amount necessary to fund the Specialty Mental Health Services (SMHS) County Fund Account (CFA) effective May 1, 2026, through December 31, 2026; and
2. Approve and Authorize the Chairman to execute a retroactive IGT Agreement with the California DHCS to manually transfer the county share in an amount necessary to fund the Drug Medi-Cal-Organized Delivery System (DMC-ODS) CFA effective May 1, 2026, through December 31, 2026.
REPORT
There is no Net County Cost associated with the recommended actions, which will retroactively authorize the County to fund the county share of Medi-Cal payments costs associated with the provision of Specialty Mental Health Services (SMHS) and Substance Use Disorder (SUD) Treatment Services. The County's share, together with the applicable Federal Financial Participation (FFP) and State funds, will be paid by DHCS to the Department based on approved claims. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the Department would not be eligible to continue to draw down FFP for services provided. There are no viable alternative actions. Effective May 30, 2026, the DHCS discontinued the withhold option applied to the Mental Health Services Fund, Local Revenue Fund, and Local Revenue Fund 2011. Counties are required to establish new IGT Agreements to implement a manual transfer process for SMHS and DMC-ODS programs.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to May 1, 2026. The Notice of Discontinuation of IGT Withhold ...
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